CHAPTER 13 SAFETY
What should you do if there is a fire in a persons room?
R.A.C.E
Unconscious person can choke what are the common causes?
aspiration of vomitus, and the tongue falling back into the airway
For a safe setting the person must receive?
the right care and treatment. Follow the person's care plan. Also practiced the safety measures in this chapter
What does the abdominal thrust do?
the thrust force air out of the lungs and create an artificial cough to expel the foreign body( food or object) from teh airway
What are the common causes of OLder persons being at risk of choking?
weakness, dentures that fit poorly, dysphagia (difficulty swallowing), and chronic illness
A surveyor may ask you About fire safety this includes?
what to do if a fire alarm goes off what to do if you find a fire in a person room where to find fire alarms and fire extinguishers how to use a fire extinguisher
How do you prevent burns for eating and drinking?
-assist with eating and drinking as needed spilled hot food or liquids can cause burns -Be careful when carrying hot foods and liquids -Use center of the counter or table not the edges those can cause spill and that is a burn -Do not pour hot liquids near a person
How do you prevent burns for Appliances and other electrical equipment?
-do not allow the use of space heaters, If used, be at least 3 feet away from items tat can burn. Turn off heaters before leaving room -Do not let person sleep with a heating pad or an electric blanket -turn off unplug irons,curling irons etc
How do you prevent burns for smoking?
- be sure patients and residents smoke in smoke areas only -dont leave smoking materials at the bedside -Supervise the smoking of person who cannot protect themselves -dont allow smoking in bed -dont allow smoking where oxygen is used or stored -Be alert to ashes that may fall onto a person
Health hazards can?
- cause cancer -affected blood cell formation and function -damage the kidney,nervous system,lungs,skin, eyes, mucous membranes -Cause birth defects, miscarriages, and fertility problems
PROMOTING SAFETY AND COMFORT identifying the person COMFORT. ID bracelets must not be too loose or too tight. You be able to slide how much fingers?
1 or 2 if too loose or too tight tell the nurse
Other identifying information and numbers are included example is ?
A medical record number MRN used to identify the persons medical record
three things are needed for a fire?
A spark or flame A material that will burn Oxygen
Coma
A state of being unaware of one's setting and being unable to react or respond
If the persons is clutching his throat what do you do
abdominal thrust
For an equipment related accident you should complete?
an incident report. The Safe Medical Devices Act requires that agencies report equipment related illnesses,injuries,and deaths
incident
any event that has harmed or could harm a patient, resident, visitor, or staff member
What is poison?
any substance harmful to the body when ingested,inhaled,injected, or absorbed through skin
What are common causes of suffocation?
choking,drowning,inhaling gas or smoke, strangulation, electrical shock
When choking the conscious person usually?
clutches at the throat aka universal sign of choking if obstruction not removed the person will die
What are some of the causes for a person could be poisoned?
confuse, poor vision
PREVENTING EQUIPMENT ACCIDENTS All equipment is unsafe if broken, not used correctly, not working properly, or in need of repair. This includes hospital beds. Inspect all equipment before use. What should you check for?
cracks, chips, and sharp or rough edges. They can cause cuts, stabs or scratches. Follow the bloodborne pathogen standard
What could happen if someone is choking and is obstruction is not removed?
die
FIRE SAFETY what are major causes of fire?
faulty electrical equipment and wiring, over-loaded electrical circuits, and smoking. health team must prevent fires and act quickly during a fire
Physical hazards can cause?
fires or explosives
Frayed cords and overloaded electrical outlets can cause?
fires, burns and electrical shocks
Foreign bodies (food or object) can cause mild or severe airway obstruction. With mild airway obstruction, some air moves in and out of lungs. The person is conscious and usually can speak. What can help remove the object?
forceful coughing. breathing may sound like wheezing between coughs
Exposure to hazardous chemicals can occur?
from equipment failures, container ruptures, or a release of a hazard into the workplace
FOCUS ON LONGTERM AND HOMECARE you should Provide ?
good lighting when patients take their drugs. Make sure they read prescription labels correctly and are taking the correct drugs and dosage
Heath hazard can cause?
health problems
When IDENTIFYING THE PERSON Each person has different treatments,therapies, and activity limits.The wrong care can?
threaten life and health
Abdominal thrusts are used?
to relieve severe airway obstruction
How is a stretcher used
to transport patients
Wheelchairs are useful for people who cannot walk or who have been severe problems walking. Stretchers are used ?
to transport persons who cannot sit up or must lie down. they are used in hospitals and by emergency medical personnel
What are types of natural disasters
tornadoes,hurricanes,blizzards,earthquakes,volcano,eruption, flood, and some fires
Hazardous chemical safety measures?
•Read and follow the safety measures on the warning label and SDS. • Make sure each container has an undamaged warning label. • Use a leak-proof container to carry or transport a hazardous chemical. • Wear personal protective equipment (PPE) to clean up spills and leaks. Follow the warning label or SDS for what to wear (mask, gown, gloves, eye protection, safety boots). • Clean up spills at once. Work from clean areas to dirty areas with circular motions. • Dispose of hazardous chemicals in sealed bags or containers. • Stand behind a lead shield during x-ray or radiation therapy procedures. Follow agency procedures to prevent radiation exposure. Do not enter a room while a person is having x-rays or radiation therapy. • Wash your hands after handling hazardous chemicals. Work in well-ventilated areas to avoid inhaling gases. • Use cleaning products safely. • Read and follow warnings and label directions. • Keep products in their original containers. • Make sure the area is well-ventilated. • Do not mix products. Mixing products can cause dangerous gases. For example, do not mix ammonia and bleach. Close containers properly. • Put cleaning products away after use. • Do not store cleaning products near food. • Empty buckets, pails, basins, and other containers with cleaning solutions. • Do not use an empty container for other purposes or things. • Dispose of or store a hazardous chemical according to the SDS.
For mild airway obstruction you should?
-stay with the person -Encourage person to keep coughing to expel object -do not interrupt the person efforts to clear the airway. If the person breathing and coughing abdominal thrusts are not needed - if obstruction persists call for help
How do you prevent poisioning?
- keep drugs and harmful products in high, locked areas where persons cannot reach them -Use prescription drugs correctly use at right time prescribed do over use especially for pain relief drugs - Only take licensed health care professional that prescribed the drugs -Do not share or sell drugs -Read and follow all directions and warning labels. Have good lighting -keep drugs in their original bottles or containers - read all labels carefully before using the product -do leave harmful products or drugs unattended when in use -Point spray nozzles away from your face and other people -do not store harmful products near food -dispose outdated, unwanted, and un used drugs and products
For safety a surveyor may ask you?
-About measures in the persons care plan to reduce the risk for an accident -When and how you report risks and hazards -When and how you correct an immediate hazard.A spill is an example -agency procedures for removing or reducing a hazard remember give surveyors complete and honest answers
You use the ID bracelet to identify the person before giving care. You assignment sheet states what care to give. Now to identify the person you must?
-Compare identifying information on the assignment sheet with that on the ID bracelet ( the ID bracelet is checked against the assignment sheet to accurately identify the person) carefully check the information some people have the same names -Use at least 2 identifiers. Some agencies require the person to state and spell his or her name and give his or her birth date. --Others require using the person ID number. YOU CANNOT USE PERSON ROOM OR BED NUMBER always follow agency policy
Communities, fire and police departments, and health care agencies have disaster plans (emergency preparedness plans). They include caring for people needing treatment. The plan generally provides for?
-Discharging persons who can go home Assigning staff and equipment to an emergency area -Assigning staff to transport persons from treatment areas -Calling off-duty staff to work - Evacuation procedures if the agency is damaged
How do you prevent burns for Smoke Alarms?
-Have working smoke alarms on every level of home -Test alarms every month -Replace batteries when daylight savings time changes. use long-life batteries when possible. Replace batteries even if alarms are hard wired Use alarms with flashing strobe lights for hard of hearing persons
If you receive a shock , report it at once. Do not use item. Warning signs of a faulty electrical item include?
-Shocks -loss of power or a power surge -Dimming or flickering lights -Sparks -Sizzling or buzzing sounds -burning odor -Loose plugs
A severe storm may occur when you are in a patient's home. For safety
-Stay informed through local TV and radio stations. Satellite services may not have a signal with heavy storm clouds. -Keep a flashlight with you for power outages. -Move the patient, family, and yourself to a "safe room." -Basement -Room on the ground floor -interior room away from outside walls, windows, and doors -Center hallway -Bathroom -Closet
what are ways to prevent suffocation? in all age groups
-cut foods into small bite sized pieces, -make sure dentures fit properly & are in place, -make sure person can chew and swallow -report loose teeth or dentures -check the care plan for swallowing problems before serving food even snacks or fluids b/c the person may ask for something they cannot swallow -tell nurse at once if the person has swallowing problems -do not give oral foods or fluids to person with feeding tubes -Follow aspiration precautions -Do not leave a person unattended in a bathtub or shower -Remove the key from a gas fireplace. Short it out reach -Move all person from the area you smell smoke -Position the person in bed properly -use bed rails correctly -use restraints correctly -prevent entrapment in bed systems -preventing equipment accidents
What are common poisons?
-drugs (legal or illegal) and vitamins -Household products- detergents, soaps, sprays, paint,bleach, window cleaners, gasoline, glue etc - Personal care products- shampoo, conditioner, hair oils, nail polish ,lotion etc -Fertilizers, insecticides, bug sprays -Lead -House plants -Wild mushrooms -Alcohol -Carbon monoxide
FOCUS ON LONGTERM AND HOMECARE steps for drug disposal in the household trash?
-mix drugs with cat liter or used coffee grounds do not crush tablets or capsules -place the mixture in a container in your household trash -scratch out all personal information on the prescription label then dispose of the container
How do you prevent burns for water?
-set the water heater no higher than 120 degrees Fahrenheit -Have anti-scald devices on faucets and shower heads - turn ON cold water first, then hot water, turn off hot water first then cold water -Measure water temperature before person gets into bath -check for hot spots in bath water. Move your hands back and forth in the water
You may observe a person choking. And you may perform emergency measures to relieve choking. When does relief of choking occur?
-when the foreign body( food or object) is removed -when you feel air move and see the chest rise and fall when giving rescue breaths
in TEAMWORK AND TIME MANAGEMENT A SAFE SETTING you can correct some safety hazards. Do so as soon as possible. Give examples?
-wipe up spills right away. Do so even if you did not cause spill -A person is sliding out of a wheelchair. Position the person correctly. Do so even if a co-worker is responsible for persons care -A person has problems holding a coffee cup. Offer to help the person -Food is unattended in an oven. Turn off oven. Then tell your co-worker the reason for your action
FOCUS ON COMMUNICATION to identify the person you ask for?
2 identifiers you can say "Please tell me your full name and birthdate" Compare to identifiers with the information on the ID bracelet and your assignment sheet
What may a surveyor ask you about fire safety?
Do you know where exit is? where is fire alarm?
If the person doesnt have ID bracelet how do you identify person?
Follow agency policy
FOCUS ON LONGTERM CARE AND HOMECARE identifying the person long- term care Alert and oriented residents may not wear ID bracelets this is noted on the persons care plan. What should you do to identify the person?
Follow center policy and the care plan
Can you identify an unsafe electric plug
Frayed cords, overloaded plugs
Who must help provide safety?
Health Team
Abdominal thrust are quick upward thrusts to the abdomen they are also known as?
Heimlich maneuver
FOCUS ON COMMUNICATION to identify the person, call the person by name and ask to see the ID bracelet. For example?
Hello, Mr Hall May I see your ID bracelet
How do you make sure you are giving the right care to the right person
Id them 2 ways. Compare assignment sheet chart & ID bracelet & follow the agency policy
What to do during a fire?
Know your agency fire emergency and evacuation procedures. Know where to find fire alarms,fire extinguishers, and emergency exits
Where would you find safety measures for a resident?
Nurse Care Plan
WHAT IS RACE
Rescue- rescue persons in immediate danger move them to a safe place Alarm- Sound the nearest fire alarm. Call 911 or the operator Confine- close doors and windows to confine the fire turn off oxygen or electrical items used in the general area of the fire Extinguish- use a fire extinguisher on a small fire that has not spread to a larger area clear equipment from all normal and emergency exits do not use elevators if there is a fire
What should you check before using a hazardous chemical?
SDS material safety data sheet
Electrical shock can affect?
burn in the skin,muscle nerves,and other tissues and affect the heart and cause death
When a hazardous chemical is spill or leaked what should you do?
call for the nurse about a leak or spill right away, do not leave a leak or spill unattended
Ground
carries leaking electricity to the earth and away from an electrical item
A foreign body (food or object) can obstruct (block) the airway. This is called choking or foreign body airway obstruction. Air cannot pass through the airways into the lungs. The body does not get enough oxygen. What can result?
death
PREVENTING BURNS older persons. OLder persons are at risk for burns. What are the risk factors (what are the ways of them being risk to burn)?
decreased skin thickness, decreased sensitivity to heat, reduced reaction time decreased mobility, communication problems, confusion and dementia
How do you prevent burns?
do not allow smoke when oxygen use, check temperature,
Hazardous chemicals containers have warning labels. The warning labels contain pictograms (symbols to communicate specific information about a chemical hazard) If a warning label is removed or damage what should you do?
do not use chemical, show the container to the nurse and explain the problem, Do not leave container unattended
What do you do if a warning label is damaged
do not use it, report to nurse
When does choking often occur?If
during eating a large poorly chewed piece of meat is a common cause, Laughing and talking while eating, excessive alcohol intake
Without a ground (in three prolonged plugs) leaking electricity can be conducted to the person It can cause?
electrical shocks and possible death
What can poisoning cause?
illness, brain damage, coma, and death
Disaster
injured people or property
Disaster?
is a sudden, catastrophic event, People are injured and killed.
Hazardous chemical?
is any chemical that is a physical hazard or a health hazard
What is a hazard?
is any thing in the person's setting that could cause injury or illness
What is suffocation?
is when breathing stops from lack of oxygen
Electrical shock
is when electrical current passes through body
Abdominal thrust are not used for what type of persons?
obese and pregnant
Chest thrust are used for?
obese or pregnant persons
A person with severe airway obstruction has difficulty breathing. Air does not move in and out of lungs. The person may not be able to breathe,speak or cough. If able to cough, the cough is of poor quality. When the person tries to inhale there is no noise are a high pitched noise. What does the person may appear?
pale and antibiotic (bluish color) severe airway obstruction is an emergency
Common sense and safety measures can prevent most accidents. You must protect who?
patients,residents,visitors, co-workers and yourself
what should you If you assist a choking person?
report and record what happened, include what you did and the person's response
What should you do if you are injured at work
report incident
What do you do if you spill a hazardous material
report to the nurse
How do you prevent suffocating?
sit them up straight,make sure dentures fit properly
PREVENTING BURNS What are common causes of burns?
smoking, spilled hot liquids, children playing with matches, grills, fireplaces, stoves, electricity items, and very hot water (sinks,tubs, showers)
What are examples of harzard?
spills, loose hand rails, unanswered call lights, burn out bulbs, unsafe equipment, and other safety issues
How do you help a agitated person
stay away from them, talk calm,
What would you do if there was a flood warning issue in your area and you are at work?
stay, follow agency plan
What are common causes of choking
talking and laughing, drinking alcohol, poorly chewed piece of meat
What do Safety Measures must no interfere?
the person's rights
The safety measures in this chapter apply to all health care settings and daily life. The goal is to prevent accidents &injuries without limiting what?
the persons mobility and independence
The person may receive an identification (ID) bracelet when admitted to the agency. The bracelet has?
the persons name,ID number,room and bed number, DOB date of birth,age, and doctor
What will happen if the person does not stop suffocating
will die if he or she does not start breathing
PROMOTING SAFETY AND COMFORT identifying the person SAFETY. Always identify the person before giving care. Do not identify the person and then leave the room for supplies and equipment. why?
you could go to the wrong room and give care to the wrong person. The person needing care would not receive it. Harm could result.
OSHA has guidelines for preventing workplace vio-lence. Work-site hazards are identified. Prevention measures are followed. Also, staff receive safety and health training. You need to?
• Follow your agency's workplace violence prevention programs. • Follow safety and security measures. • Voice safety and security concerns. • Report suspicious persons right away. • Report violent incidents promptly and accurately. • Serve on committees that review workplace violence. • Attend training programs to recognize and manage agitation, assaultive behavior, and criminal intent
what should do when you are caring for a Agitated or aggressive persons?
• Stand away from the person. Judge the length of the person's arms and legs. Stand far enough away that the person cannot hit or kick you. -Stand close to the door. Do not become trapped in the room. -Identify items in the room that can be used as weapons. Move away from such objects. Vases, phones, radios, music players, letter openers, paper weights, and belts are examples. -Know where to find and how to use panic buttons, call lights, alarms, closed-circuit monitors, pagers, personal alarms, and other security devices. -Keep your hands free. -Stay calm. Talk to the person in a calm manner. Do not raise your voice or argue, scold, or interrupt the person. -Be aware of your body language. Do not point a finger or glare at the person. Do not put your hands on your hips. -Do not touch the person. -Tell the person that you will get the nurse to speak to him or her. -Leave the room as soon as you can. Make sure the person is safe. -Tell the nurse and security officer about the matter at once. -Report items in the room that can be used as weapons.