Chapter 10 Safety All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Safety Safety is a basic need. The health team must provide for resident safety. The goal is to decrease the person’s risk of accidents and injuries without limiting mobility and independence. Measures to protect residents must not interfere with their rights. Ordinary and sometimes extraordinary measures are needed to prevent accidents and keep residents safe. The Omnibus Budget Reconciliation Act of 1987 (OBRA) requires that nursing centers follow safety policies and procedures. Common sense and simple safety measures can prevent most accidents. You must protect residents, visitors, yourself, and co-workers. The care plan lists other safety measures needed by the person. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 2

The Safe Environment A person has little risk of illness or injury. The person feels safe and secure physically and mentally. The risk of infection, falls, burns, poisoning, and other injuries is low. Temperature and noise levels are comfortable. Smells are pleasant. There is enough room and light to move about safely. The person and the person’s property are safe. The person is not afraid. The person has few worries and concerns. A safe setting is free of hazards to the extent possible. A hazard is anything in the person’s setting that may cause injury or illness. The person must receive the right care and treatment. To protect the person from harm, follow the person’s care plan. The entire health team must provide a safe setting. Review Teamwork and Time Management: A Safe Setting on p. 128. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 3

Accident Risk Factors You need to be aware of these risk factors: Age The person in a coma relies on others for protection. Residents with dementia rely on others. Agitated and aggressive behaviors Vision loss Hearing loss Impaired smell and touch Impaired mobility Drugs Coma is a state of being unaware of one’s surroundings and being unable to react or respond to people, places, or things. Dementia is the loss of cognitive and social function caused by changes in the brain (see Chapter 39). Paralysis means loss of muscle function, loss of sensation, or loss of both muscle function and sensation. Paraplegia is paralysis in the legs and lower trunk. Quadriplegia is paralysis in the arms, legs, and trunk. Hemiplegia is paralysis on one side of the body. Some drugs have side effects that include loss of balance, drowsiness, and lack of coordination. Reduced awareness, confusion, and disorientation can occur. Report behavior changes to the nurse. Review Residents with Dementia: Accident Risk Factors (Awareness of Surroundings) on p. 128. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 4

Identifying the Person You must give the right care to the right person. To identify the person: Compare identifying information on the assignment sheet or treatment card with that on the identification (ID) bracelet. Call the person by name when checking the ID bracelet. Alert and oriented residents may choose not to wear ID bracelets. Follow center policy and the care plan to identify the person. Learn to use your center’s resident identification system safely. Life and health are threatened if the right care is given to the wrong person. You use the bracelet to identify the person before giving care (Fig. 10-1, p. 129). Confused, disoriented, drowsy, hard-of-hearing, or distracted persons may answer to any name. Use at least two identifiers. An identifier cannot be the person’s room or bed number. Some centers require that the person state his or her name and birth date. Others require using the person’s ID number. Always follow center policy (Fig. 10-2 on p. 129). Some centers have a photo ID system (Fig. 10-3 on p. 130). The person’s photo is taken on admission and placed in the medical record. Review Promoting Safety and Comfort: Identifying the Person on p. 129. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 5

Preventing Burns Causes of burns in nursing centers include: Smoking Spilled hot liquids Electrical items Very hot bath water Burn severity depends on water temperature and length of exposure. Burns are a leading cause of death among children and older persons. Risk factors for burns in older persons are decreased skin thickness, decreased sensitivity to heat, reduced reaction time, decreased mobility, communication problems, confusion, and dementia. The person’s condition is also a factor in burn severity. Review Table 10-1 on p. 130. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 6

Third- Degree Burn to Occur Table 10-1: Water Temperature and Length of Exposure for a Third-Degree Burn Fahrenheit (F) Centigrade (C) Time Required for a Third- Degree Burn to Occur 155 F 68 C 1 second 148 F 64 C 2 seconds 140 F 60 C 5 seconds 133 F 56 C 15 seconds 127 F 52 C 1 minute 124 F 51 C 3 minutes 120 F 48 C 5 minutes 100 F 37 C Usually a safe temperature for bathing First-degree burn—this involves the epidermis (top layer of skin). Sunburn is an example. Second-degree burn—this involves the epidermis and dermis. The person has pain and blisters. Third-degree burn—the epidermis and dermis, fat, muscle, and bone may be injured or destroyed. The safety measures in Box 10-1 on p. 130 can prevent burns. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 7

Preventing Poisoning Poisoning is a health hazard and a major cause of death. Carelessness, poor vision, and confusion are major risk factors. Drugs and household products are common poisons. To prevent poisoning: Make sure residents cannot reach hazardous materials. Follow agency policy for storing personal care items. As a result of poor vision and confusion, a person may take too much of a drug. Sometimes poisoning is a suicide attempt. The measures in Box 10-2 on p. 131 can prevent poisoning. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 8

Preventing Suffocation Suffocation occurs when breathing stops because of lack of oxygen. Causes of suffocation include: Choking Drowning Inhaling gas or smoke Strangulation Electrical shock Carbon monoxide poisoning A large, poorly chewed piece of meat is the most common cause. Laughing and talking while eating also are common causes. So is excessive alcohol intake. Weakness, dentures that fit poorly, dysphagia (difficulty swallowing) and chronic illness are common causes. Measures to prevent choking are listed in Box 10-3 on p. 131. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 9

Choking Some air moves in and out of the lungs. Choking (foreign-body airway obstruction [FBAO]) Air cannot pass through the air passages to the lungs. The body does not get enough oxygen. It can lead to cardiac arrest. Choking often occurs during eating. Older persons are at risk for choking. Choking can occur in the unconscious person. With mild airway obstruction: Some air moves in and out of the lungs. The person is conscious. Usually, the person can speak. Often, forceful coughing can remove the object. Clear the airway if a person is choking. For mild airway obstruction: Stay with the person. Encourage the person to keep coughing to expel the object. Do not interrupt the person’s efforts to clear the airway. If breathing and coughing, abdominal thrusts are not needed. If the obstruction persists, call for help. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 10

Severe Airway Obstruction: Air Is Not Moving With severe airway obstruction: The conscious person clutches at the throat (the “universal sign of choking”). The person cannot breathe, speak, or cough. The person appears pale and cyanotic (bluish color). Air does not move in and out of the lungs. If the obstruction is not removed, the person will die. The Heimlich maneuver is used to relieve severe airway obstruction. It involves abdominal thrusts. It is performed with the person standing, sitting, or lying down. The Heimlich maneuver is not used for very obese persons or pregnant women. Difficulty breathing occurs with severe airway obstruction because air does not move in and out of the lungs. Severe airway obstruction is an emergency. The conscious person clutches the throat (Fig. 10-4 on p. 131). This is often called the “universal sign of choking.” Abdominal thrusts are quick, upward thrusts to the abdomen (Fig. 10-6 on p. 133). They force air out of the lungs and create an artificial cough. They are done to try to expel the foreign body from the airway. Relief of choking occurs when the foreign body is removed. Or it occurs when you feel air move and see the chest rise and fall when giving rescue breaths. The person may still be unresponsive. Chest thrusts are not used for very obese persons or pregnant women. You may perform emergency measures to relieve choking. Report and record what happened, what you did and the person’s response (Fig. 10-5 on p. 132). All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 11

Relieving Choking Call for help when an adult or a child (>1 year of age) has: Severe airway obstruction Mild airway obstruction that persists despite the person’s efforts to remove the object by coughing The unresponsive adult: Do not assume the cause is choking. If the person is not responding, start cardiopulmonary resuscitation (CPR). You can perform the Heimlich on yourself (self-administered Heimlich maneuver). Ask the person if he or she is choking. Help the person if he or she nods “yes” and cannot talk. Call for help: In a public area, activate the Emergency Medical Services (EMS) system by calling 911. Send someone to get an automated external defibrillator (AED). In a center, call the center’s Rapid Response Team (RRT). This team quickly responds to give care in life-threatening situations. Send someone to get the AED. In the unresponsive adult after activating the RRT or EMS, if indicated CPR should be started without delay (see Chapter 43). All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 12

Preventing Infection Infection is a risk for persons who are: Older Chronically ill Disabled The spread of infection is a major hazard in nursing centers. Infections are caused by microorganisms that easily spread from one person to another. Preventing infections is discussed further in Chapter 13. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 13

Preventing Equipment Accidents All equipment is unsafe if: Broken Not used correctly Not working properly Inspect all equipment before use. Follow your center’s policy on reporting damaged or nonfunctioning equipment. Frayed cords and overloaded electrical outlets can cause: Fires, burns, and electrical shocks Equipment includes hospital beds. Follow the Bloodborne Pathogen Standard (see Chapter 13). Check all glass and plastic items for cracks, chips, and sharp or rough edges. Electrical shock occurs when electrical current passes through the body. It can burn the skin, muscles, nerves, and other tissues. It can affect the heart and cause death. Frayed cords (Fig. 10-9 on p. 134) and overloaded electrical outlets (Fig. 10-10 on p. 134) can lead to fires, electrical shock, and possible death. Practice the safety measures in Box 10-4 on p. 135 when using equipment. An incident report is completed if a resident, visitor, or staff member has an equipment-related accident. The Safe Medical Devices Act requires that centers report equipment-related illnesses, injuries, and deaths. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 14

Electrical Safety Three-pronged plugs are used on all electrical items. Warning signs of a faulty electrical item include: Shocks Loss of power or a power outage Dimming or flickering lights Sparks Sizzling or buzzing sounds Burning odor Loose plugs Do not use or give damaged items to residents. The third prong on a plug is the ground (Fig. 10-11 on p. 134). A ground carries leaking electricity to the earth and away from an electrical item. If a ground is not used, leaking electricity can be conducted to the person. It can cause electrical shocks and possible death. If you receive a shock, report it at once. Do not use the item. Take damaged items to the nurse. The nurse will have you either discard the item following center policy or tag the item and send it for repair following center policy. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 15

Wheelchair Safety Check the wheel locks (brakes). Check for flat or loose tires. Make sure the wheel spokes are intact. Make sure the casters point forward. Position the person’s feet on the footplates. Make sure the person’s feet are on the footplates before moving the chair. Push the chair forward when transporting the person. Do not pull the chair backward unless going through a doorway. Lock both wheels before you transfer a person to or from the wheelchair. If able, the person propels the chair using the hand rims or his or her feet. Other wheelchairs are propelled by motors (Fig. 10-13 on p. 135). If the person cannot propel the wheelchair, another person pushes it using the handgrips/push handles. Stretchers are used to transport persons who cannot use wheelchairs. They cannot sit up or must lie down in the stretcher. Follow the safety measures in Box 10-5 on p. 136 when using wheelchairs and stretchers. The person can fall from the wheelchair or stretcher, or the person can fall during transfers to and from the wheelchair or stretcher. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 16

Wheelchair Use Clean the wheelchair according to center policy. Ask a nurse or physical therapist to show you how to propel wheelchairs up steps and ramps and over curbs. Follow measures to prevent equipment accidents. Follow the safety measures in Box 10-5 on p. 136 when using wheelchairs and stretchers. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 17

Handling Hazardous Substances The Occupational Safety and Health Administration (OSHA) requires that health care employees: Understand the risks of hazardous substances Know how to safely handle them Exposure to hazardous substances can occur: Under normal working conditions During certain emergencies A hazardous substance is any chemical in the workplace that can cause harm. Physical hazards can cause fires or explosions. Health hazards are chemicals that can cause acute or chronic health problems. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 18

Handling Hazardous Substances (Cont’d) Hazardous substances include: Drugs used in cancer therapy Anesthesia gases Gases used to sterilize equipment Oxygen Disinfectants and cleaning agents Radiation used for x-rays and cancer treatments Mercury OSHA requires a hazard communication program. Labeling Hazardous substances need warning labels. The hazard communication program includes container labeling, material safety data sheets (MSDSs), and employee training. The center also provides eyewash and total body wash stations in areas where hazardous substances are used. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 19

Labeling Warning labels identify: Physical and health hazards Precaution measures What personal protective equipment to wear How to use the substance safely Storage and disposal information If a warning label is removed or damaged: Do not use the substance. Take the container to the nurse and explain the problem. Do not leave the container unattended. Hazardous substance containers include bags, barrels, bottles, boxes, cans, cylinders, drums, and storage tanks. All need warning labels (Fig. 10-15 on p. 137). The manufacturer supplies all labels. They must not be removed or damaged in any way. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 20

Safety Data Sheets Safety data sheets (SDSs) Previously called Material Safety Data Sheets (MSDS) Every hazardous substance has an SDS. Employees must have ready access to SDSs. Check the SDS before: Using a hazardous substance Cleaning up a leak or spill Disposing of the substance Tell the nurse about a leak or spill right away. Do not leave a leak or spill unattended. Your employer provides training about hazards, exposure risks, and protection measures. Each hazardous substance requires certain protection measures. The Global Harmonized System of Classification ensures all sheets have a standardized format. SDSs may be found in a binder at a certain place on each nursing unit, or on the computer. You learn to read and use warning labels and SDSs (Fig. 10-16 on p. 137). Learn the location of eyewash and total body wash stations. Box 10-6 on p. 138 lists general rules for handling hazardous substances. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 21

Fire Safety Major causes of fire include: The entire health team must: Faulty electrical equipment and wiring Overloaded electrical circuits Smoking The entire health team must: Prevent fires Act quickly and responsibly during a fire Fire is a constant danger. Remind people about the no-smoking rules as needed. Know your agency’s policies and procedures for fire emergencies. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 22

Fire and Oxygen Fire and the use of oxygen Three things are needed for a fire. A spark or flame A material that will burn Oxygen Safety measures are needed where oxygen is used and stored. Centers have no-smoking policies and smoke-free areas. You may have to remind a resident or visitor not to smoke inside the center. Air has some oxygen. However, some people need extra oxygen (see Chapter 25). Review the list of safety measures where oxygen is used and stored in the textbook. Review Focus on Communication: Fire and Use of Oxygen on p. 138. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 23

Fire Safety Measures Preventing fires Follow the safety measures for oxygen use. Smoke only where allowed to do so. Be sure all ashes, cigars, cigarettes, and other smoking materials are out before emptying ashtrays. Empty ashtrays into a metal container partially filled with sand or water. Provide ashtrays for persons who are allowed to smoke. Supervise persons who smoke. Follow safety practices when using electrical items. Review Box 10-7 on p. 138. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 24

Fire Safety Measures (Cont’d) Keep matches and lighters away from confused and disoriented persons. Do not leave cooking unattended on stoves, in ovens, or in microwave ovens. Store flammable liquids in their original containers. Keep the containers out of residents’ reach. Do not smoke or light matches or lighters around flammable liquids or materials. Review Box 10-7 on p. 138 for further details of fire prevention measures. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 25

During a Fire What to do during a fire Know your center’s policies and procedures for fire emergencies. Know where to find fire alarms, fire extinguishers, and emergency exits. Remember the word RACE. R is for rescue. A is for alarm. C is for confine. E is for extinguish. Fire drills are held to practice emergency fire procedures. The acronym RACE means: (Fig. 10-17 on p. 139): R—Rescue persons in immediate danger. Move them to a safe place. A—Sound the nearest fire alarm. Notify the switchboard operator. C—Close doors and windows to confine the fire. Turn off oxygen or electrical items used in the general area of the fire. E—Use a fire extinguisher on a small fire that has not spread to a larger area. Review Promoting Safety and Comfort: What to Do During a Fire on p. 139. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 26

During a Fire (Cont’d) Clear equipment from all normal and emergency exits. Do not use elevators if there is a fire. To use a fire extinguisher, remember the word PASS. P (Pull the safety pin.) A (Aim low.) S (Squeeze the lever.) S (Sweep back and forth.) Centers have evacuation policies and procedures. Once firefighters arrive, they direct rescue efforts. Pull the fire alarm. Centers require that all employees demonstrate use of a fire extinguisher. Different extinguishers are used for different kinds of fires. Review the procedure for using a fire extinguisher. Remember the acronym PASS. If evacuation is necessary, residents closest to the fire are taken out first. Those who can walk are given blankets to wrap around themselves. A staff member takes them to a safe place. Figures 10-19 and 10-20 on pp. 140-141 show how to rescue persons who cannot walk. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 27

Disasters A disaster is a sudden catastrophic event. People are injured and killed. Property is destroyed. There are natural disasters and human-made disasters. The center has procedures for disasters that could occur in your area. Communities, fire and police departments, and health care agencies have disaster plans. Centers have procedures for bomb threats. Disaster plans include procedures to deal with the people needing treatment. The plan generally provides for: Discharging residents 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 A disaster may damage the center. The disaster plan includes evacuation procedures. You must follow the procedures for bomb threats if a caller makes a bomb threat or if you find an item that looks or sounds strange. If you see a stranger in the center, tell the nurse at once. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 28

Workplace Violence Workplace violence is defined as violent acts directed toward persons at work or while on duty. Workplace violence can occur in any place where an employee performs a work-related duty. According to OSHA, more assaults occur in health care settings than in other industries. Nurses and nursing assistants are at risk. Workplace violence includes threats—obscene phone calls; threatening oral, written, or body language; and harassment of any nature (being followed, sworn at, or shouted at). Locations of workplace violence include buildings, parking lots, field sites, homes, and travel to and from work assignments. The nurse assesses the behavior and the behavioral history of new and transferred residents. Review risk factors listed in the text that put nurses and nursing assistants at higher risk for assault. What risk factors can you think of? All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 29

Violence Prevention OSHA has guidelines for violence prevention programs. The goal is to prevent or reduce employee exposure to situations that can cause death or injury. Worksite hazards are identified. Prevention measures are developed and followed. Employees receive safety and health training. You need to: Understand and follow your center’s workplace violence prevention program. Understand and follow safety and security measures. Voice safety and security concerns. Report strange or suspicious persons right away. Report violent incidents promptly and accurately. Serve on health and safety committees. Attend training programs. Review the measures to prevent or control workplace violence listed in Box 10-8 on p. 143 in the textbook. Training programs can help you recognize and manage agitation, assaultive behavior, and criminal intent. Box 10-9 on p. 144 lists personal safety practices. Follow them all the time. Complete an incident report, as needed, for workplace violence. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 30

Risk Management Risk management identifies and controls risks and safety hazards affecting the center. The intent of risk management is to: Protect everyone in the center Protect center property from harm or danger Protect the person’s valuables Prevent accidents and injuries Risk managers work with all center departments. They look for patterns and trends in incident reports, resident complaints, staff complaints, and accident and injury investigations. Risk managers look for and correct unsafe situations. They also make procedure changes and training recommendations as needed. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 31

Risk Management (Cont’d) Risk management deals with these and other safety issues: Accident and fire prevention Negligence and malpractice Resident abuse Workplace violence Federal and state requirements All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 32

Wristbands 33 Color-coded wristbands Red = allergy alert Promote the person’s safety and prevent harm Communicate an alert or warning Commonly used colors: Red = allergy alert Yellow = fall risk Purple = “do not resuscitate” order To safely use color-coded wristbands: Know the wristband colors used in your center. Check the care plan and your assignment sheet when you see one. Ask the nurse if you have questions. Do not confuse “social cause” bands with them. Check for wristbands on person transferred from another agency. The nurse needs to remove them. Tell the nurse if you think a person needs one. Color-coded wrist bands quickly communicate an alert or warning (Fig. 10-24 on p. 145). Red is a warning to “stop.” A red wristband is used to warn of allergies to food, drugs, treatment supplies such as tape or latex gloves, dust, plants, grass, and so on. The specific allergies are not listed on the wristband. Yellow implies “caution.” The person is at risk for falling. Yellow wristbands are used for persons with a history of falls. Or they are used for persons at risk for falls because of dizziness, balance problems, confusion, and so on. Purple means the person has a “do not resuscitate” (DNR) order (see Chapter 44). All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 33

Personal Belongings and Valuables The person’s belongings must be kept safe. A personal belongings list is completed. A valuables envelope is used for jewelry and money. Items kept at the bedside are listed in the person’s record. Items brought from home are labeled with the person’s name. A valuables envelope is used for jewelry and money. Each jewelry item is listed and described on the envelope. Describe what you see (Fig. 10-25 on p. 146). For valuables: Count money with the person. Put money and each jewelry item in the envelope with the person watching. Seal the envelope. Sign the envelope like a personal belongings list. Give the envelope to the nurse. The nurse takes it to the safe or sends it home with the family. Dentures, eyeglasses, hearing aids, watches, some jewelry, radios, computers, and other electronic devices are kept at the bedside. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 34

Reporting Incidents Report accidents and errors at once. Accidents involving residents, visitors, or staff Giving the wrong care Giving care to the wrong person Not giving care Broken or lost items owned by the person Lost money or clothing Hazardous substance incidents Workplace violence incidents An incident is any event that has harmed or could harm a resident, visitor, or staff member. It includes accidents and errors in giving care. Review Box 10-10 on p. 147 in the textbook for examples. An incident report is completed as soon as possible after the incident. Review the list of information required for an incident report in the textbook. Incident reports are reviewed by risk management and a committee of health care workers. They look for patterns and trends of accidents or errors reported. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 35

Quality of Life Promote safety by: You need to: Knowing the common safety hazards Knowing the causes of accidents Knowing who needs protection Using common sense You need to: Practice safety measures. Use safety devices as needed. Follow the person’s care plan. Most accidents can be prevented. Remember, persons who are older and disabled are at great risks for accidents. You may see something unsafe. Do what you can to correct the matter. Everyone must keep the center safe for residents, visitors, and staff. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 36