1. Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 10 - Patient and Resident Safety and Restraints

2. Slide 2 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Accidents

3. Slide 3 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Some factors that place people at risk for accidents are Age Medication effects Impaired mobility Sensory impairment Risk Factors that Cause Accidents

4. Slide 4 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Infants are helpless accidental suffocation falls Young children lack knowledge about things that are dangerous falls burns poisoning and drowning The elderly are at high risk for accidents because of the physical and mental effects of the aging process Risk Factor: Age

5. Slide 5 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Medications that affect the ability of a person to be safe include: Pain medications Medications that affect blood pressure Effects of medication are: Dizziness Sedative effect Confusion Risk Factor: Medication

6. Slide 6 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person is unable to move or feel part of the body Puts the person at a risk of falls, burns, and other injuries Caused by a spinal cord injury or a stroke (“brain attack”) Paralysis from the waist down is known as paraplegia Paralysis from the neck down is known as quadriplegia Paralysis on one side of the body is known as hemiplegia Risk Factor: Paralysis

7. Slide 7 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Factors associated with poor mobility are: Pain and stiffness from arthritis Conditions that cause a person to shuffle his feet when he walks (e.g., stroke) Injuries or surgeries involving the leg Risk Factor: Poor Mobility

8. Slide 8 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Visual impairment can lead to Falls, accidental poisonings Hearing impairment can lead to Road accidents, suffocation or fire accidents, accidental poisonings Impaired sense of touch can lead to Accidental burns Impaired sense of smell can lead to Food poisoning, suffocation or fire accidents due to gas leak Risk Factor: Sensory Impairment

9. Slide 9 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Confusion and disorientation caused by reactions to medication, head injuries, dementia, and other medical conditions can lead to falls. A person who is unconscious or comatose is totally unable to respond to his or her environment and needs assistance to remain safe. Risk Factor: Limited Awareness of Surroundings

10. Slide 10 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Using Restraints

11. Slide 11 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Restraints are used to: restrict a person’s freedom of movement prevent a person from reaching parts of his or her body confine a person to a bed or a chair prevent movement of a specific body part Restraints can be either: Physical, or Chemical Restraints

12. Slide 12 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A physical restraint can be applied to: Wrists Ankles Chest Waist or elbows Some types of chairs or attachments to chairs can act as restraints The side rails of beds or tightly tucked sheets can act as restraints Not permitting a person free access to other rooms or parts of the facility is also considered a form of physical restraint. Physical Restraints

13. Slide 13 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A chemical restraint is any medication that alters a person’s mood or behavior Chemical restraints are sedatives or tranquilizers Chemical restraints are used to calm an anxious, combative (physically aggressive), or agitated (very upset) person Chemical restraints are not used for staff convenience Chemical restraints should not be used in so high a dose as to make the person sleepy or unable to function in a normal fashion Chemical Restraints

14. Slide 14 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Examples of some situations where the use of a restraint may be appropriate: A person is at risk for falling but will not stay in his bed or a chair and will not call for help A person may wander away from the facility A person tries to remove tubing needed for medical treatment A person is combative (physically aggressive) Using Restraints

15. Slide 15 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Strangulation, which can lead to death Bruises, nerve damage, and skin abrasions Permanent tissue damage as a result of impaired blood flow Broken bones Pneumonia, pressure ulcers, and blood clots Mental effects such as agitation, increased confusion, humiliation, and embarrassment Complications Associated with Using Restraints

16. Slide 16 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Only a doctor can order a restraint for a patient or resident Always follow your facility’s policies regarding the application and use of restraints Only a registered nurse (RN) or a licensed practical nurse (LPN) can apply a restraint Nursing assistants are responsible for providing care for the person while he or she is restrained Applying Restraints

17. Slide 17 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation