1. 1 Chapter 19 Safety

2. 2 Major nursing responsibility Hospital errors: ranked as sixth leading cause of death by Centers for Disease Control and Prevention Safety

3. 3 1. Infants Falling off changing tables Unrestrained in automobiles 2. Toddlers Climbing; accidental poisoning; falling downstairs or from high chairs; burns; electrical shock; drowning Age-Related Safety Factors

4. 4 3. School-aged children and adolescents School-aged children: play-related injuries Adolescents: sports-related injuries 4. Adults: Ignoring safety issues, fatigue, sensory changes, effects of disease Age-Related Safety Factors(cont’d)

5. 5 Latex sensitization Thermal burns Asphyxiation Electrical shock Poisoning Falls Environmental Hazards

6. 6 Latex sensitization is an allergic response to the proteins in latex Latex is natural rubber Component of many household items Predisposition to latex sensitivity Types of latex reactions Contact dermatitis Immediate hypersensitivity Environmental Hazards (cont’d)

7. 7 Safeguarding clients and personnel Prevent latex sensitization If using latex gloves, avoid oil-based hand creams Wash hands thoroughly after removing gloves Environmental Hazards (cont’d)

8. 8 Burns Thermal burns or chemical burns Burn prevention: exits identified, lighted, unlocked; ensure safety measures Fire plans Fire management: RACE o Rescue o Alarm o Contain (احتواء) o Extinguish Environmental Hazards (cont’d)

9. 9 Burns (cont’d) Roles and responsibilities at and away from fire’s origin Use of fire alarm system Agency fire plan concepts Rescue and evacuation; proper use of equipment Building compartmentalization for containing smoke and fire Fire extinguishers Environmental Hazards (cont’d)

10. Evacuation of Clients 10

11. 11 Asphyxiation Airway obstruction Carbon monoxide (CO) o CO binds with hemoglobin o CO poisoning: symptoms similar to flu, except for cherry-red skin color Environmental Hazards (cont’d)

12. 12 Drowning Fluid occupies airway, interferes with ventilation Accidental drownings Resuscitation Immediate CPR CPR certification in nurses Environmental Hazards (cont’d)

13. 13 Electrical shock Body prone to electric shock Macro shock; micro shock Grounded equipment reduces electrical shock potential Measures to prevent electrical shock Environmental Hazards (cont’d)

14. 14 Poisoning Caused by ingestion, inhalation, or absorption of toxic substance More common in homes than in health care institutions Accidental poisonings; medication errors Environmental Hazards (cont’d)

15. 15 Poisoning prevention Educate children; teach parents Cognitive-impaired adults: use prefilled medication containers Environmental Hazards (cont’d)

16. 16 Falls Most common accident with the most serious consequences in older adults Contributing factors: visual impairments; disorders affecting gait, balance, and coordination; medications to lower blood pressure Contributing factors (cont’d) o Urinary urgency o Environmental factors o Hospitalization o Confusion, impaired judgment Environmental Hazards (cont’d)

17. 17 Assessment Determine risk factors Fall prevention measures Environmental Hazards (cont’d)

18. 18 Restraints: methods of restricting a person’s freedom of movement, physical activity, or normal access to his or her body Use of restraints is closely regulated Last intervention used after all others exhausted Restraints

19. 19 Risks of use: Increase client confusion Cause chronic constipation, incontinence, infections (pneumonia) May cause pressure ulcers Experience decline in ability to perform ADLs independently Restraints(cont’d)

20. 20 Recognize safety hazards Identify clients at greatest risk for injury Identify several nursing diagnoses Client safety; allegations of malpractice Best wishes Nursing Implications