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Chapter 26: Safety

Professional Nursing

Safety: The condition of being protected from or unlikely to cause danger, risk, or injury: "they should leave for their own safety". Denoting something designed to prevent injury or damage: "a safety barrier"; "a safety helmet".
Security: The state of being free from danger or threat. The safety of a state or organization against criminal activity such as terrorism, theft, or espionage: "national security".
Factors Affecting Safety: Developmental considerations Lifestyle Mobility Sensory perception Knowledge Ability to communicate Physical health state Psychosocial health state
Developmental: Each developmental stage is associated with inherent risks. The identified risks change as the individual transitions from one developmental stage to the other; from infancy throughout adult hood.
Developmental cont': changes in physical and cognitive function and skill set are associated with the transitions.
Developmental cont': environmental safety and potential for risks for injury and harm need to be identified in an expedited manner by nurses with an awareness of developmental stages
Developmental cont': potential risk to developing fetus with maternal consumption ETOH, illicit medications; substance abuse, physical abuse - adolescence- risk for teen pregnancy, sexual transmitted disease, alcohol related accidents, suicide
Developmental cont': abuse; children, elders, victims of intimate partner violence = the nurse maybe the first healthcare worker in contact with these individuals
Role: work in partnership with families, communities and other healthcare workers to reduce and eliminate the risks of accidents in the home.
Role: cont' increase awareness of risks of teen drinking and driving, preventative education on multiple topics, and referrals to support systems and resources.
Lifestyle: certain occupations, lifestyle habits, social behavior, recreational activities and environments place people at risk
Mobility: risks related to ambulation and movement.
Knowledge: intellectual processing and literacy level – vital to assess to properly educate patient about safety in a manner beneficial to them.
Communication: language difference? Side effect of medications?
Psychosocial Health: stress can limit one’s attention span, increasing risk of accidents. Depression can associated with confusion, inattentiveness.
Assessment: Observe patients posture, ROM, strength, balance and body alignment.
Diagnoses: (potential or actual) Risk for injury related to seizures and balance disorders or related to altered mobility. Risk for skin integrity related to immobility
Outcome and Plan: Design your interventions to help a patient feel safe to move about and interact freely within the environment.
Evaluate: Pt remained safe when rising up in bed Patient demonstrated use of cane appropriately when ambulating
Infants & Neonates: Developmental Factors Cannot recognize danger Tactile exploration of environment Totally dependent
Infants & Neonates: Actions Avoid behaviors that might harm the fetus. Never leave the infant unattended. Use crib rails, back to sleep Monitor setting for objects that are choking hazards. Use car seats properly
Toddlers & Preschoolers: Developmental Factors More adventurous, explore environment and Play extends outside, riding toys. climbing Everything in mouth
Toddlers & Preschoolers: Actions Childproof home environment. Prevent poisoning. Be alert to manifestations of child abuse. Use car seats properly.
School Age: Developmental Factors Try new activities without practice More time outside the home Stranger danger Playing with weapons
School Age: Actions Help to avoid activities that are potentially dangerous. Provide interventions for safety at home, school, and neighborhood. Teach bicycle safety. Teach about child abduction. Wear seatbelts.
Adolescence: Developmental Factors False confidence; feel indestructible Risk-taking behaviors Lack adult judgment Peer Pressure
Adolescence: Actions Teach safe driving skills. Teach avoidance of tobacco and alcohol. Teach risk of infection with body piercing. Teach about guns and violence.
Adults: Developmental Factors Exposed to injury in the workplace Can make poor lifestyle choices Some decline in strength and stamina
Adults: Actions Discuss the effects of stress on lifestyle and health. Counsel about unsafe health habits (reliance on drugs and alcohol). Counsel about intimate partner violence.
Aging Adults: Developmental Factors Loss of muscle strength, joint mobility; slowing reflexes; sensory losses
Aging Adults: Actions Prevent accidents. Orient person to surroundings (avoid falls). Maintain vehicle in working order, schedule eye exams, and keep noise at a minimum. Promote safe environment at home (avoid fires). Use medication trays (avoid poisoning).
Bioterrorism: involves the deliberate spread of pathogenic organisms into a community.
Sentinel Event: is an unexpected occurrence involving death or serious physical or psychological injury, or the risk of death or injury.
Safety Event Report: is a confidential document, formerly referred to as an incident report, that objectively describes the circumstances of the accident or incident.
Mummy Restraint: restraint swaddles an infant to prevent him or her from harm.
Intimate Partner Violence: Domestic violence or battering between two people in a close relationship.
Among adults older than 65: falls are the leading cause of injury fatality.
All infants and toddlers: should ride in a rear-facing car seat until they are 2 years of age or until they reach the highest weight and height allowed by their car seat’s manufacturer.
Safety Hazards for Health Care Workers: Back injury Needle stick injury Radiation injury Workplace violence
PREVENTION: Body mechanics Sharps awareness, proper disposal Radiation precautions Environmental awareness of personal safety
Physical Restraints: Wrist, Vest, Mummy, Elbow
Chemical Restraints: Drugs
Created by: mr209368