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safety chpt 13
nursing chapter 13
| Question | Answer |
|---|---|
| A national standard for patient safety has been established by | The Joint Commission |
| fall assessment rating scales | forms that, when filled out, give a numerical rating for each patient’s risk for falls. The higher the number, the greater the patient’s |
| They are not true restraints, which are | vests, jackets, or bands with connected straps that are tied to the bed, chair, or wheelchair to keep the patient in one place. |
| restraint alternatives are | less restrictive ways to help patients remember not to get up and try to walk or to alert nursing staff that the patient is attempting to do so. |
| 2 product used as a restraint alternative is the | chair monitor, bed monitor, or position alarm,A leg monitor |
| Soft Devices. | Soft devices include bolsters can be placed in the bed on either side of the patient to prevent them from slipping between or through the side rails. In some states, soft devices are considered restraints and do require a health-care provider’s order. |
| Other names for restraints are | protective devices or safety reminder devices. |
| Safety: No restraint, either physical or chemical, is ordered or used unless | absolutely necessary to keep the patient safe. They are never used for the convenience of staff. |
| types of restraints | waist mitt vest extremity |
| Types of Fires and Extinguishers | Type A: Type B: Type C: Type D: Type K: |
| Type A: | Paper, wood, fabric, and trash |
| Type B: | Combustible liquids such as oil, gasoline and other petroleum-based products, and flammable gases |
| Type C: | Electrical fires such as short-circuits in wires, motor, or equipment fires |
| Type D: | Powders, flakes, or shavings of combustible metals |
| Type K: | Kitchen fires caused by combustible cooking fluids such as oils and fats |
| Most fire extinguishers are a combination of | A, B, and C extinguishers that can be used to fight all three types of fires. |
| HAZARDS ARE | Biological Hazards Chemical Hazards Radiation Hazards PHYSICAL |
| Your facility is required to have a safety data sheet (SDS) on file for | every chemical, which contains information about potential harm caused by exposure and directions for what to do if the product gets in your eyes, on your skin, or in your mouth |
| It is very important that the patient be released from the restraints every | 2 hours; otherwise, you could be accused of false imprisonment |
| It is extremely important that you know how to correctly apply restraints. You should be able to insert_____and always tied with____ | 2 fingers and quick release knott |
| Use a fall assessment rating scale or other assessment tool to determine the likelihood of | fall risk |
| check pt every ___with restraints | 30min |
| center of gravity is | This is a middle point of the body, below the umbilicus and above the pubis, around which the body’s mass is distributed. |
| base of support | which refers to your feet and lower legs |
| When an order has been obtained and the restraints are in place, nursing staff are required by the Health Care Financing Administration and The Joint Commission to follow these guidelines: | Check on the patient every 30 minutes, making sure to check the skin for redness or chafing under the restraint and the extremities for warmth and color. Remove the restraint every 2 hours. While the restraint is off: |
| placing restraint cont | Offer fluids to the patient. Assist with toileting as needed. Change the patient’s position if they are in bed. Assess the extremities for edema, capillary refill time, sensation, and function. |
| placing restraint cont | Assess skin over pressure points for integrity and erythema. Assist the patient to ambulate if that is appropriate. Stay with the patient the entire time the restraint is off. |
| Actions to Take If a Patient Has Fallen | Check the patient for obvious injuries. Look for bleeding, check level of consciousness, assess for signs of hip fracture , observe for deformities at any joint, and assess for paralysis or weakness on one side of the body. |
| Actions to Take If a Patient Has Fallen | Call for help. It will take several staff members to move the patient off the floor. Follow facility policy for moving patients who have fallen. |
| Actions to Take If a Patient Has Fallen | Take the patient’s vital signs. The fall may be the result of underlying cardiac or neurological problems such as an arrhythmia or a cerebrovascular accident. |
| Actions to Take If a Patient Has Fallen | If the patient is not conscious, has unstable vital signs, or is not breathing or is without a pulse, call a Code Blue immediately. Assist the conscious patient to bed with the help of others, following facility policy. |
| Actions to Take If a Patient Has Fallen | Notify the health-care provider. Explain what occurred and give the patient’s current condition. Be prepared to take orders for x-rays and other tests. |
| Actions to Take If a Patient Has Fallen | Document the incident according to facility policy. An incident report must be completed. Charting should include details of finding the patient, vital signs, assistance to bed, notifying the health-care provider, and orders obtained. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Place a patient who is at risk for falls in a room near the nurses’ station to make it easier for more people to see and check on them. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Stay with patients at risk for falls when they are in the bathroom or on the bedside commode. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Keep the bed at the lowest level at all times except when the nursing staff is at the bedside. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | If there is a recurrent problem where the patient is unsafe because of repeated attempts to get out of bed, the mattress may be placed on the floor to prevent injury to the patient. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Place the overbed table across the wheelchair like a tray to help patients remain seated in the chair. You can also use furniture or equipment to block areas that are off limits to the patient so that they remain in a safe zone. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Some patients who are at risk for falls seem to have a lot of energy and are looking for ways to stay busy. Try having them sit in a rocking chair near the nurses’ station. Often the motion of rocking helps them relax and use pent-up energy. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | You can also give them simple but purposeful activities to do, such as folding washcloths or towels. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Offer regular opportunities for the patient to go to the bathroom or to have a snack or something to drink. Sometimes patients are attempting to do one of these things when they get out of bed unsafely. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Assess your fall-risk patients frequently for subjective complaints such as nausea, pain, or other discomfort. These patients may be trying to get more comfortable but are unable to do so safely. |
| A number of simple strategies may be used by nursing staff to help prevent falls in at-risk patients: | Provide back rubs and distractions, such as music or television, to help patients be more comfortable and less restless. Use a nightlight to decrease anxiety at night when surroundings are unfamiliar. |
| Morse Fall Scale 1-3 | 1. History of falling; immediate or within 3 months 2. Secondary diagnosis 3. Ambulatory aid: Bedrest/nurse assist Crutches/cane/walker Furniture |
| Morse Fall Scale 4/5 | 4. IV/saline lock 5.. Gait/transferring Normal/bedrest/immobile Weak Impaired |
| Morse Fall Scale 6 | 6. Mental status Oriented to own ability Forgets limitation |
| Morse Fall Scale risk factors | Preventive fall precautions interventions (Level I) Modified fall risk interventions (Level II Strict fall risk interventions (Level III) |
Created by:
mmishue