Chap 20: Patient Environment And Safety

Front 1

Environment

Back 1

The total of all elements and conditions that surround us and influence our development. Important factor in providing holistic care.
Goal: Provide safety and comfortability to patient at the same time.

Front 2

Factors affecting environment

Back 2

(1)Temperature, (2)Ventilation and humidity, (3)Lighting, (4)Odor, (5)Noise, (6)Neatness and (7)Privacy

Front 3

Temperature

Back 3

Infants and older people may need warmer rooms. Operating rooms and critical care is kept slightly cooler due to metabolic demands. Normal range 68-74F.

Front 4

Ventilation

Back 4

The process or act of supplying a building or room continuously with fresh air. Fans are discouraged due to its air currents spreading microorganisms.Fans acceptable for patients with respiratory conditions(when air movement is felt it is easier for them to breathe)

Front 5

Humidity

Back 5

the amount of moisture in the air. Range of 30%-50% is normal. Low humidity drys up skin and airways. Low humidity in hospital is to discourage growth of organisms. Vaporizers or humidifiers are used in hospital to raise humidity.

Front 6

Lighting

Back 6

A sunny cheerful room improves patients spirits. Areas must have enough light to safely do your task but not cause eyestrain or glares. *Try to use a flashlight when checking I.V.'s fluid levels etc... at night to not disturb patient*

Front 7

Odor

Back 7

Good ventilation and cleanliness will effectively control odors. In addition (1)make sure that bed pans, urinals and bedside commodes are emptied and rinse promptly, (2) dispose of dressings and used equipment, (3)never leave anything that could be come odorous in the patients room, (4)avoid being the source of odors whether good or bad, and (5)remove old flowers and stagnant water.

Front 8

Neatness

Back 8

Very important to keep room neat for the safety of the patient. Clear the over the bed table, remove dishes and trays and straighten the room whenever appropriate.

Front 9

Noise

Back 9

Main source in hospital is people. Soft music helps to reduce sensory overload from the noise and promote relaxation.Reduce noise by (1) avoid long convo'c in hallway, (2) staff should speak in lowered voices, (3)avoid jokes and laughter at nurses station and (4) answer alarms and bell rings promptly.

Front 10

Privacy

Back 10

Essential for well being of patient. Always knock and identify yourself before entering the room. Pull curtains when performing personal task when in multi-patient rooms. Place a sign on the door when performing personal task in rooms.

Front 11

Beds

Back 11

(1)Mattress is firm, (2) Surface is made of easily cleaned material, (3)Always check to make sure the wheels are locked when not moving it, (4)may have to use overlay to prevent pressure ulcers and (5) bed linens should be neat, dry and free of wrinkles. *Occupied beds are only made if the patient cannot get out of the bed at anytime*

Front 12

Accidents among patients

Back 12

(1) Falls, (2)burns, (3)cuts, (4)bruises, (5)fights with others, (6)loss of personal possessions, (7) choking, and (8)electrical shock

Front 13

Falls

Back 13

Most common factors are: (1)impaired physical mobility, (2) altered mental status and (3) sensory and/or motor deficit. Patients at risk may need a bed or leg alarm. Falls are most frequent at acute care facility. *Every patient should be assessed and reassessed periodically.*

Front 14

Burns

Back 14

Most common in: (1) Diabetics(or impaired circulation), (2)paralyzed patients, and (3)patients on drugs that alter mental awareness. Can be caused by hot or cold material.The nurse should: (1)check temperature of liquids or foods before giving them to the patient, (2)caution patient about sleeping with heating or cold pads, and (3)inspect cords for breaks or frayed areas.

Front 15

Smoking

Back 15

Banned in most health care facilities, allowed in few long term facilities. Carefully supervise patients(sedated, confused or irrational) that want to smoke. Never allowed near oxygen use. *No other equipment that might cause a spark is also prohibited near oxygen use*

Front 16

Nurses Actions to promote patient safety---(@Hospital)

Back 16

On admissions: (1)orientate patient to unit, (2) assess risk for falling, and (3) evaluate med regiment for side effects that increase risk for falling

Front 17

Nurses Actions to promote patient safety---(@Hospital)

Back 17

Safety: (1) Keep bed in low position when not giving direct care, (2) toilet patient on regular schedule, (3)lock wheels on bed, (4)provide night-light for late bathroom visits, (5)promote nonskid slippers, (6)answer calls promptly, (7)inform patient of next check in, and (8)promote use of grab bars.

Front 18

Nurses Actions to promote patient safety---(@Hospital)

Back 18

Nurse should: (1) place high-risk patients closer to nurse's station, (2)patient bell should be within reach, (3) stay with confused/unsteady patients, (4)wheel chair breaks are locked and (5)provide activities for confused patients.

Front 19

Nurses Actions to promote patient safety---(@home)

Back 19

(1)place non skid bath mat in tub/shower,(2)use night light in bathroom, (3)install door buzzer and bed alarms, (4)keep same furniture arrangement, and (5)provide community resources. Promote (1)installation of grab bars, (2)removal of extension cords and toys and animals(if necessary).

Front 20

Fire

Back 20

Must be familiar with the fire regulations in every institution. Must know location of fire extinguishers, fire escape routes and know how to notify telephone operator of a fire in your area. **(R)escue.(A)ctivate.(C)ontain.(E)tinguish**

Front 21

Bio-hazards

Back 21

A biological agent, chemical, or condition that can be harmful to a person's health.

Front 22

Occupation Safety and Health Organization(OSHA)

Back 22

Classifies materials in the work enviroment according to the degree of hazard to health that they impose. It publishes guidelines for the labeling, handling, spill cleaning and how the material should be disposed of.

Front 23

Material Safety Data Sheet(MSDS)

Back 23

Available for each individual bio-hazard substance stored or used in the nursing facility. The sheets you refer to for the recommended methods of storage, labeling, spill handling and disposal.

Front 24

Bio-terrorism

Back 24

The release of pathogenic microorganisms into a community to achieve political and/or military goals.

Front 25

Chemical Terrorism

Back 25

The use of certain compounds to cause destruction to achieve political and/or military goals. Comes in gas, liquid and solid forms. Healthcare facilities have plans to handle these threats.Types(several), a few are: (1) pulmonary, (2)cyanide, (3)incapacitating and (4)nerve agents and (5)Vesicants.

Front 26

"Dirty Bomb"

Back 26

Radioactive substances attached to an explosive device in order to disperse radiation. You protect from radiation by (1) decreasing your time of exposure to the source, (2) increasing your distance from the source and (3) increasing the barrier between you and the source. Radiation can exist naturally in soil (i.e Uranium)

Front 27

Acute Radiation Sickness(ARS)

Back 27

Develops when most or all of the body is exposed to a high dose of radiation usually over a short period of time. Initial symptoms: nausea, vomiting and diarrhea. Later effects: loss of appetite, fatigue, fever, skin damage, hair loss, potential seizures, coma and death.

Front 28

Common Diseases spread through Bio-terrorism

Back 28

(1)Anthrax, (2)Botulism, (3)Ebola Virus, (4)Lassa fever, (5)Plague, (6)Ricin, (7)Smallpox, and (8)Tularemia. **You should know your institutions policy and procedures for handling victims of a terrorist attack**

Front 29

Military Mission-oriented Protective Posture (MOPP)

Back 29

Suit that may be used by medical personnel after a terrorist attack to protect the skin and body from contamination. It has hooded pull-over top, drawstring trousers and rubber boots and gloves.

Front 30

Decontamination

Back 30

(1)After a terrorist attack all emergency medical personnel must wear suits impervious to chemicals that covers all the skin and a chemical mask with filtered respirator is worn. (2)There is a emergency protocol from local health departments disaster response plan that is followed to decontaminate victims before they enter the hospital.

Front 31

Triage

Back 31

Patients are assessed and labeled as either (1)"immediate"-meaning they require life sustaining care, (2)delayed- those in need of major or prolonged care, that can briefly be delayed, (3)minimal- those with minor injuries and (4) expectant- those that would likely not survive in spite of medical care

Front 32

Treatment

Back 32

Based on the type of agent to which the patient was exposed and the degree of exposure. Either antibiotics are used for biological agents, antidotes are used for chemical and poisonous agents or treatment geared toward supporting organ functions is used while the body recovers

Front 33

Poison

Back 33

A substance that when ingested, inhaled, applied, injected, developed within th body or absorbed may cause functional or structural disturbances. Some don't have antidotes or treatment. Poison control center can be contacted to get treatment or antidotes. When reporting have the name of product, patients age, amount believed to be involved and any symptoms or complaints you observe.

Front 34

Protective Devices

Back 34

Used to be called restraints and were overused in the past. Used in two types of situations: (1) a behavioral health setting in which a patient is in a psychiatric setting or shows a sudden change in mental status/ behavior and (2) non-behavioral usage is for the continuation of medical treatments.

Front 35

Alternatives to protective devices

Back 35

(1)Move to a less restricted environment, (2)frequent observations of the patient and (3) allow family or friends of confused patients to sit with them to promote safety

Front 36

Principles Related use of protective deices

Back 36

(1)Devices must be a direct benefit to the patient. (2)The order for the device(ones that limit or restrict movement) must be written out by the physician before it is applied to the patient. (3)In an emergency the device can be applied but the order must be written as soon as possible. (4)An order has to be written to discontinue the device. (5)The order must specify what device and how long it is to be used. (6)The device must fit snuggly but not restrict circulation or nerve function.(7) the patients position must be changed every 2 hours when wearing the device or exercises are performed during brief removal of device