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72 Cards in this Set
- Front
- Back
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coma
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A risk factor for accidents because of lack of awareness of surroundings, A person in a coma relies on others for protection.
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Risk for Injury: Poison
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A healthhazard and major cause of death.
Poisoning can be either intentional or unintentional. Children and older persons are at risk. Drugs and household products are common poisons. |
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Unintentional poisoning
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The person takes or gives a substance without intending to cause harm. This includes drugs or chemicals used in excessive amounts (overdose)
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Intentional poisoning
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The person takes (suicide) or gives (homicide) a substance with the intent to cause harm.
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Common poisons
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Drugs and vitamins, household products, person care products, fertilizers, inseciticides, bug sprays, lead, house plants, wild mushrooms, alcohol, carbon monoxide
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Lead Poisoning
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inhalation or ingestion of the metal which affects normal body functions. Can injure the brain, nervous system, red blood cells, kidneys, liver, teeth and bones, lower intelligence, and learning /behavior problems. Common in old pipes, batteries, pottery glazes, printing inks, plastics, and dirt. Paint was banned in 1970's. children from 6 months to 6 years and at the highest risk.
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Carbon Monoxide Poisoning
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the person breaths in co instead of oxygen. Red blood cells pick up the co faster than oxygen, so oxygen does not get into the body. CO can damage tissues and cause sudden illness and death. People and animals are at risk. Produced by burning fuel.Death rate highes for people over 65
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Fire and Oxygen Use
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3 things are needed for a fire: a spark or flame, a material that will burn, and oxygen. Safey measures needed: No smoking signs on door and near bed, person/visitor reminded not to smoke in room, smoking materials are removed from the room, electrical items are turned off before being unplugged, wood blankets and synthetic fibers that cause static are removed from room, person wears cotton gown/pajamas, electrical items in good working order, lit candles (etc) are not allowed, materials that ignite easily are removed form the room (grease, nail polish remover)
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suffocation
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common causes: choking, drowning/aspiration, inhaling gas or smoke, strangulation (restraints, call lights), electrical shock ( damaged equipment)
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Prevent suffocation
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cut food into small, bite-sized pieces, avoid foods that pose choking hazard, check dentures for a good fit, difficulty swallowing, elevate head of beds
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choking
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FBAO, foreign bodies obstruct airway, air cannot pass through the air passages to the lungs, body does not get enough oxygen, can lead to cardiac arrest, often occurs during eating, can occur in unconscious person. (aspiration of vomitus and tongue falling back into airway)
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Mild obstruction
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some air moves in and out of the lungs, person is conscious, usually person can speak, forceful coughing may remove object, breathing may sound like wheezing, encourage to keep coughing to expell
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severe obstruction
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-conscious person clutches at throat, person has difficulty breathing, person may not be able to breathe, speak or cough, if person can cough the cough is of poor quality, wehn person inhales either no noise or high-pitched noice, infants cannot cry, person may appear pale and cyanotic, air does not move in or out of lungs, conscious person is frightened, if obstruction not removed person will die
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Relieving choking
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abdominal thrusts are used for severe airway obstructions (can be done while person, sits, stands, or lies down), chest thrusts are used for the very obese and pregnant. Call for help, in agency activate RRT, in public area dial 911
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Safe Medical Devices Act
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Requires that agencies report equipment-related illness, injuries, and deaths to provide for great safety incase of manufacturer recall, etc.
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Spills
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Clean spills up at once working from clean areas to dirty areas in circular motions. Wear PPE when cleaning up spills and leaks. Consult MSDS to know how to clean up spill and what ppe is needed
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MSDS
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Every hazardous substance has an MSDS which provides info on: chemical name/common names, ingredients, physical/chemical characteristics, potential physical effects, conditions that could cause chemical reaction, how chemical enters body, health hazards (signs/symptoms), Protective measures, emergency/first aid info, explosion info and fire-fighting measures, how to clean up, ppe needed, how to dispose, manufacturer information
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OSHA/hazardous materials
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OSHA requires that health employees: understand the risks of hazardous substances, know how to safely use them. Requires a hazard communication program
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OSHA Hazard communication program
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container labeling, material safety data sheets, employee training. Agency must provide eyewash and total body wash stations where hazardous materials are used
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smoke
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If present cover nose and mouth with damp cloth and do the same for patients, residents, visitors, and other staff, have everyone crawl to nearest exit
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RACE
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Rescue, alarm, confine, extinguish/evacuate
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Spills
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Clean spills up at once working from clean areas to dirty areas in circular motions. Wear PPE when cleaning up spills and leaks. Consult MSDS to know how to clean up spill and what ppe is needed
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PASS
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Pull the pin, Aim low, sqeeze trigger, sweep back and forth base
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MSDS
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Every hazardous substance has an MSDS which provides info on: chemical name/common names, ingredients, physical/chemical characteristics, potential physical effects, conditions that could cause chemical reaction, how chemical enters body, health hazards (signs/symptoms), Protective measures, emergency/first aid info, explosion info and fire-fighting measures, how to clean up, ppe needed, how to dispose, manufacturer information
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Violence prevention programs
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OSHA has guidelines for violence prevention programs; the goal is to prevent or reduce employee exposure to situations that can cause death or injury. Many have inservices training staff in alarms, help, safety plans, alerts, male presence, notify situations
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OSHA/hazardous materials
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OSHA requires that health employees: understand the risks of hazardous substances, know how to safely use them. Requires a hazard communication program
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Risk Factors for workplace violence (healthcare)
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people with weapons, police holds, acutely disturbed and violent people seeking healthcare, alcohol/drug abuse, mentally ill persons who dont take prescribed drugs, pharmacies have drugs and are a target for robbery, gang members/substance abusers as patients, upset/agitated/disturbed family and visitors, long waits in ED, being alone with person during care/transport, low staff levels, poor lighting in hallways, rooms, parking lots, lack of training.
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OSHA Hazard communication program
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container labeling, material safety data sheets, employee training. Agency must provide eyewash and total body wash stations where hazardous materials are used
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Risk of Fall
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increases with age, a history of falls increases the risk of falling again, most common acciden in nursing centers
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smoke
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If present cover nose and mouth with damp cloth and do the same for patients, residents, visitors, and other staff, have everyone crawl to nearest exit
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RACE
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Rescue, alarm, confine, extinguish/evacuate
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PASS
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Pull the pin, Aim low, sqeeze trigger, sweep back and forth base
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Violence prevention programs
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OSHA has guidelines for violence prevention programs; the goal is to prevent or reduce employee exposure to situations that can cause death or injury. Many have inservices training staff in alarms, help, safety plans, alerts, male presence, notify situations
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Risk Factors for workplace violence (healthcare)
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people with weapons, police holds, acutely disturbed and violent people seeking healthcare, alcohol/drug abuse, mentally ill persons who dont take prescribed drugs, pharmacies have drugs and are a target for robbery, gang members/substance abusers as patients, upset/agitated/disturbed family and visitors, long waits in ED, being alone with person during care/transport, low staff levels, poor lighting in hallways, rooms, parking lots, lack of training.
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Risk of Fall
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increases with age, a history of falls increases the risk of falling again, most common accident in nursing centers
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Causes/risk factors-falls
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most falls occur in patient/resident rooms and bathrooms (causes: poor lighting, cluttered floors, throw rugs, and out-of-place furniture, wet/slippery floors, bathtubs, showers), neededin gto use the bathroom (urinating) is major cause of falling; most falls occur between 1800-2100 (and during shift changes)
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Fall Prevention Programs
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Agencies have these programs to provide: common sense and simple safety measures can prevent many falls, the health team works with the person/family to reduce the risk of falls, goal is to prevent falls without decreasing quality of life
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Identifying the person
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must give care to correct person. person receives an id bracelet, carefuly compare identifying information on assignment sheet with that on the ID bracelet, use at least 2 identifiers, call person by name when checking id bracelet
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Reporting injury
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Report accidents and errors at once including: accidents involving patients, residents, visitors, or staff, errors in care (giving care to wrong person, giving wrong care, not giving care), broken or lost items owned by person, lost money or clothing, hazardous substance incidents, workplace violence incidents. Should be reported as soon as possible after incident
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Bedrail Safety
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Bed rails are raised and lowered, lock in place with levers, latches, or buttons, are half, three quarters, or full length of bed, nurse/careplan tell you when to raise bed rails, are needed by persons who are unconscious or sedated with drugs, some confused or disoriented people, if a person needs bed rails keep them up at all times except when giving bedside nursing care.
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Bedrails Hazard/Restraint
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Bedrails can be hazards as there is a risk of entrapment, considered restraints if person cannot get out of bed or lower them without help. Accrediting agency standards and federal/state laws affect bed rail use
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If bed rails are in use
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check the person often, report to the nurse that you checked the person, chart, record when you checked the person and your observations
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Hand rails/Grab bars
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Are used in hallways and stairways to give support to persons who are weak or unsteady when moving. In bathrooms and shower/tub rooms they provide support for sitting and getting up from toilet, are used for getting in and out of hte shower/tub. Bed wheels are locked at all times except when moving the bed, and wheelchair and stretcher wheels are locked during transfers
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Transfer/Gait belt precaustions
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do not leave excess strap hanging, remove belt after use, do not use for person if has: ostomy-colostomy, ileostomy, urostomy; a gastronomy tube, chronic obstructive pulmonary disease (COPD); an abdominal wound, incision, or drainage tube; monitoring equipment; a hernia; or other conditions or equipment involving the chest or abdomen
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Causes for falling
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weakness, light-headedness, or dizziness, fainting, slipping/sliding on spills, waxed floors, throw rugs, or improper shoes
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Helping a falling person
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Do not try to prevent the fall-if person starts to fall ease person to the floor, do not let person move or get up before checked for injuries, complete an incident report for all falls
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CMS Rules for use of Restraints and Seclusion (2006)
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Rules apply to all agencies receiving funds from Medicare/Medicaid. Must only be used for immediate physical safety of the person, staff or others; only used when less restrictive measures fail to protect person, staff or others; must be discontinued at the earliest possible time
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Guidelines for Restraint and Seclusion
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FDA and JC have guidelines for use of restraints and seclusion. They require alternative restraints to be tried first. Every agency has policies and procedures about the use of restraints and seclusion. Staff have mandatory training to learn to identify at risk patients in order to place precautions
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Restraint Alternatives
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Focus on the reason behind the behavior, may be able to help fix the cause; alternatives are identified and put into care plan. Examples: diversion; habits/routine followed; family/friends make videos; time is spend in supervised areas; pillow, wedge cushions, posture aids are used; signal light within reach; food, fluid, hygeine, and elimination needs met; back massages; companions/sitters; extra time spent with the restless; calm quiet setting; exercise programs; outdoor time; sleep not interrupted
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Risks of Restraints
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Agitation, anger, constipation, contractures, cuts/bruises, decline in physical function, dehydration, delirium, depression, loss of dignity, embarrassment/humiliation, falls, fractures, head trauma, incontinence, infections, mistrust, nerve injuries, pressure ulcers, self-respect, social contact reduced, stragulation, withdrawl
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Chain of infection
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source; resevoir, portal of exit, method of transmission, portal of entry, susceptible host
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Populations are risk for infection
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Burn patients- skin is destroyed leaving a wound as a portal of entry for microbes, and immune system is weakened so ability to fight infection is reduced.
Transplant patients-drugs are given to suppress immune system so body will not reject transplanted organ reducing antibodies which lessen the ability to fight infection. Chemotherapy- affect ability to produce WBC, WBC needed to fight infection |
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Healthcare Associated Infection HAI
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Caused by normal flora or by microbes transmitted from other sources.
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Possible HAI
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Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE), RSV, Influenza, HIV, Hepatitis A,B,C, Clostridium Difficile, Tuberculosis, Gastro-intestinal infections
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Common sites for HAI
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urinary system, respiratory system, wounds, bloodstream
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Medical Asepsis
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used to remove or destroy pathogens, prevent pathogens from spreading from on person/place to another.
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Surgical Asepsis
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practice of keeping an area or item free of all microbes
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Standard Precautions
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A part of the CDC's isolation precautions which reduce the risk of spreading pathogens. They are used for all persons whenever care is given. Prevent the spread of infection from blood, body fluids, secretions, excretions, non-intact skin, and mucous membranes
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Transmission based Precautions
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CDC isolation guidelines for people based on type of disease and how it is transmitted.
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Contact Precautions
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Used for persons with known or suspected infections or conditions that increase the risk of contact transmission. Placement: a single room preferred, if shared keep curtain closed, change ppe when treating other person in room, gloves, gown, Patient transfer-limit transport, cover area of body that is infected, remove ppe, don clean ppe at destination, use disposable equip when possible, clean and disinfect non-disposable equip
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Droplet Precautions
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used for persons known/suspected to be infected with pathogens transmitted by respiratory droplets (coughing, sneezing, talking), single room preferred, if shared keep curtain pulled, change ppe for other patient care, don mask, transport limited, person wears mask, no mask needed for those transporting
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Airborne precautions
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used for infections with pathogens transmitted person-person by airborne route (TB, measles, chickenpox, smallpox, SARS), placed in Airborne Infection Isolation Room, staff susceptible are restricted, PPE and approved respirator, transport limited, person wears surgical mask, cover skin lesions, no mask or respirator needed for transport team
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Bloodborne pathogen Standard
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Intended to protect health team from exposure. Regulated by OSHA. HIV/HBV are found in blood, are bloodborne pathogens, exit the body through blood and spread to others by blood
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Exposure Control plan
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identifies staff at risk for exposure to blood OPIM, includes actions to take for an exposure incident, staff at risk receive free training upon employment and then yearly, training is required for new/changed tasks involving exposure to bloodborne pathogens
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Isolation precautions
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based on clean and dirty. Clean areas/objects are free of pathogens, dirty areas/objects are contaminated with pathogens, clean and dirty also depend on how a pathogen is spread. Precautions precent the spread of communicable diseases. Blood, body fluids, secretions, and excretions can transmit pathogens and sometimes barriers are needed to prevent their escape
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Supplies and equipment
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most equipment is disposable, single-use items are discarded after use, do not borrow a multi-use item for another patient, non-disposable items are cleaned, disinfected, and sterilized
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Disinfection and cleaning
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Cleaning reduces the # of microbes present and removes organic matter. Disinfection destroys pathogens (not spores). Germicide is a disinfectant for skin, tissue, and non-living objects. Chemical disinfectants are used to clean surfaces. Sterilization kills all pathogens and non-pathogens including spores
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Code 4-Total Dependence
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person cannot help with transfer, task is done by staff. person is lifted/transferred with a full-sling mechanical lift for transfers between beds, chairs, and toilets, bathtubs and weighing scales
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Code 3:Extensive Assistance
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person can bear some weight, can sit up with help, and mey be able to pivot to transfer. person is lifted/transferred with mechanical lift between beds, charis, toilets, bathtubs, and scales. Type of lift is noted in care plan
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code 2: Limited Assistance
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person is highly involved in moving/transfer procedure. needs some help moving legs but can stand and bear weight, has upper body strength, can pivot transfer. stand-assist devices may be used (gait/transfer belt) sliding boards are useful
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code1: supervision
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staff need to look after, encourage, or cue person. devices for code 2 may be used
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code 0-independent
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person can walk without help, sometimes may need limited assistance
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