Safety Concerns Safety Concerns Throughout the Throughout the

LifespanLifespan

SafetySafety

Freedom from psychological and Freedom from psychological and physical injuryphysical injury

A basic human need that must be A basic human need that must be metmet

Nurse must assess environment for Nurse must assess environment for safety hazardssafety hazards

Maintain safe environment for clientsMaintain safe environment for clients

Environmental SafetyEnvironmental SafetyBasic NeedsBasic Needs

OxygenOxygen

NutritionNutrition

Temperature and Temperature and HumidityHumidity

Environmental SafetyEnvironmental SafetyPhysical HazardsPhysical Hazards

LightingLighting ObstaclesObstacles Bathroom hazardsBathroom hazards SecuritySecurity Home Hazard Assessment (P&P pg. Home Hazard Assessment (P&P pg.

968, Box 37-2)968, Box 37-2)

Environmental HazardsEnvironmental HazardsTransmission of PathogensTransmission of Pathogens

Pathogen: Any microorganism capable of Pathogen: Any microorganism capable of producing an illnessproducing an illness

Medical asepsisMedical asepsis ImmunizationsImmunizations Standard precautions (transmission of HIV, Standard precautions (transmission of HIV,

Hepatitis)Hepatitis) Nosocomial InfectionsNosocomial Infections Contact IsolationContact Isolation STD’sSTD’s Adequate disposal of human waste, insect, Adequate disposal of human waste, insect,

rodent control rodent control

Environmental SafetyEnvironmental SafetyPollutionPollution

Pollutant: harmful chemical or waste Pollutant: harmful chemical or waste material discharged into water, soil, material discharged into water, soil, airair

Air pollutionAir pollution Water pollutionWater pollution Noise pollutionNoise pollution Terrorism/BioterrorismTerrorism/Bioterrorism

Safety Risks at Developmental Safety Risks at Developmental StagesStages

Infant-Preschooler: Injuries, accidentsInfant-Preschooler: Injuries, accidents School-Age: Stranger adduction, sport-School-Age: Stranger adduction, sport-

related injuries, bicycle injuries,related injuries, bicycle injuries, Adolescent: Smoking, drug and alcohol Adolescent: Smoking, drug and alcohol

use, MVA, STD’suse, MVA, STD’s Adult: MVA, smoking related disorders. Adult: MVA, smoking related disorders.

StressStress Older Adult: Physiologic changes Older Adult: Physiologic changes

increase risk for falls, MVA’s, home increase risk for falls, MVA’s, home injuries injuries

Individual Risk FactorsIndividual Risk Factors

LifestyleLifestyle Impaired MobilityImpaired Mobility Sensory or Communication ImpairedSensory or Communication Impaired Lack of safety awarenessLack of safety awareness

Safety Risks in HospitalSafety Risks in Hospital

Preventing Falls/Pressure UlcersPreventing Falls/Pressure Ulcers Client-Inherent Accidents (Seizures)Client-Inherent Accidents (Seizures) Procedure-related accidents (surgery, chest Procedure-related accidents (surgery, chest

tube & catheter insertions, med/IV errors)tube & catheter insertions, med/IV errors) Equipment-related Accidents (electrical Equipment-related Accidents (electrical

hazards, fires from faulty equipment)hazards, fires from faulty equipment) Preventing Nosocomial InfectionsPreventing Nosocomial Infections Preventing Medication ErrorsPreventing Medication Errors Recognizing changes in client conditionRecognizing changes in client condition

National Patient Safety National Patient Safety InitiativesInitiatives

Joint Commission National Patient Joint Commission National Patient Safety GoalsSafety Goals

Institute for Healthcare Institute for Healthcare Improvement Improvement “5 Million Lives” Campaign“5 Million Lives” Campaign

The Leapfrog GroupThe Leapfrog Group

Joint Commission National Joint Commission National Patient Safety GoalsPatient Safety Goals

Improve the accuracy of patient identificationImprove the accuracy of patient identification Improve the effectiveness of communication Improve the effectiveness of communication

among caregiversamong caregivers Improve the safety of using medicationsImprove the safety of using medications Reduce the risk of health care-associated Reduce the risk of health care-associated

infectionsinfections Accurately and completely reconcile medicationsAccurately and completely reconcile medications Reduce the risk of patient harm from fallsReduce the risk of patient harm from falls Encourage patients’ active involvement in their Encourage patients’ active involvement in their

own care as a patient safety strategyown care as a patient safety strategy The organization identifies safety risks inherent in The organization identifies safety risks inherent in

its populationits population Improve recognition and responses to changes in Improve recognition and responses to changes in

a patient’s conditiona patient’s condition

The Leapfrog GroupThe Leapfrog Group

Reduce preventable medical Reduce preventable medical mistakes and improve the quality mistakes and improve the quality and affordability of health careand affordability of health care

Encourage health providers to Encourage health providers to publicly report their quality outcomes publicly report their quality outcomes so consumers can make informed so consumers can make informed choiceschoices

IHI “5 Million” Lives IHI “5 Million” Lives Campaign”Campaign”

Deploy rapid response teamsDeploy rapid response teams Deliver reliable evidence-based care Deliver reliable evidence-based care

for acute MIfor acute MI Prevent adverse drug eventsPrevent adverse drug events Prevent central line infectionsPrevent central line infections Prevent surgical-site infectionsPrevent surgical-site infections Prevent ventilator-associated Prevent ventilator-associated

pneumoniapneumonia

Safety and the Nursing Safety and the Nursing ProcessProcess

AssessmentAssessment Nursing DiagnosisNursing Diagnosis PlanningPlanning ImplementationImplementation EvaluationEvaluation

ImplementationImplementation

Health Promotion (wearing seat Health Promotion (wearing seat belts, use of car seats, bike helmets, belts, use of car seats, bike helmets, participation in wellness programs)participation in wellness programs)

Developmental Interventions: Developmental Interventions: Infant, Toddler, PreschoolerInfant, Toddler, Preschooler School-AgeSchool-Age AdolescentAdolescent AdultAdult

ImplementationImplementationOlder AdultOlder Adult

Reduce the risk for falls and other Reduce the risk for falls and other injuriesinjuries

Compensate for physiological changes Compensate for physiological changes related to agingrelated to aging

MVA prevention (Safe driver tips, MVA prevention (Safe driver tips, eyesight/hearing issues)eyesight/hearing issues)

Burn and scald preventionBurn and scald prevention Pedestrian accidents (wear reflectors, Pedestrian accidents (wear reflectors,

walk on sidewalks, cross at light)walk on sidewalks, cross at light)

Environmental InterventionsEnvironmental Interventions

General Preventive Measures: Meet General Preventive Measures: Meet client needs (Oxygen, nutrition/fluids, client needs (Oxygen, nutrition/fluids, temperature)temperature)

Medical AsepsisMedical Asepsis Isolation PrecautionsIsolation Precautions Environmental lightingEnvironmental lighting Security measures and concernsSecurity measures and concerns

Specific Safety ConcernsSpecific Safety Concerns

Falls (Fall Assessment Tool)Falls (Fall Assessment Tool) Restraints and bed alarmsRestraints and bed alarms Side rails, bed height, bed and wheelchair Side rails, bed height, bed and wheelchair

lockslocks FiresFires PoisoningsPoisonings Electrical HazardsElectrical Hazards SeizuresSeizures RadiationRadiation