Chapter 27 Safety, Security, and Emergency Preparedness

Factors That Affect Safety

-Developmental Considerations-lifestyle-Social Behavior-Environment-Mobility-Sensory perception-Knowledge-Ability to communicate-Physical and Psychosocial health state

The Focus of Safety Assessments are ____

-The Person-The Environment-Specific risk factors

During a physical examination you should____

-Assess mobility status, the ability to communicate, the level of awareness or orientation, and sensory perception-Identify potential safety hazards-Recognize manifestations of domestic violence or neglect

Assess a patients history for _____

- Falls or accidents- note assistive devices- any history of drug or alcohol abuse- Knowledge of family support systems and home environment

What Factors Contribute to Falls?

- Lower body weakness- Poor Vision- Gait and/or balance issues- Problems with feet and/or shoes- Use of psychoactive medications- Postural dizziness- Hazards within the home (and community)

Risk Factor Assessments include:

-Falls-Fires-Poisoning -Suffocation and choking-Firearm injuries

What are Patient Outcomes for Safety - Patient will:

- Identify real and potential unsafe environmental situations-Implement safety measures in the environment- Use available resources for safety information- Incorporate accident prevention practices into ADLs- Remain free of injury

What should health teaching in schools look like?

- Monitoring the internet use for children- Getting involved in school activities and asking pertinent questions- Volunteering for safety committees that include staff and parents- Ensuring that the school's emergency preparedness plan is current

Safety considerations for Neonates

- Avoid behaviors that might harm the fetus- never leave the infant unattended- use crib rails- monitor setting for objects that are choking hazards- use car seats properly - handle infant securely while supporting the head- place infant on back to sleep

Safety considerations for toddlers/preschoolers

- supervise child closely to prevent injury- select toys appropriate for developmental level- use appropriate safety equipment in the home- never leave child alone in bathtub- childproof the environment; prevent poisoning- be alert to manifestations of child maltreatment or abuse- use car seats properly- teach about fire safety/practice emergency evacuation measures

Safety Considerations for School-aged children

- Help to avoid activities that are potentially dangerous- provide interventions for safety at home, school, and within the neighborhood- Reinforce teaching about symptoms the require immediate attention- Continue immunizations as scheduled- Teach bicycle safety- each about child abduction- wear seatbelts!!!!!

indications of a concussion

- Physical: headache, vomiting, problems with balance, fatigue, dazed or stunned appearance- Cognitive: mentally foggy, difficulty concentrating and remembering, confusion, forgets recent activities- Emotional: irritability, nervousness, very emotional behavior- Sleep: drowsiness, difficulty falling asleep, sleeping more or less than usual

Safety considerations for Adolescents

- Teach safe driving skills and avoid distracted driving- Teach avoidance of tobacco and alcohol- Emphasize gun safety- Follow healthy lifestyle- Teach about sexuality, STIs, and birth control- Get physical examination before participating in sports- teach risk of infection associated with body modifications such as body piercings and tattoos- teach about guns and violence- discuss the dangers associated with the Internet

Safety considerations for Adults

- Remind them of the effects of stress on lifestyle and health- Enroll in defensive driving course- Counsel about unsafe health habits (reliance/addiction to drugs and/or alcohol)- Evaluate workplace for safety - Counsel about domestic violence

Safety Plans for victims of domestic abuse

- Safety while living with an abusive partner- safety planning with children- safety planning for pets- safety planning during pregnancy- leaving a relationship

Safety considerations for older adults

- Identify Safety hazards in the environment- modify the environment as necessary- Attend defensive driving courses or courses designed for older driversEncourage regular vision and hearing tests- Ensure hearing aids and eyeglasses are available and functioning- Have operational smoke detectors in place- Objective document and report any signs of neglect and abuse

Improvement strategies for Safety

- Preventing Falls Targeted Solutions Tool (TST)- Falls toolkit- Falls Prevention Training program- Root Cause Analysis (RCA)

What does RACE stand for?

R- Rescue anyone in immediate dangerA- Activate the fire code and notify appropriate personsC- Confine the fire by closing doors and windowsE- Evacuate patients and other people to a safe area

What are SOME areas where Procedure-related Accidents/ Possible Errors can occur

- Administering medications or intravenous solutions- Transferring a patient- Changing a dressing- Applying external heat to a patient's extremity

What are things to know about Safety Reports?

- must be completed after any accident or incident in a health care facility that compromises safety- Describes the circumstances of the accident or incident- details the patient's response to the examination and treatment of the patient after the incident- Be completed by the nurse IMMEDIATELY after the incident- IS NOT part of the medical record and should NOT be mentioned in documentation

What are some physiologic and psychologic hazards associated with restraints?

- Increased possibility of serious injury due to fall- Skin breakdown- Contractures- Incontinence- Depression- Delirium- Anxiety- Aspiration and respiratory difficulties- Death

Maintaining Emergency Preparedness should include

- Addressing biological threats- Addressing chemical threats- addressing radiation threats- Addressing cyber terror- preparing for mass trauma terrorism- Identifying disaster resources- Addressing psychological aspects of disasters

Chemicals Used for mass Destruction #1

- Biotoxins- blister agents/ vesicants- Blood agents- Choking/lung/pulmonary agents- Incapacitating agents- Long-acting anticoagulants

Chemicals/Material used for Mass Destruction #2

- Metals- Nerve agents- Organic Solvents- Riot control agents- Toxic alcohols- Vomiting Agents