Patient Safety Ch 27

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    Client SafetyFree from

    Harm

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    Environmental

    Physical Needs – Oxygen

     – Nutrition

     – temperature

    Psychosocial Needs – Acceptance

     – Safety

     – Sense of well being

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    Physical Haards

    !"A#s $alls%% Poisoning &rownings $ires 'urns

    %%$alls are the most common admissioncriteria for older adults

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    Prevention

    Ade(uate lighting

    )emove obstacles

    Provide assistance e(uipment

    Secure environment

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    Psychosocial Haards

    Carbon monoxide

    Poor nutrition

     *emperature extremes

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    +nterventions

    Educate – +nspect home e(uipment

     – S,S of carbon monoxide poisoning

    Home assessment Handwashing

    Physical assessment

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    Other EnvironmentalHaards *ransmission of pathogens Pollution

     – Air- .and- /ater- Noise

     *errorism – 'ioterrorism

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    Safety )is0s of

    &evelopmentalStages

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    +nfant- *oddler- Preschooler

    +n1uries are leading cause of death inchildren 2 3 yr old

    Poisoning Accidents,$alls

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    School Age Child

    Stranger danger Sports in1uries

    'i0e in1uries%% – %%3,4 of all bicycle fatalities occur with

    children b,t 5637yrs

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    Adolescent

    )is06ta0ing behaviors – Smo0ing

     – &rugs

     – Promiscuity

    !"A#s &rownings

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    Adult

    .ifestyle Habits – Alcohol

     – Smo0ing

     – &rugs

     – Stress

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    Older adult

    $alls !"A#s

    'urns !edication errors

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    Physical Assessment $indings that+ncrease )is0s in Older Adults

    !usculos0eletal changes – &ecrease strength and function

    Nervous system changes – Slower reaction time- decrease

    sensitivities

    Sensory changes – Cataracts- impaired hearing,sight

    89 changes – Nocturia- incontinence

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    )is0s in the Health CareSetting !edical errors $alls

    Accidents – Client

     – Procedure

     – E(uipment

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    Nursing +nterventions

    Assessment – Attain a good history :p 4;

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    &ecreasing the !edicalError )is0s

    National Patient Safety 8oals from ?CAHO

    !edication safety procedures Hand6o@ reports &ocumentation

    Healthcare associated infections Surgical re ris0s &ecrease $lu,Pneu ris0s for

    institutionalied patients

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    Nursing +nterventions

    &iagnosis – )eview collected data

     – +dentify related factors,dening

    characteristics – $ormulate nsg diagnoses

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    Nursing &iagnoses

    +mpaired home maintenance )is0 for +n1ury

    Bnowledge decit DDDDDDDDDDDDD  &isturbed thought processes )is0 for poisoning

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    Nurse#s Plan

    Planning – /hat areas can help> :ex Home health-

    P*=

     – +nclude client – Have everyone collaborate together

     – Prioritie

     – Educate

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    Nurse#s Plan

    +mplementation

     – Health Promotion

     – &evelopmental +nterventions

     – Environmental +nterventions

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    EducateFFFFF

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    Environmental +nterventions

    $alls )estraints

    Side rails Seiures $ires

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    )estraints

    9se as a last resort

    Bnow agency policy

    Attach to bed frame only

    Guic0 release tie $re(uent assessment of :usually (3h=

     – S0in- color- temp- sensation

     –

    Pulses distal to the restraint – 'athroom needs

     – Oral needs :water- food- etc=

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    )estraints cont#

    )emove restraints (

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    Heat andCold

    Application

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     *herapeutic E@ectsHeat

    "asodilation )educed blood viscosity

    )educed muscle tension +ncreased tissue metabolism +ncreased capillary permeability

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     *herapeutic E@ectsCold

    "asoconstriction .ocal anesthesia

    )educed cell metabolism +ncreased blood viscosity &ecreased muscle tension

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    "ariables to *olerance

    .ittle body fat Open wounds- bro0en s0in- stomas

    Edema I,or immature scar tissue P"& Confusion,unconscious state

    Spinal cord in1ury .ocalied infection

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     *ypes of Heat and ColdApplications

    !oist hot compress Sit bath,warm soa0

    A(uathermia pads Hypo,hyperthermia blan0ets Cold

     –

    !oist- cold compress – +ce application

     – Polar pac0

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    Safety )is0s +nterventions

    Protect damaged s0in *ime application *est temperature and set Sensitive areas Chec0 fre(uently Bnow the ris0 factors Safely position client

     – Call light%%%

    Educate of reason and location to be

    treated

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    $ire Safety

    Alarms Plan of action

     – )6rescue and remove all clients indanger

     – A6activate the alarm

     – C6conne the re close all

    doors,windows- cut o@ oxygen supply – E6extinguish the re

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    Poison

    Child resistant caps Beep poisonous agents out of reach

    !edicine,Pill organier

    Call the Poison Control Center

    immediately

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    Seiures

    Assess history Pad side rails and headboard Have airway and suction ready

    Side6lying if possible Call !& when seiure begins Stay at 'S- note time began and ended +nform pt what happened Status Epilepticus6medical emergency-

    oral airway if possible :p 4J;=

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    Education is the key!!


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