Suzonne McLean RN MSNOctober 2009

Client SafetySafety and Security is a basic human needIt is 2nd highest priority on Maslow HierarchySafety is freedom from physical or

psychological injury

Client SafetyNurses are responsible to understand all the

different threats to client safetyNurses are responsible to teach clients to

recognize threats and teach ways to reduce threats (smoke detectors)

Client Safety

In the healthcare setting, nurses must always assume client can’t protect self and provide that protection for them (prevent falling, prevent medication error)

A Safe Home Environment1. Basic needs are met2. Physical hazards are reduced3. Transmissions of pathogens are reduced4. Sanitation is maintained5. Noise, Air, Land, Water pollution is controlled6. The threat of terrorist attack is minimized

Environmental Threats: Loss of Oxygen Supply

Carbon Monoxide – colorless, odorless, poison that is commonly caused by:

Improperly functioning heating systemsCar left running in a closed garageGenerators not properly placed on the outside

of the home

Environmental Threats: Loss of Oxygen Supply

Carbon Monoxide binds with hemoglobin No oxygen is being delivered to the tissues hypoxia

Small concentrations of carbon monoxide – nausea, dizziness, fatigue

concentrations of carbon monoxide - death

Environmental Threats: Loss of Oxygen Supply

Prevention Requires:Yearly inspection of heating systems,

chimneys, and fuel burning appliancesCarbon Monoxide Detector for home usePublic education about the correct use of a

generator (never used inside home or partially closed garage)

Food Poisoning

Food not properly stored or contaminated by unsanitary handling susceptible to bacterial infestations which cause food poisoning

Common bacteria: SalmonellaHepatitis A contracted by ingesting food, water,

milk that has been exposed to fecal contamination

Food Poisoning

Client and Restaurant Worker Education is key to prevention

All households should have a working refrigerator with freezer compartment

Clean running water for kitchen and bathroom

All dishes must be thoroughly cleaned before next use

Food Poisoning

All surfaces and utensils that touch raw meat must be thoroughly cleaned before being used with other foods

All food must be thoroughly cooked and stored (no undercooked eggs, no rare meats)

Wash vegetables/fruit carefully

Food Poisoning

Adequate garbage disposalNo handling of animal or human waste

products in the food preparation areaCareful disinfecting of hands after handling

raw meat, going to bathroom, changing diapers, handling animal waste

Hypothermia

Hypothermia – Core body temp is 95° or below

Caused by prolonged exposure to severe coldMost at risk are those who can’t take care of

themselves:

Hypothermia

1. Children 2. Older adults (especially those with

Alzheimer's, dementia)3. Adults with cardiac conditions4. Clients with extreme psychiatric disorders

(does not have reality-based, rational thought process, can’t recognize danger)

Hypothermia

5. Client who has ingested large amounts of alcohol or drugs (judgment impaired)

6. Homeless, Illegal Aliens (no physical protection from the elements)

HyperthermiaHyperthermia – Core body temp is 104-105 °Caused by prolonged exposure to severe heatMost at risk are those who can’t take care of

themselves:1.Infants (left in cars in extreme heat)

Hyperthermia2. Older adults with chronic medical problems

(Renal Failure, Asthma those with Alzheimer's, dementia)

3. Clients with extreme psychiatric disorders (does not have reality-based, rational thought process)

4. Homeless, Illegal Aliens

Accidental Death

• Leading cause of accidental deaths: 1. MVA’s2. Poisonings3. Falls (90% of all fractures in older adult r/t falls

– 50% never regain full mobility)4. Drowning

Accidental Death5. Fires6. Burns7. Risk for injuries and injury prevention

strategies are based on growth and development , i.e. Toddlers at greater risk for choking on marble than school age child because of smaller airway

Physical Hazards: Falls

Most common cause of trauma admissions for the older adult is falls, especially hip fractures

Risk of falls in home for older adult is caused by intrinsic factors (illness, drug therapy)and extrinsic factors (hazards in home)

Physical Hazards: Falls

Common reasons older adults fall at home are:Poor balance/coordination r/t agingUrgency to get to bathroom, especially at night

(Most common reason people fall)

Physical Hazards: Falls• use of some meds can cause dizziness if

standing up too quickly• tripping over small rugs, clutter on floor, small

pet, or electrical cords, • slipping on ice or spilled water from tub bath

Physical Hazards: Falls

• Outside steps, handrails, walkways in disrepair,• Uneven surfaces in house/porch/yard• No grab bars for toilet or tub (falls in/out of tub

common)• Poor lighting in/around house

Physical Hazards: Falls

History of falls most significant risk factor for predicting future falls!!!!!

Other factors: confusion, age over 65, impaired judgment, incontinence

In-Home Fall Prevention• Risks of falls from home can be minimized by

assessing the home environment for several hazards:

• Need for adequate soft, non-glaring lighting(75 watts or lower)

In-Home Fall Prevention

• Adequate lighting of stairs and halls• Adequate outdoor lighting of walkways• Adequate night lighting to allow client to see

way to bathroom or phone

Preventing Falls in the Home

• Repair uneven surfaces, broken steps, poor lighting

• Add grab bars to toilet area• Gripper-type shoes, slippers

Preventing Falls in the Home

• Non-slip floor mats where water may collect on floor

• Skid-resistant strips or mats for the tub• Keep clutter-free environment