Safety

Chapter 26

Safety, Security, and Emergency Preparedness

I. Factors Affecting Safety

a. Developmental Considerations

b. Lifestyle (ex, occupations, recreational activities, environments)

c. Mobility

d. Sensory Perception (ex. Impairment in sight, hearing, smell, taste, touch)

e. Knowledge (awareness of safety and security precaution)

f. Ability to communicate

g. Physical Health State

h. Psychosocial Health State

II. The Nursing Process for Maintaining Safety

a. Assessment

i. Assessing the Individual

1. Nursing History Ð'- ex history of accidents, assistive devices)

2. Physical Examination (assess mobility status, ability to communicate, level of awareness or orientation, sensory perception)

ii. Assessing the Environment (risk in home, community, healthcare agency)

iii. Performing A specific Risk Factor Assessment

1. Falls - especially elderly

2. Fires Ð'- many home fires started because someone smoked in bed or fell asleep while smoking

3. Poisoning

a. Accidental poisoning in children

b. Older person Ð'- inadvertently take overdose of medication

c. Poison Control Centers Ð'- provide checklists for poison-proofing a home and provides lists of toxic household items

4. Suffocation and Choking

a. Asphyxiation Ð'- suffocation

i. Incidence greatest in children

5. Firearm Injuries

b. Nursing Diagnosis

c. Outcome Identification and Planning

d. Implementation

i. Acquiring First-Aid Knowledge

ii. Teaching to Prevent Accidents

iii. Preventing Injury Ð'- Four E's

1. Engineering (Modifying environment)

2. Enforcement (laws/regulations that can modify individual behavior)

3. Education (persuading individual at risk to change behavior)

4. Economics (financial incentives for implementation of injury control measures)

iv. Addressing Developmental Considerations

1. Neonate and Infant

a. Fetus: avoid alcohol, smoking, all drugs, exposure to pesticides, radiation, environmental chemicals

b. Neonate Ð'- place on back to sleep, support head, infant car seat, never leave them unsupervised

c. Infant Ð'- all 50 states mandate use of infant car seats

i. 1 year Ð'- front facing seat

2. Toddler and Preschooler

a. Parents need to childproof home environment

b. Ingestion of poison major threat

c. Be alert to manifestations that indicate child abuse

3. School Aged Ð'- bicycle accidents

4. Adolescents Ð'- motor vehicle accidents, tobacco, body piercing, use of guns

5. Adult Ð'- effects of stress; domestic violence

6. Older Adult Ð'- falls, fires, motor vehicle accidents , burn injuries

v. Orienting Person to Surroundings

vi. Preventing Falls

1. Preventing Falls in Home

a. Installing hand rails in bathroom, ensuring good lighting, discarding or repairing broken equipment

b. "Get up and Go" Test

2. Preventing Falls in Healthcare Facility

a. Restraints Ð'- physical devices used to limit a patients