1. 7 Safety and Body Mechanics 1. Define important words in this chapter aspiration: inhaling food or drink into the lungs. atrophy: weakening or wasting of muscles. body mechanics: the way the parts of the body work together when you move. chemical restraint: medications used to control a person’s behavior.

2. 7 Safety and Body Mechanics 1. Define important words in this chapter (con’t) combustion: the process of burning. cyanosis: blue or pale skin and/or mucous membranes due to decreased oxygen in the blood. disorientation: confusion about person, place and time. dysphagia: difficulty in swallowing.

3. 7 Safety and Body Mechanics 1. Define important words in this chapter (con’t) flammable: easily ignited and capable of burning quickly. hoarding: collecting and putting things away in a guarded way. Material Safety Data Sheet (MSDS): sheets that provide information on the safe use, hazards, and emergency steps to take when using chemicals. PASS: acronym for use of a fire extinguisher; stands for Pull-Aim- Squeeze-Sweep.

4. 7 Safety and Body Mechanics 1. Define important words in this chapter (con’t) postural support: device that maintains good posture or body alignment; also considered a restraint. protective device: device that maintains good posture or body alignment; also considered a restraint. RACE: acronym for steps taken during a fire; stands for Remove- Activate-Contain-Extinguish. restraint: a physical or chemical way to restrict voluntary movement or behavior.

5. 7 Safety and Body Mechanics 1. Define important words in this chapter (con’t) restraint alternatives: measures used instead of physical or chemical restraints. restraint-free: an environment in which restraints are not kept or used for any reason. scalds: burns caused by very hot liquids. slip knot: a special quick-release knot used to tie restraints.

6. 7 Safety and Body Mechanics 1. Define important words in this chapter (con’t) suffocation: death from a lack of air or oxygen. synthetic: artificial or man-made.

7. 7 Safety and Body Mechanics 2. List common accidents in facilities and ways to prevent them Common accidents in facilities include: Falls Resident Misidentification Burns/Scalds Poisoning Choking Cuts and Other Injuries

8. 7 Safety and Body Mechanics 3. Explain the Material Safety Date Sheet (MSDS) OSHA requires that all dangerous chemicals have an MSDS. The information the MSDS provides includes: The chemical ingredients of the product The dangers of the product The protective items to wear when using the product The correct method of using and cleaning up the product The emergency response needed when the product is spilled or splashed The safe handling procedures for the product

9. 7 Safety and Body Mechanics 4. Describe safety guidelines for sharps and biohazard containers For safe use of sharps and biohazard containers: Always wear gloves. Keep your hands above the opening of the biohazard container. Only touch the bottom of a biohazard container. Replace the sharps container when it’s ¾ full. Use the biohazard container for anything contaminated with infectious waste. Wash your hands after putting anything into the sharps container or biohazard container.

10. 7 Safety and Body Mechanics 5. Explain the principles of body mechanics and apply them to daily activity Body mechanics is the way the parts of the body work together when you move. The basic principles of body mechanics are: Alignment Center of gravity Base of support

11. 7 Safety and Body Mechanics Transparency 7-1: Body Alignment

12. 7 Safety and Body Mechanics Transparency 7-2: Lifting Heavy Objects from the Floor

13. 7 Safety and Body Mechanics Transparency 7-3: When a Resident is Restrained The resident must be checked at least every 15 minutes. At least every two hours the following must be done: Release the restraint for at least 15 minutes. Offer assistance with toileting. Check for episodes of incontinence and provide care. Offer fluids. Reposition the resident. Ambulate resident if able.

14. 7 Safety and Body Mechanics 6. Define two types of restraints and discuss problems associated with restraints Physical restraints restrict voluntary movement or behavior. Chemical restraints are medications used to control a person’s behavior.

15. 7 Safety and Body Mechanics 7. Define the terms “restraint free” and “restraint alternatives” and list examples of restraint alternatives Restraint-free care means that restraints are not kept or used for any reason. Restraint alternatives are creative ideas that help avoid the need for restraints and include: Taking the resident for a walk Answering the call light immediately Getting the resident involved with hobbies, etc.

16. 7 Safety and Body Mechanics 8. Describe beginning and ending steps in care procedures Beginning steps (for most care procedures) Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. Explain the procedure to resident. Provide for the resident’s privacy with a curtain, screen, or door. Practice good body mechanics.

17. 7 Safety and Body Mechanics 8. Describe beginning and ending steps in care procedures (con’t) Ending steps (for most care procedures) Make resident comfortable. Return bed to low position, if raised. Ensure resident’s safety. Remove privacy measures. Leave call light within resident’s reach. Wash your hands. Report any changes in the resident to the nurse. Document procedure using facility guidelines.

18. 7 Safety and Body Mechanics 9. Identify what must be done if a restraint is ordered Restraints are used only after everything else has been ruled out and only with a doctor’s orders. Guidelines for restraints: Know your state’s laws. Follow manufacturer’s instructions. Use the correct size and style of restraint. Always use a slip knot. Never tie the restraint to side rails.

19. 7 Safety and Body Mechanics 9. Identify what must be done if a restraint is ordered (con’t) Guidelines for restraints (con’t): Ensure that the restraint is not too tight. Apply vest or belt restraint over clothing. Place the call light within resident’s reach. Document all information.

20. Applying a Physical Restraint Tie Safely Equipment: correct size and type of restraint 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. Encourage resident to assist if possible.

21. Applying a Physical Restraint Tie Safely 4.Provide for the resident’s privacy with a curtain, screen, or door. 5.Apply the restraint carefully. Follow manufacturer’s directions and facility policy. For each type of restraint, make sure that it is not too tight. 6.CHEST or BELT-STYLE RESTRAINTS: Make sure you do not catch breasts or skin in the restraints. Double-check before actually tying together or attaching buckle.

22. Applying a Physical Restraint Tie Safely 7.VEST: The criss-cross in the vest restraint must be placed on the front of the body. 8.MITT: Place a rolled-up washcloth or commercial hand roll in the mitt restraint. This helps the hand stay in proper alignment and helps prevent contractures (permanent and painful shortening of a muscle).

23. Applying a Physical Restraint Tie Safely 9.WRIST/ANKLE: Make sure the restraint will not slide off the wrist or ankle. 10.Use slip knot to tie the restraint. Make sure it is not too tight. If restraint is used on a resident who is in bed, tie it to the movable part of the bed frame. Do not tie it to the side rail. 11.Make resident comfortable.

24. Applying a Physical Restraint Tie Safely 12.Be courteous and respectful at all times. 13.Report any changes in the resident to the nurse. Document procedure using facility guidelines. 14.Check resident every 15 minutes. (Residents with mitt restraints must be checked every five minutes because they are unable to use the call light.)

25. Applying a Physical Restraint Tie Safely (con’t) Release the restraint(s) every two hours for at least 15 minutes and provide all care, such as giving fluids, toileting, walking (if ambulatory), or range of motion exercises.

26. 7 Safety and Body Mechanics 10. List safety guidelines for oxygen use Guidelines for safety with oxygen: Post “No Smoking” and “Oxygen in Use” signs. Remove fire hazards from the room. Remove flammable liquids from the room. Do not allow candles, lighters, or matches around oxygen. Residents must not wear wool, nylon, or other synthetic clothing. Check the residents nasal area and behind the ears for irritation. Learn how to turn off oxygen in case of fire.

27. 7 Safety and Body Mechanics 11. Identify safety guidelines for intravenous (IV) lines Do not: Take blood pressure on an arm with an IV. Get the IV site wet. Pull on or catch the tubing. Leave the tubing kinked. Lower the IV bag below the IV site. Touch the clamp. Disconnect the IV or the alarm.

28. 7 Safety and Body Mechanics 11. Identify safety guidelines for intravenous (IV) lines (con’t) Notify nurse if the following occurs: The needle or catheter has fallen out or moves out of the vein. The armboard becomes loose. The tubing is disconnected. Blood appears in the tubing. The IV fluid in the bag is gone or almost gone. The IV pump is beeping, etc.

29. 7 Safety and Body Mechanics 12. Discuss fire safety and explain the “RACE” and “PASS” acronyms RACE – in case of fire: Remove residents from danger Activate alarm (or call 911) Contain the fire by closing doors and windows, if possible Extinguish the fire PASS – to use an extinguisher Pull the pin Aim at the base of the fire when spraying Squeeze the handle Sweep back and forth at the base of fire

30. 7 Safety and Body Mechanics 13. List general safety steps to protect yourself and residents in a facility Keep valuable personal items at home. Ask the nurse to lock up residents’ valuable items. If a visitor or staff member makes you uneasy, do not leave resident alone with him. Follow guidelines for number of visitors allowed at one time in a resident’s room. Do not share staff or resident information with anyone.