1. Safety Concerns Throughout the Lifespan

2. Safety Freedom from psychological and physical injury Freedom from psychological and physical injury A basic human need that must be met A basic human need that must be met Nurse must assess environment for safety hazards Nurse must assess environment for safety hazards Maintain safe environment for clients Maintain safe environment for clients

3. Environmental Safety Basic Needs Oxygen Oxygen Nutrition Nutrition Temperature and Humidity Temperature and Humidity

5. Environmental Safety Physical Hazards Lighting Lighting Obstacles Obstacles Bathroom hazards Bathroom hazards Security Security Home Hazard Assessment (P&P pg. 968, Box 37-2) Home Hazard Assessment (P&P pg. 968, Box 37-2)

6. Environmental Hazards Transmission of Pathogens Pathogen: Any microorganism capable of producing an illness Pathogen: Any microorganism capable of producing an illness Medical asepsis Medical asepsis Immunizations Immunizations Standard precautions (transmission of HIV, Hepatitis) Standard precautions (transmission of HIV, Hepatitis) Nosocomial Infections Nosocomial Infections Contact Isolation Contact Isolation STD’s STD’s Adequate disposal of human waste, insect, rodent control Adequate disposal of human waste, insect, rodent control

8. Environmental Safety Pollution Pollutant: harmful chemical or waste material discharged into water, soil, air Pollutant: harmful chemical or waste material discharged into water, soil, air Air pollution Air pollution Water pollution Water pollution Noise pollution Noise pollution Terrorism/Bioterrorism Terrorism/Bioterrorism

10. Safety Risks at Developmental Stages Infant-Preschooler: Injuries, accidents Infant-Preschooler: Injuries, accidents School-Age: Stranger adduction, sport- related injuries, bicycle injuries, School-Age: Stranger adduction, sport- related injuries, bicycle injuries, Adolescent: Smoking, drug and alcohol use, MVA, STD’s Adolescent: Smoking, drug and alcohol use, MVA, STD’s Adult: MVA, smoking related disorders. Stress Adult: MVA, smoking related disorders. Stress Older Adult: Physiologic changes increase risk for falls, MVA’s, home injuries Older Adult: Physiologic changes increase risk for falls, MVA’s, home injuries

11. Individual Risk Factors Lifestyle Lifestyle Impaired Mobility Impaired Mobility Sensory or Communication Impaired Sensory or Communication Impaired Lack of safety awareness Lack of safety awareness

13. Safety Risks in Hospital Preventing Falls/Pressure Ulcers Preventing Falls/Pressure Ulcers Client-Inherent Accidents (Seizures) Client-Inherent Accidents (Seizures) Procedure-related accidents (surgery, chest tube & catheter insertions, med/IV errors) Procedure-related accidents (surgery, chest tube & catheter insertions, med/IV errors) Equipment-related Accidents (electrical hazards, fires from faulty equipment) Equipment-related Accidents (electrical hazards, fires from faulty equipment) Preventing Nosocomial Infections Preventing Nosocomial Infections Preventing Medication Errors Preventing Medication Errors Recognizing changes in client condition Recognizing changes in client condition

14. National Patient Safety Initiatives Joint Commission National Patient Safety Goals Joint Commission National Patient Safety Goals Institute for Healthcare Improvement “5 Million Lives” Campaign Institute for Healthcare Improvement “5 Million Lives” Campaign The Leapfrog Group The Leapfrog Group

15. Joint Commission National Patient Safety Goals Improve the accuracy of patient identification Improve the accuracy of patient identification Improve the effectiveness of communication among caregivers Improve the effectiveness of communication among caregivers Improve the safety of using medications Improve the safety of using medications Reduce the risk of health care-associated infections Reduce the risk of health care-associated infections Accurately and completely reconcile medications Accurately and completely reconcile medications Reduce the risk of patient harm from falls Reduce the risk of patient harm from falls Encourage patients’ active involvement in their own care as a patient safety strategy Encourage patients’ active involvement in their own care as a patient safety strategy The organization identifies safety risks inherent in its population The organization identifies safety risks inherent in its population Improve recognition and responses to changes in a patient’s condition Improve recognition and responses to changes in a patient’s condition

16. The Leapfrog Group Reduce preventable medical mistakes and improve the quality and affordability of health care Reduce preventable medical mistakes and improve the quality and affordability of health care Encourage health providers to publicly report their quality outcomes so consumers can make informed choices Encourage health providers to publicly report their quality outcomes so consumers can make informed choices

17. IHI “5 Million” Lives Campaign” Deploy rapid response teams Deploy rapid response teams Deliver reliable evidence-based care for acute MI Deliver reliable evidence-based care for acute MI Prevent adverse drug events Prevent adverse drug events Prevent central line infections Prevent central line infections Prevent surgical-site infections Prevent surgical-site infections Prevent ventilator-associated pneumonia Prevent ventilator-associated pneumonia

18. Safety and the Nursing Process Assessment Assessment Nursing Diagnosis Nursing Diagnosis Planning Planning Implementation Implementation Evaluation Evaluation

19. Implementation Health Promotion (wearing seat belts, use of car seats, bike helmets, participation in wellness programs) Health Promotion (wearing seat belts, use of car seats, bike helmets, participation in wellness programs) Developmental Interventions: Developmental Interventions: Infant, Toddler, Preschooler Infant, Toddler, Preschooler School-Age School-Age Adolescent Adolescent Adult Adult

20. Implementation Older Adult Reduce the risk for falls and other injuries Reduce the risk for falls and other injuries Compensate for physiological changes related to aging Compensate for physiological changes related to aging MVA prevention (Safe driver tips, eyesight/hearing issues) MVA prevention (Safe driver tips, eyesight/hearing issues) Burn and scald prevention Burn and scald prevention Pedestrian accidents (wear reflectors, walk on sidewalks, cross at light) Pedestrian accidents (wear reflectors, walk on sidewalks, cross at light)

22. Environmental Interventions General Preventive Measures: Meet client needs (Oxygen, nutrition/fluids, temperature) General Preventive Measures: Meet client needs (Oxygen, nutrition/fluids, temperature) Medical Asepsis Medical Asepsis Isolation Precautions Isolation Precautions Environmental lighting Environmental lighting Security measures and concerns Security measures and concerns

23. Specific Safety Concerns Falls (Fall Assessment Tool) Falls (Fall Assessment Tool) Restraints and bed alarms Restraints and bed alarms Side rails, bed height, bed and wheelchair locks Side rails, bed height, bed and wheelchair locks Fires Fires Poisonings Poisonings Electrical Hazards Electrical Hazards Seizures Seizures Radiation Radiation