SafetyUnit 8

Situations or conditions that influence safety

• Confusion or forgetfulness resulting in faulty judgment.

• Impaired mobility due to such conditions as dizziness, tremors, weakness, slowed reflexes or response time.

• Side effects from medications may include impaired mobility and confusion.

Situations or conditions that influence safety

continued…• Sensory impairment– Vision-clarity or field of vision may be

diminished(macular degeneration, CVA, or brain injury)

– Hearing-ability to hear warning sounds.

– Diminished sense of smell and taste(cannot identify warning odors)

Situations or conditions that influence safety

continued..• Diminished sense of touch and temperature.– Cannot identify warning sensations of

pressure, heat or cold

Safety Precautions to prevent resident falls

• Among older adults, fall are the leading cause of injury deaths.– Clothing

• Non-slip soles on resident’s shoes.• Shoe strings tied.• Long gowns or robes may cause resident

to trip

Preventing Falls• In a resident’s room

– Items that resident uses frequently are kept within reach.

– Answer call signal promptly. Provide needed assistance to resident before he/she takes unsafe action.

– Provide a clear walking path through room.– Provide adequate light to see where one is

walking.

Preventing Falls in res room continued…

– Spills in any walking area promptly wiped dry.

– Electrical devices properly used(cords out of walking path, no extension cord, intact electrical cord and outlet)

– Bed kept in the lowest position– No throw rugs– Use brakes or wheel locks appropriately

while transferring resident from one surface to another.

Preventing Falls in Hallway• Encourage ambulating residents to

use handrails.

• Keep hallways clear of objects.

• Do not store w/c or other items in hallway(Also a fire hazard)

Preventing Falls when Toileting

• Assist resident with toileting on a regular basis as needed and according to plan of care.– Use of lifts????– Get other staff if needed– Watch for “accidents” on the floor

and clean if necessary prior to getting resident off of toilet.

Reporting Hazard/Potential Hazards

• Report to nurse any resident behavior that made him/her at risk for falling.

• Malfunctioning equipment must be removed from use until safe.– Follow facility policies on removing

equipment that is not working.

Safety Precautions to prevent resident burns

• Provide mealtime assistance to resident as needed to prevent spilling or swallowing foods or liquids that are too hot.

• Water temperature– Check water temperature before assisting

resident with bath or shower.– Report water temperature that seems too

hot.

Safety precautions to prevent resident burns

continued…• Monitor resident during bathing so that they do not change water temperature to an unsafe level.

• Monitor resident activity when they are in a food preparation area or an area where hot equipment such as steam tables are present.

• Devices that produce heat or cold should be carefully monitored while in use. Decreased sensory perception may allow tissue damage.

Smoking• Some facilities may permit• Allowed only in designated

smoking areas. (20 feet from main entrance)

• Provide supervision• Resident may wear a protective

smoking apron

Safety precautions to prevent electrical injury

• Report malfunctioning equipment, faulty plugs or outlets and frayed cords immediately.

• Follow facility policy for electrical safety.– Some require that any electrical device

brought in by resident/family must be checked by maintenance before use.

– NO SPACE HEATERS

Safety precautions for chemicals

• Assume that an unlabeled bottle or container contains harmful material. DO NOT USE.

• Container label will give instructions for safe use of contents.

• Potentially harmful substances should be kept in locked cabinet when not in use.– While being used, the container needs to be under

visual control of the staff member.• Soap• Nail polish and remover• Topical(skin) medications

Safety precautions for chemicals continued…

• Facility will keep Material Safety Data Sheets (MSDS) for chemicals in the workplace.

• MSDS sheets describe safe use and first aid measures

• KNOW WHERE THIS MANUAL IS AT!!!!!

Safety precautions for choking

Present food and liquids to res in a form that the resident can handle(cut up, chopped, thickened)

Observe for symptoms of partial or complete airway obstruction.

Use standard procedure for correcting airway obstruction:– Resident symptoms– Rescuer position and action– After care

Safety precautions for O2 use

• Precautions for O2 safety should be posted outside resident room when O2 is used.

• Limit any situations that might start a fire because O2 supports combustion.– NO SMOKING – Check with the nurse before using any

electrical equipment while the resident is receiving O2

– Follow facility policies

O2 safety• Observe O2 flow rate setting,

reports to nurse if flow rate is not at ordered rate.– COPD

• Secure O2 tank so that it does not fall.

Fires• Follow facility’s emergency plan.

Know the plan prior to emergency. Knowledge of the plan is both the responsibility of the employer and employee.

R.A.C.E• RESCUE-remove residents who are in

immediate danger.• ALERT-activate the fire alarm. Let others

know about the fire emergency.• CONFINE OR CONTAIN- isolate the fire

by closing doors and windows.• EXTINGUISH/EVACUATE- Attempt to put

out the fire if safe to do so. Remove resident to safety as part of facility evacuation plan

Fire Extinguisher - PASS• P-pull pin• A-aim toward the base of the flame• S-squeeze the handle to start the

flow of extinguishing material.• S-sweep spray from the

extinguisher side to side at the base of the fire.

Evacuation• Evacuate building if directed to do

so.– Use resident’s beds and w/c ’ s if

possible.

– Use evacuation carries to remove non-mobile resident from a fire area, if other safer means of evacuation are not available• One person carries, such as blanket drag,

hip carry, pack-strap carry• Two person carries, such as chair carry

and extremities carry• Four person blanket carry.

Severe Weather/Tornados• Plan usually includes moving resident

to a safe area.– The facility will designate an area that is

structurally strong.– Get away from windows and close blinds.– Protect the resident from flying broken

glass with blankets.– Gather plenty of blankets

Other possible emergencies

• Flood• Chemical spill• Violence• Prolonged power outage• Prolonged disruption of water

supply

Safety for resident elopement or exiting

• Elopement-resident with impaired decision-making ability, unable to judge own safety needs, leaves a safe area or the facility without staff supervision.

• Preventing elopement– Identify residents at risk(those not previously

identified may still leave)– All facility entrance’s and exits are monitored

electronically unless under visual monitoring– Resident care plan may have specific

interventions for wandering behaviors.

Elopement and Exiting continued

• Doors may have audible alarms or send a signal to a pager when they are opened.

• Staff must respond immediately when such an alarm is triggered.

• An alarm must not be reset until the triggering cause is identified.

• If resident is missing, follow facility’s emergency plan.