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LPN 101 Safety - Faculty Sites

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LPN 101 Safety - Faculty Sites Powered By Docstoc
					NURS 1510
   According to the Institute of Medicine,
    44,000 – 98,000 people die each year
    because of “preventable” medical errors
   Most often these deaths result from a
    combination of errors and oversights by
    several people, and not simply o person’s
    error=Procedural errors
   The most common error involve medications
   1. Patient identification: Improve the accuracy
    of patient identification:
    ◦ 2 identifiers: name band + DOB
   2. Communication: improve the effectiveness
    of communication among caregivers: VO or
    PO note “read Back” Standardize
    abbreviations to be used
   Improve the safety of using high-alert
    medications:
       Remove concentrated meds from client
    care units
       Standardize and limit the number of drug
    concentrations available per organization
   4. Eliminate Wrong: eliminate wrong-site,
    wrong-patient, wrong procedure or surgery
    Create and use pre-op verification process,
    checklists, to confirm that appropriate
    documents are available
    Implement a process to mark the surgical site
    and involve client in the marking process
   Improve the safety of using infusion pumps:
    ◦ Ensure free-flow protection on all general-use and
      PCA IV pumps by the organization
   Improve the effectiveness of clinical alarm
    systems:
    ◦ Implement reg preventive maintenance and testing
      of alarm systems
    ◦ Assure alarms to be activated and audible
   Infection control:
    ◦ Handwashing and reporting nosocomial infections
    ◦ Reporting deaths from nosocomial infections
   Primary responsibility as a nurse is to protect
    client from harm
   Safe environment includes:
    ◦   Comfortable
    ◦   Private
    ◦   Low risk of infection
    ◦   Low risk of injury
    ◦   Low risk of undesirable effects of RX, TX
   Falls account for 90% of all reported incidents
    in hospitals
   Hip Fx results in more hospital admissions
    than any other injury
   Client- inherent accidents: accidents other
    than falls. Cuts, burns, seizure with injury
   Procedure-Related accident: caused by HCO,
    med errors, contamination of equipment or
    wound
   Improper performance of nursing procedure

   Equipment-related incidents: result from the
    malfunction or improper use of medical
    equip-electrocution and fire.
    ◦ Mark faulty equipment
    ◦ Place in designated place
    ◦ Call bio-med
   Oxygen-furnace malfunction leading to
    carbon monoxide. Gas binds with
    hemoglobin reducing available O2 to tissues
   Nutrition-poor food handling and storage
    may lead to food poisoning, Hep A.
   Temperature-exposure to extremes
    temperature=accidental hypothermia or heat
    exhaustion
   MVA leading cause of death f/u by falls,
    poisonings, drowning, fires and burns.
   Common Hazards in the home include:
    ◦ Inadequate lighting
    ◦ Clutter
   Others:
    ◦ Lack of security
    ◦ Pathogens, carcinogens, sanitation and pollution
   Developmental age: infant, toddler,
    preschooler need supervision hi risk for
    accidents
    ◦   School age sports injuries
    ◦   Adolescents have risk taking behaviors
    ◦   Adults life style concerns: alcohol, stress
    ◦   Older adults physiological changes of age,
        medications, other illnesses. The older, the greater
        the incidents of falls
   Impaired mobility
   Sensory impairments
   Cognitive impairments
   Safety awareness-placing meds out of reach
    of young children, maintaining smoke, CO2
    detectors, furnace checks, wearing seat belts,
    etc
   Consider your action and how they affect patient safety
   Don’t leave products behind
   Evaluate products before purchasing (avoid look a likes)
   Know how to use products, equipment, etc
   Don’t misuse containers
   Stay alert for things that do not seem right
   Take appropriate steps to address the problem
   Trust your instincts and don’t make assumptions
   Listen to patients as they express a problem and
    communicate it effectively
   Healthcare is a complex system
   Everyone makes errors or has near misses
   Promote learning
   Identify why key systems, processes, or
    procedures are in place, learn them and
    follow through correctly consistently
   Falls
   Physical / chemical restraint (see handout)
   Bed/chair alarms
   Side rails
   Fire RACE: Rescue, Alarm, Confine,
                 Extinguish or Evacuate
   Code-BLS        (see Alegent handout)
   Body Image
   Economics
   Level of Knowledge
   Socio-economic variables
   Personal preferences
   Physical condition
   Age
   Gender
   Practice Standard precautions
   Utilize safety practices
   Provide privacy
   Maintain body warmth –use bath blanket
   Promote independence
   Oral hygiene: cleanse teeth of food particles,
    plaque & bacteria
   Massage gums to prevent periodontal ds
   Moisturize oral mucosa
   Improve sense of taste
   Enhances client’s sense of well being
   Palm dentures to clean
 Note drainage
 Soak gently with H20 if crusted
 Wipe from inner to outer canthus
                   EARS
 Note drainage
 Ear wax (cerumen)
 DO NOT use cotton tipped applicators
   Maintain integrity
   Control body odors
   Improves self image
   Promotes relaxation
   Daily cleanse folds and peri area
   Observe for dryness, inflammation
   Corns, calluses
   Clean toenails carefully
   Dry thoroughly
   DO NOT cut corns or calluses
   Use lotion
   File nails
   Greenish-black indicates fungus growth
   Note ingrown nails or thickened nails
   DO NOT cut nails of diabetics
   If ordered to cut nails in general population
    soak for 20 min to soften prior to cutting
   Clean to soiled (outer to inner)
   Front to back
   Retract foreskin in uncircumcised male
   Replace foreskin over glans after rinsing and
    drying
   Rinse and dry area well
   Promotes relaxation
   Stimulates circulation
   Opportunity to inspect skin
   Relieves muscle tension
   Promotes comfort
   Complete bedbath        Partial
   Self with help –sponge bath
   Shower                 Chair-shower
   Tub-often avoided post-op
   Tipid                   Sitz
   Aveeno / oatmeal therapeutic

				
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posted:12/11/2012
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