Chapter 6

Some potential hazards exist that are specific to long-term care facilities and hospitals. Why?

Aging may affect a patients sight hearing or balance, turning everyday actions and objects into potential hazards. Medication may cause a patient to be dizzy or drowsy. Physical or mental difficulties may also put a patient at greater risk for falls, burns, and other accidents.

A patient can signal a problem by which way? The primary way is

Pressing the call light is the patients primary way to signal a problem.

Seven safety rules apply in any health care setting. Name six?

1. Identify the patient,

2. take care in halls and on stairs,

3. maintain equipment,

4. check linens,

5. follow instructions and ask questions,

6. report dangers.

When you are working in a health care facility, you may have several patients that are a fall risk. How can you prevent them from falling? Need only to list a few safety measures.

1. remove or report facility hazards
2. use safety devices appropriately
3. position patients and their beds properly
4. check shoes and clothing
5. report patients who are at risk
6. monitor high risk patients more often

What are five ways to prevent burns in health care settings?

1. make sure the patient understands and follows the facility's smoking policy and report patients who are not complying
2. test the water temperature in the bath or shower before allowing the patient to enter. 110F is generally considered the maximum safe temperature for bathing
3. check the food temperature when setting up food trays. Stir hot food to cool it down and warn the patient when the food is hot.
4. Use electrical equipment properly. Assist patients who wish to use electrical equipment. Many facilities require that personal electrical equipment be safety checked before use at the facility.
5. Apply heat treatments with the upmost care, following your facilities policy. The use of any warming or heating device is strictly prohibited without a physicians order. When applying an ordered device, specific procedures must be followed- including frequent monitoring of the affected site- to prevent burns.

Would you give medicine to a patient if you could not read the label on a medicine dropper? ______________ What would you do?

No, I would take it to my supervisor immediately.

What are three ways one can prevent suffocation in a patient/resident?

-Never leave a patient unattended in a bathtub even if there is only a small amount of water.
-If you notice a patient has difficulty chewing or swallowing, report this to your supervisor.
This patient will need to be supervised while eating. Help the patient if necessary by cutting food into smaller pieces.
- Check all restraints regularly to make sure they are not interfering with breathing.

When lifting any heavy object from the ground, list three safety steps you can take to prevent a back injury?

1. Keep your back straight. Always bend from the hips and knees, not at the waist
2. Stay balanced. When lifting, keep your feet apart at about shoulder-width (approximately 12 inches). This provides a good base of support to keep your balance and avoid straining.
3. Avoid twisting your body. Try not to twist your body at the waist. Instead, pivot, or turn, your feet together with your trunk as a single unit

In moving a chair into a patient’s room, explain below why and how you would use proper body mechanics in lifting and moving the chair?

When moving a chair into a patients room, I will :
- watch my posture and keep my abdomen and muscles tight because it takes strain off my back
- I will avoid lifting whenever possible and try to push or pull the chair because I want to protect myself from any injury
- I would keep my back straight, bending from the hips and knees because if I lift with my back, I can injure myself or pull a muscle.
- I would stay balanced and keep my feet shoulder width apart because I need to provide a good base of support to keep my balance and avoid straining my self.
- I would avoid twisting my body and instead I would pivot or turn my feet together with my trunk as a single unit
- I would hold the hold the chair close to my body if it's heavy and lean into the chair when picking it up to avoid injuring myself.

What are the four common types of physical restraints? (BSGP)

1. cloth belts
2. straps
3. garments that are used to hold a patient in position or restrict the movement of a limb
4. pelvic support

You have a patient who can’t seem to stay upright in her wheelchair who continues to keep sliding low & almost out of her chair. What should you do as a nursing assistant?

I should advocate for my patient by talking to my supervisor and the patients physician and tell them that I'm concerned that the patient keep sliding out of the wheelchair. I would ask if they can order the patient pelvic supports to help him stay in the wheelchair.

When patients have restraints in place. What should you check and how often?

breathing and circulation every 30 minutes

How often do you need to remove restraints, what should you allow the patient to do, and how long do you need to wait before replacing the restraint?

I need to remove restraints for 10 minutes every 2 hours so that the limbs can be exercised and the patient repositioned.

In order for a fire to start, what are the three things that need to be present simultaneously to ignite a fire?

Fuel
Heat
Oxygen

What are some of the measures (4) you can take in order to be prepared should a fire start?

• Practice fire emergency procedures often enough so that they become automatic. Take fire drills seriously, reacting to all alarms as if they were real fires.
• Know the facility's floor plan and the location of all exits.
• Know the locations of all fire alarms and extinguishers and how to use them.
• Keep fire exits clear of obstacles.

If you see or smell smoke coming from a patient’s power supply cord. What are steps you should take?

report it immediately and know the facility's fire plan

What does R.A.C.E. stand for?

R-Remove patients to a safe zone.
A-Activate the alarm.
C-Contain the fire.
E-Extinguish the fire.

What special precautions should you take to prevent fire in rooms of patients that use oxygen?

- Always post a "NO SMOKING: OXYGEN IN USE" sign on the door of the patient's room and over the patient's bed. Do not allow any smoking or open flames in these areas. Remove all smoking materials, including lighters and matches.
- Remove flammable liquids from the room.
- Avoid using electrical appliances such as hair dryers and electric razors in the room.
- Use cotton blankets and clothing instead of wool or synthetic fabric.
Wool and synthetic fabrics may cause static electricity.

There are many different kinds of disasters; fire, natural disasters and man-made disasters. In any case, what is your number one priority at all times?

The immediate life safety of my patients

Prevent injury to yourself and the patient by

using proper body mechanics

As a nursing assistant, you can help promote safety by:

1. answer the call button promptly

2. use infection control procedures

3. use proper body mechanics

Define toxic

poisonous

Define body mechanics

Special techniques to coordinate balance and movement in order to prevent strain and injury

Define base of support

the area on which an object rests; when you are standing, your feet are your base of support.

Define restraints

belts, straps or garments used to hold a patient in position or to restrict the movement of a limb.

where casn restraints be applied?

1. wrists

2. ankles

3. hands

4. chest

5. waist

6. pelvis

Define chemical restraints

certain drugs such as sedatives that restrain the person by controlling his or her behavior.

When can restraints be used?

only after a written order from a physician. ( if it wasn’t written down, it didn’t happen)

When applying restraints, if the patient is asleep, disoriented or upset, should you still explain what you are going to do?

Yes

Do restraints go under or over clothing?

Over clothing

how should you protect bony areas of a person when applying restraints?

use soft padding in those areas

Where can you tie restraints?

to the bed frame or wheel chair. never the side rails.

Define clove hitch

the type of knot that can be easily released in an emergency such as a half bow or slip knot

What information should be charted when a restraint is applied?

1. what restrained was applied

2. times of application or removal

3. the reason or condition of application

4. the patients skin condition

5. any complications, injuries, or related patient response

restraints may have to be cut off with scissors if they were not tied properly at what point?

during a fire or emergency

What are some of the major causes of fire in a healthcare facility?

1. Smoking

2. Paper or cloth clutter

3. overloaded circuits and plugs that are not properly grounded (not 3 pronged plus)

4. Faulty electrical wiring or equipment

Fire extinguishers are rated A B or C depending on what fires they put out. name them

1. Class A extinguishers are for paper, wood, or trash fires

2. Class B extinguishers are for oil or grease fires

3. Class C extinguishers are for electrical fires

What are most extinguishers rated in healthcare facilities?

They are rated ABC meaning they can be used on all 3 types of fires

Other than fire disasters, what other types of disasters can affect a healthcare facility?

1. natural disasters such as floods, earthquakes, hurricanes, and tornadoes

2. Human made disasters such as train or airplane crash, explosions, and riots