Patient Safety 2

Adults (19 Years and Older)

• Changing Safety Risks:

  • Safety risks evolve due to physical and cognitive changes with aging.

  • Stress and poor coping strategies can increase risks.

  • Middle-aged adults face higher risks of alcohol abuse, mental disorders, and obesity.

  • Young and middle-aged adults are also at risk for workplace and leisure activity accidents.

• Older Adults (65 Years and Older):

  • Higher chronic illnesses, less physical activity, impaired mobility, cognitive and sensory deficits.

  • Main Safety Risk: Falls.

    • 1 in 3 older adults falls annually; one fall is fatal every 20 minutes.

  • Importance of routine fall risk assessments by nurses.

  • Resource: CDC's STEADI program for fall prevention education.

• Frailty in Older Adults:

  • Decline in function across organ systems linked to aging; varies per individual.

  • High risk clients typically have poorer outcomes.

  • Frailty Evaluation: Recommended at hospital admission.

  • Focus on specific treatments tailored for frail clients.

School-Age Children (5-12 Years)

• Increased Freedom and Risks:

  • Greater freedom leads to more safety risks.

  • Vehicle safety remains a critical concern (car, school bus, bicycles).

    • Children under 12 should be in backseats, using appropriate child safety measures.

• Sports Safety:

  • Emphasis on appropriate protective gear (helmets, eye protection).

  • Proper-fitting footwear essential for injury prevention.

• Drowning Risks:

  • Same water safety rules apply as for younger children.

  • Adult supervision critical.

• Internet and Firearm Safety:

  • Risks of online bullying and exploitation.

    • Encourage adult supervision of internet use.

  • Firearm education: firearms should not be treated as toys.

  • Accidental shootings account for 20% of child deaths in ages 14 and younger; store firearms safely.

Adolescents (13-19 Years)

• Continuing Risks:

  • Risks from water, fire, sports, firearms, and vehicles persist.

  • Peer-related risks such as bullying and intimate partner violence linked to suicide risk.

• Risk-Taking Behaviors:

  • Common activities include speeding, substance abuse, and unprotected sex.

  • Encouraging family communication and support is vital.

  • Any behavioral changes or self-harm discussions must be taken seriously.

  • Promote healthy lifestyle choices: nutrition, sleep, exercise.

Age-Related Considerations

• Safety risks vary among age groups due to development and physical status.

• Cultural and socioeconomic factors influence risk (preventive health access, lifestyle choices).

Infants and Preschoolers (0-4 Years)

• Burn Injuries:

  • Key preventive measures include keeping hot items out of reach.

  • Set water heaters to a maximum temperature of 120°F.

• Accidental Poisonings and Choking:

  • Keep toxic substances out of reach; label them correctly.

• Drowning Prevention:

  • Fencing, life jackets, and constant adult supervision are crucial.

• Car Safety:

  • Importance of age-specific car seats (rear-facing until age 2-4).

Radiation Safety (Page 4)

• Radiation Use and Safety Protocols:

  • Identify areas using radiation and post warning signs.

  • Safety Principles:

    • Reduce exposure time.

    • Increase distance from the source.

    • Use shielding like lead aprons.

Chemical Safety (Page 5)

• Safety Data Sheets (SDS):

  • Mandatory labeling informs about risks and safety measures.

  • Personal Protection Equipment (PPE): Gloves, masks, goggles.

• First Aid for Chemical Exposure:

  • Immediate removal from exposure area; utilize eye wash stations and emergency showers.

Client Identification (Page 7)

• Importance of Proper Identification:

  • Misidentification can cause severe adverse events.

  • Verify identity using at least two identifiers (name, date of birth, medical record number).

• Joint Commission Recommendations:

  • Standardize identification, document timely, and utilize client photos in records.

Electrical Safety (Page 6)

• Safety Protocols for Electrical Equipment:

  • Avoid using devices with wet hands or in wet locations.

  • Check cords for damage and ensure safe unplugging practices.

  • Tag malfunctioning equipment for removal.

Safety Assessment (Page 8)

• Safety Regulations:

  • Governed by agencies and necessitate regular training of staff.

• Agency for Healthcare Research and Quality (AHRQ) Recommendations:

  1. Prevent infections.

  2. Simplify discharge instructions.

  3. Establish VTE prevention protocols.

  4. Improve medication education.

  5. Limit continuous care time.

  6. Collaborate with patient safety organizations.

  7. Enhance facility design for safety.

  8. Survey staff about safety culture.

  9. Improve team communication.

  10. Use evidence-based protocols.

Occurrence Reporting (Page 9)

• Purpose of Reporting:

  • Reports are for tracking and preventing future incidents, not punitive.

• Common Reportable Incidents:

  • Client accidents, unexpected reactions, incorrect treatments, property damage.

Types of Unexpected Events (Page 10)

• Definitions:

  • Near Miss: Potential for harm caught before impact.

  • Client Safety Event: Unexpected occurrences with or without injury.

  • Adverse Event: Actual harm occurred.

  • Sentinel Event: Critical unexpected adverse events causing severe harm or death.

ISBARR Communication Tool (Page 11-12)

• Communication Framework:

  • Identity: Who you are and where you are reporting from.

  • Situation: Overview of the client’s current issue.

  • Background: Relevant medical history and medications.

  • Assessment: Current client status and findings.

  • Recommendations: Suggested interventions.

  • Read Back: Reiterate important information for clarity.

Transforming Care at the Bedside Plan (Page 13-14)

• Key Components:

  • Increase direct client care time by nurses to 70%.

  • Leadership development programs for nurse management.

  • Establish rapid response teams to manage critical client changes.

  • Conduct hourly rounding for proactive client care.