nursing leadership and management

Absolutely, Taisha — here is your clean, structured, exam‑ready STUDY GUIDE for Chapter 1: Leading & Managing Client Care, built directly from your uploaded document and keeping only the essential points.

⭐ Leadership vs. Management

Management

• Planning → Organizing → Staffing → Directing → Controlling

• Formal authority; responsible for resources, budget, hiring/firing.

Leadership

• Inspires and motivates others.

• Can be informal; requires followers.

⭐ Leadership Styles

Autocratic/Authoritarian

• Leader makes decisions.

• Downward communication.

• High output; best in crises.

• Works well with inexperienced staff.

Democratic

• Group participates in decisions.

• Up & down communication.

• High‑quality output; collaboration needed.

Laissez‑Faire

• Minimal direction.

• Motivation left to individuals.

• Low output unless informal leader emerges.

• Effective with highly skilled professionals.

⭐ Types of Leaders

• Transactional: Focus on problems, rewards, status quo.

• Transformational: Inspires long‑term vision.

• Situational: Adapts style to situation.

• Laissez‑faire: Permissive, decentralized decisions.

• Bureaucratic/Authentic: Leads by strong moral code.

⭐ Emotional Intelligence (EI)

Definition: Ability to perceive and manage emotions of self and others.

Characteristics of an EI Leader

• Insight into team emotions.

• Understands others’ perspectives.

• Open to ideas & constructive criticism.

• Manages emotions positively.

• Avoids judgment until facts gathered.

• Committed to high‑quality care.

⭐ Clinical Decision-Making

Critical Thinking

• Foundation of decision-making.

• Includes analysis, evaluation, creativity, reasoning.

Clinical Reasoning

• Mental process of analyzing clinical situations.

• Selects relevant data; ongoing as client condition changes.

Clinical Judgment

• Decision based on critical analysis of data.

• Considers client needs and response to interventions.

⭐ Clinical Judgment Models

Nursing Process

Assessment → Analysis → Planning → Implementation → Evaluation

Tanner’s Model

Noticing → Interpreting → Responding → Reflecting

NCSBN CJMM

Recognize cues → Analyze cues → Prioritize hypotheses → Generate solutions → Take actions → Evaluate outcomes (Analyze cues + Prioritize hypotheses = Nursing Process “Analysis”)

⭐ Prioritization Principles

• Systemic before local (“life before limb”)

• Acute before chronic

• Actual before potential

• Emergencies before expected findings

• Trends before isolated findings

• Timing matters (insulin, antibiotics)

⭐ Priority Frameworks

Maslow

Physiological → Safety → Love → Esteem → Self‑actualization

ABC

Airway → Breathing → Circulation Severe circulation issue may outrank minor breathing issue.

Safety/Risk Reduction

Address greatest/imminent risk first.

Least Restrictive / Least Invasive

Choose safest option with minimal restriction or invasion.

Survival Potential

Used in disaster triage; greatest good for most people.

Acute vs. Chronic / Urgent vs. Nonurgent / Unstable vs. Stable

Acute, urgent, unstable clients take priority.

⭐ Time Management

Do First

• Unstable clients

• Analgesics, antiemetics

• Immediate assessments

Do by Specific Time

• Routine meds

• Vitals

• Blood glucose checks

Do by End of Shift

• Ambulation

• Dressing changes

Time Savers

• Plan ahead

• Gather equipment first

• Group tasks

• Delegate appropriately

• Complete one task before starting another

Time Wasters

• Procrastination

• Socializing during care time

• Poor planning

• Missing equipment

• Under‑delegating

⭐ Assigning, Delegating, Supervising

Assigning

Transfers responsibility & accountability.

Consider:

• Client condition & acuity

• Precautions (isolation, fall, seizure)

• Time‑intensive procedures

• Staff skill level & experience

Delegating

Transfers responsibility but RN retains accountability.

RN can delegate to: RN, PN, AP PN can delegate to: PN, AP

RN CANNOT Delegate

• Nursing process

• Education

• Clinical judgment

• Unstable clients

Five Rights of Delegation

1. Right task

2. Right circumstance

3. Right person

4. Right direction/communication

5. Right supervision/evaluation

⭐ Room Assignment Principles

Private Room Required

• Airborne precautions

• Protective environment

Private Room Preferred

• Droplet/contact precautions (unless cohorting criteria met)

• Agitated clients

• Dementia with wandering

• Clients needing quiet (↑ICP)

• Sensory overload risk

• End‑of‑life privacy

Other

• Confused clients → away from exits/noise

• Children transitioning from critical care → near nurses’ station

⭐ Quality Improvement (QI)

Steps

1. Identify standard

2. Collect data

3. Compare to benchmark

4. Analyze

5. Implement change

6. Reevaluate

Indicators

• Outcome: client results

• Process: how care is delivered

• Structure: environment/resources

⭐ Conflict Resolution

Types

• Intrapersonal

• Interpersonal

• Intergroup

Strategies

• Avoiding

• Smoothing

• Competing

• Accommodating

• Compromising

• Collaborating (best win‑win)

⭐ Cost-Effective Care

• Use resources wisely.

• Delegate appropriately.

• Prevent complications through education.

• Follow evidence-based practice.

If you want, I can turn this into:

• Flashcards

• Fill‑in‑the‑blank review sheet

• NCLEX‑style practice questions

• A condensed 1‑page cheat sheet

Just tell me the format you want next.

Absolutely, Taisha — here is your separate, clean, exam‑ready STUDY GUIDE for Chapter 2: Coordinating Client Care, built directly from your uploaded document and keeping only the essential, high‑yield points.

Chapter 2: Coordinating Client Care

⭐ Patient‑Centered Care

Definition (IOM): Care that respects and responds to individual preferences, needs, and values — client values guide all decisions.

Eight Principles (Picker Institute)

• Access to reliable health care advice

• Trusted professionals delivering treatment

• Continuity of care

• Family/caregiver involvement

• Clear, understandable communication

• Respect for preferences & decision‑making

• Empathy and respect

• Attention to physical needs & environment

⭐ Client Rights

Clients retain legal rights in all health care settings.

Nursing Responsibilities

• Ensure clients understand their rights

• Protect rights during care

• Support informed decision‑making

• Provide competent, respectful care

Key Rights

• Be informed

• Accept/refuse/modify care

• Receive competent, respectful care

⭐ Refusal of Treatment / AMA

PSDA: Clients must be informed of their right to accept or refuse care.

If Client Refuses Treatment

• Explain risks

• Ask client to sign refusal form

• Document teaching + refusal

• Notify provider

If Client Leaves AMA

• Explain risks (complications, disability, death)

• Ask client to sign AMA form

• Document refusal + provider notification

• If client refuses to sign → document

⭐ Advocacy

Nurses support clients by ensuring:

• They are informed

• Their rights are respected

• They receive appropriate care

Nursing Role

• Provide information for decision‑making

• Mediate when care is not in client’s best interest

• Question unsafe prescriptions

• Support privacy, informed consent, access to care

Advocacy Skills

Risk‑taking, assertiveness, communication, confidence, respect, empowerment.

⭐ Informed Consent

Legal process: Client gives written permission for procedure/treatment.

Client Must Understand

• Reason for treatment

• Benefits

• Risks

• Alternatives

• Risks of refusing

Roles

Provider: Gives full explanation. Client: Voluntarily signs; must be competent. Nurse: Witnesses signature, ensures understanding, notifies provider if questions remain.

Who Can Consent

• Competent adult

• Emancipated minor

• Parent/guardian

• Court‑appointed representative

• Health care proxy

⭐ Advance Directives

Communicate client wishes for end‑of‑life care.

PSDA Requirements

• Ask all admitted clients about advance directives

• Provide written information if none exist

• Representative available to assist

Components

Living Will: Specifies treatments desired/not desired (CPR, ventilation, artificial feeding). Durable Power of Attorney: Designates surrogate decision‑maker.

Nursing Role

• Provide information

• Document status

• Ensure directives reflect current wishes

• Inform team

• Respect client’s choice over family/provider

⭐ DNR / AND

• Must be written by provider

• Without DNR/AND → nurse initiates CPR

• Provider consults client/family before writing order

⭐ Organ Donation

• Regulated by federal/state laws

• Facilities must provide access to trained specialists

• Nurses provide emotional support & answer questions

⭐ Confidentiality & HIPAA

Clients have right to privacy and control of their health information.

Nursing Responsibilities

• Protect written/verbal/electronic information

• Follow facility policies

• Avoid sharing info with unauthorized individuals

• Use private areas for communication

Privacy Rule Requirements

• Only team members involved in care may access records

• Clients may obtain copies of records

• No copying records except authorized transfers

• Secure charts; password‑protect electronic records

• Use code systems for phone inquiries

• No “walking rounds” where others overhear

⭐ Information Technology

Nurses use informatics for:

• Documentation

• Medication dispensing

• Reviewing disease/medication databases

• Teaching clients

• Supporting visually impaired clients

• Guiding clients to credible websites

• E‑health (appointments, labs, prescriptions, billing)

• Telehealth for remote assessment

⭐ Information Security

Follow facility protocols:

• Log off computers

• Never share passwords

• Secure printed PHI

• Shred PHI when no longer needed

⭐ Social Media Safety

Avoid breaches of confidentiality:

• Follow facility policies

• Never post client info/photos

• Maintain professional boundaries

• Avoid offensive remarks

• Report violations

Consequences: termination, BON discipline, legal action, HIPAA penalties.

⭐ Interprofessional Collaboration

Team of professionals from multiple disciplines working together.

Benefits

• Higher quality care

• Efficient, cost‑effective care

• Addresses complex client needs

• Win‑win conflict resolution

Nurse Qualities Needed

• Communication

• Assertiveness

• Conflict negotiation

• Leadership

• Professional presence

• Critical thinking

Nurse’s Role

• Coordinate team

• Provide holistic client understanding

• Ensure continuity of care

• Include client/family in planning

• Provide updates during rounds

• Initiate consultations

• Connect client to post‑discharge resources

If you want, I can turn this into:

• Flashcards

• Fill‑in‑the‑blank review sheet

• NCLEX‑style practice questions

• A condensed 1‑page cheat sheet

Just tell me what format you want next.

Absolutely, Taisha — here is your separate, clean, exam‑ready STUDY GUIDE for Chapter 3: Professional Practice, built directly from your uploaded document and keeping only the essential, high‑yield points you need for tests and clinical judgment.

Chapter 3: Professional Practice

⭐ Professional Responsibilities

Nurses must be knowledgeable in:

• Role accountability

• Qualifications & competence

• Licensure

• Professional/leadership development

• Nursing organizations

• Advocacy

• Business skills

• Legal & ethical practice

• Disruptive behavior

⭐ Role Accountability

Accountability = being answerable for actions and their impact.

ANA Core Accountabilities

• Safety, Quality, Risk Management: Ensure safe care; protect organization from liability.

• Health Advocacy: Support self‑determination; protect rights of clients, nurses, providers, populations.

• Clinical Care Delivery: Model safe, effective care.

• Healthy Work Environment: Maintain supportive, respectful workplace.

• Resource Management: Manage fiscal & human resources.

• Legal/Regulatory Compliance: Maintain compliance with laws & accreditation.

• Networking/Collaboration: Build alliances across systems.

⭐ Role Qualifications & Competence

Education

• LPN: Certificate/diploma/associate degree.

• RN: Associate, diploma, or BSN.

• BSN increasingly preferred; hospitals hire BSN more often.

• RN‑BSN mobility programs expanding.

• Nurse administrators: minimum BSN, often MSN or doctorate for system‑level leadership.

⭐ Nursing Licensure & Practice

• Regulated by state law.

• State boards define scope, issue/revoke licenses, set education standards.

• Nurses must know their state’s practice act.

Reasons for License Suspension/Revocation

• Practicing without license

• Substance use disorder

• Felony conviction

• Professional negligence

• Practicing beyond scope

⭐ Nurse Licensure Compact (NLC / eNLC)

Allows nurses in compact states to practice across state lines (in‑person or telehealth). Nurses must follow laws of the state where the client is located. Non‑compact state nurses must hold separate licenses for each state.

⭐ Professional & Leadership Development

• Lifelong learning: CE, clinical hours, portfolios.

• Leadership skills:

  • Communication

  • Collaboration

  • Constructive feedback

  • Self‑reflection

  • Mentoring & delegation

  • Promoting healthy work culture

⭐ Magnet Recognition Program

Awarded by ANCC to facilities with:

• High‑quality care

• Nurse retention

• Empowerment culture

• Transformational leadership

• Innovation & exemplary practice

Magnet status lasts 4 years.

⭐ Pathway to Excellence

Recognizes facilities with positive practice environments using 12 evidence‑based standards.

⭐ Advanced Practice Nurses (APRNs)

APRNs include:

• Nurse Practitioner (NP)

• Clinical Nurse Specialist (CNS)

• Nurse Anesthetist (CRNA)

• Nurse Midwife (CNM)

APRNs diagnose, treat, and prescribe. Certification = expertise in specialty (ANCC, NLN, AONL, etc.).

⭐ Consensus Model for APRN Regulation

Created by NCSBN to standardize APRN licensure, accreditation, certification, and education across states.

⭐ Continuing Education & Staff Development

Nurse leaders:

• Assess staff learning needs

• Identify knowledge gaps

• Provide education for new policies/skills

• Evaluate outcomes

• Mentor new nurses

• Address bullying/incivility

⭐ Professional Practice Evaluation (ANA Standards)

Nurse administrators:

• Self‑reflect regularly

• Ensure practice meets regulations

• Use feedback to improve

• Support evidence‑based practice

• Revise policies as needed

⭐ Self‑Care & Personal Development

Healthy Nurse Healthy Nation (HNHN) promotes:

• Physical activity

• Rest

• Nutrition

• Quality of life

• Safety

• Mental health

Nurses must protect their own health (ANA Code of Ethics Provision 5).

⭐ Professional Advocacy & Health Policy

Nurse leaders advocate for:

• Safe staffing

• Workplace safety

• Access to care

• APRN reimbursement

• Nursing education funding

Ways nurses influence policy:

• Join nursing organizations

• Lobby legislators

• Engage with media

• Join PACs

• Participate in drafting legislation

Nurses have strong political influence due to:

• Large numbers (3 million nurses)

• High public trust

• Increasing education levels

⭐ Business Skills

Nurse administrators participate in budgeting.

Budget Process (similar to Nursing Process)

1. Assess what should be included.

2. Diagnose needs.

3. Plan using fiscal year cycle.

4. Implement & monitor monthly.

5. Evaluate & modify.

Types of Budgets

• Operating: daily costs (supplies, salaries).

• Capital: large equipment (> $5,000), buildings.

⭐ Human Resources

Nurse managers handle:

• Staffing mix

• Recruiting/interviewing

• Orientation & mentoring

• Socialization to unit culture

• Scheduling for productivity & retention

⭐ Legal Practice & Liability

Nurses must know laws to:

• Protect client rights

• Reduce liability

• Provide safe, competent care

• Stay within scope

• Follow standards of care

Federal Laws Affecting Nursing

• HIPAA

• ADA

• MHPA

• PSDA

• UAGA

• NOTA

• EMTALA

⭐ Criminal vs. Civil Law

Criminal Law

Felony or misdemeanor. Example: falsifying records.

Civil Law (Torts)

Unintentional:

• Negligence

• Malpractice

Quasi‑intentional:

• Invasion of privacy

• Defamation (libel, slander)

Intentional:

• Assault

• Battery

• False imprisonment

⭐ Good Samaritan Laws

Protect nurses giving emergency care outside workplace if care is reasonable & prudent.

⭐ Malpractice (Professional Negligence)

Five Elements:

1. Duty

2. Breach of duty

3. Foreseeability of harm

4. Causation

5. Harm

Most common issues:

• Failure to follow standards

• Improper equipment use

• Poor communication

• Poor documentation

Avoid liability by:

• Following standards

• Giving competent care

• Communicating clearly

• Documenting thoroughly

If you want, I can turn this into:

• Flashcards

• Fill‑in‑the‑blank review sheet

• NCLEX‑style practice questions

• A condensed 1‑page cheat sheet

Just tell me what format you want next.

Absolutely, Taisha — here is your separate, clean, exam‑ready STUDY GUIDE for Chapter 4: Inclusive and Evidence‑Based Care Environment, built directly from your uploaded document and distilled to ONLY the essential, high‑yield points you need for exams and clinical judgment.

Chapter 4: Inclusive & Evidence‑Based Care Environment

⭐ Promoting Equity & Inclusivity

Caring

• Core concept of nursing; foundation of nurse‑client connection.

• ANA Code of Ethics Provision 1: practice with compassion and respect for dignity and worth of every person.

• NCSBN: caring = interaction with respect, trust, support, compassion.

⭐ Culturally Congruent Practice

ANA Standard 8: RN practices in a way congruent with cultural diversity & inclusion.

Key Components

• Apply evidence‑based practice aligned with client’s cultural values.

• Reduce health disparities.

• Practice cultural humility:

  • Lifelong self‑evaluation

  • Awareness of personal bias

  • Address inequities

  • Build partnerships with communities

  • Promote shared decision‑making

⭐ Population Trends

• Minority populations increasing: projected to reach 57% by 2060.

• Adults ≥65 increasing from 16% → 23% by 2060.

• Federally defined minority groups:

  • Asian American

  • Black/African American

  • Hispanic/Latino

  • Native Hawaiian/Pacific Islander

  • Indigenous Peoples/Alaska Native

⭐ Economic & Social Changes

• Increased unemployment, homelessness, poverty → decreased access to care.

• Poverty linked to:

  • Poor housing

  • Poor schools

  • Unsafe environments

  • Higher violence rates

• LGBTQ+ populations face discrimination → decreased access to care.

⭐ Social Determinants of Health (SDOH)

Conditions in which people live, work, play, worship.

Five Domains (HHS)

1. Neighborhood & Built Environment

2. Health Care Access & Quality

3. Social & Community Context

4. Education Access & Quality

5. Economic Stability

Examples (WHO)

• Employment/income

• Education level

• Working conditions

• Food security

• Housing quality

• Childhood development

• Social inclusion vs. discrimination

• Access to affordable, quality health services

Nursing Role

• Assess for negative SDOH impacts.

• Implement strategies to promote health.

• Identify disparities through data and research.

⭐ Promoting Equity in Nursing Education

Nursing programs should:

• Integrate SDOH & health equity throughout curriculum.

• Provide community‑based learning experiences.

• Identify & address racism in the classroom.

• Recruit & mentor diverse faculty/students.

⭐ Recruiting & Retaining a Diverse Workforce

Why It Matters

• Diverse workforce → more culturally competent care.

• Minority nurses currently underrepresented (19.2%).

• Men = 9.1% of nurses.

Retention Strategies (especially for aging workforce)

• Flexible scheduling

• Preceptor roles

• Ergonomic improvements

• Better lighting

• Mechanical lifts

• Decentralized supplies

Recruitment Strategies

• Educate hiring teams on implicit bias

• Standardize hiring processes

• Advertise in diverse communities

• Encourage minorities to pursue nursing

⭐ Evidence‑Based Practice (EBP)

Definition

Use of current, credible research to guide clinical judgment and care.

ANA Code of Ethics Provision 7

Nurses advance the profession through:

• Research

• Scholarly inquiry

• Standards development

• Health policy generation

Entry‑Level Competencies

4.1 Advance nursing scholarship 4.2 Integrate best evidence 4.3 Promote ethical conduct of scholarly activities

⭐ Strategies for New Nurses to Use EBP

• Stay current using journals, textbooks, experts.

• Use multiple sources of evidence.

• Support interventions with evidence.

• Use established specialty resources.

• Follow national clinical practice guidelines.

• Question outdated traditions.

• Collaborate locally & globally.

• Engage in interdisciplinary teamwork.

⭐ Positive Outcomes of EBP

• Improved client outcomes

• Lower cost of care

• Higher quality care delivery

⭐ Nurse Administrator Competencies (EBP Integration)

• Use evidence to guide administrative decisions.

• Encourage staff participation in research.

• Create climate for inquiry.

• Promote ethical research principles.

• Evaluate outcome evidence.

• Disseminate findings.

⭐ EBP Process (PICOT Framework)

1. Cultivate inquiry

2. Ask clinical question (PICOT)

   • P = Patient/Population

   • I = Intervention

   • C = Comparison

   • O = Outcome

   • T = Time

3. Search for best evidence

4. Evaluate evidence (validity, reliability, applicability)

5. Integrate evidence + expertise + client values

6. Evaluate outcomes

7. Disseminate results

⭐ EBP Barriers

• Lack of knowledge

• Lack of empowerment

• Lack of time/resources

• Lack of administrative support

⭐ EBP Promoters

• Knowledge of EBP

• Time/resources

• Administrative support

• EBP policies/procedures

⭐ Research Ethics

• IRB approval required

• Informed consent needed

• Protect participant rights

• Nurses must understand EBP basics and support research environments

If you want, I can turn this into:

• Flashcards

• Fill‑in‑the‑blank review sheet

• NCLEX‑style practice questions

• A condensed 1‑page cheat sheet

Just tell me what format you want next.

Absolutely, Taisha — here is your separate, clean, exam‑ready STUDY GUIDE for Chapter 5: Culture of Safety in Delivering Care, built directly from your uploaded document and distilled to ONLY the essential, high‑yield points you need for exams, NCLEX, and clinical judgment.

📘 STUDY GUIDE — Chapter 5: Culture of Safety in Delivering Care

⭐ Culture of Safety

A culture of safety promotes openness, reporting, and learning from errors. It reduces adverse events and improves outcomes.

Risk Management Tracks:

• Near Miss: Error almost occurred.

• Client Safety Event: Reached client; potential for harm.

• Adverse Event: Unexpected harm occurred.

• Sentinel Event (Never Event): Unexpected death, major injury, wrong‑site surgery, suicide attempt, hemolytic transfusion reaction, infant abduction, rape, discharge to wrong family.

• Failure to Rescue: Most severe; signs of deterioration missed → death.

⭐ QSEN Competencies

1. Patient‑Centered Care (QPCC)

2. Teamwork & Collaboration (QTC)

3. Evidence‑Based Practice (QEBP)

4. Quality Improvement (QQI)

5. Safety (QS)

6. Informatics (QI)

These guide nursing education and safe practice.

⭐ Handling Infectious & Hazardous Materials

Infection Control

• Use standard precautions for all clients.

• Use non‑latex gloves to avoid allergies.

• Ensure hand hygiene resources are available.

• Double‑bag only if outer bag is contaminated.

• Use safety needles and needle‑less systems.

• Dispose sharps immediately in sharps containers.

• Report needlesticks → risk management + incident report.

• Follow isolation precautions (standard, airborne, droplet, contact).

• Clean shared equipment between clients.

Hazardous Materials (OSHA)

Facilities must:

• Provide hazard‑free environment.

• Provide PPE for hazardous materials.

• Provide dosimeters for radiation exposure.

• Maintain Safety Data Sheets (SDS).

• Have a HAZMAT response team.

⭐ Safe Use of Equipment

Nurses must:

• Maintain competency in equipment use.

• Check equipment at start of shift.

• Ensure grounded outlets (three‑prong).

• Unplug using plug, not cord.

• Plug life‑support equipment into backup generator outlets.

• Disconnect equipment before cleaning.

• Ensure pumps have free‑flow protection.

• Avoid overcrowding outlets; tape extension cords to floor.

• Remove & report faulty equipment immediately.

⭐ Specific Risk Areas

Falls

Risk factors:

• Age‑related changes

• Weakness, balance issues

• Visual impairment

• Cognitive dysfunction

• Medications (orthostatic hypotension, sedation)

• History of falls

Fall Prevention:

• Place high‑risk clients near nurses’ station.

• Keep items within reach.

• Bed in low position; lock wheels.

• Use nonskid footwear.

• Clear pathways; adequate lighting.

• Use bed/chair alarms.

• Avoid full side rails for clients who climb out.

Seizure Precautions

For clients with seizure history:

• Room near nurses’ station.

• Rescue equipment at bedside: oxygen, suction, oral airway.

• IV access or saline lock.

• Teach triggers to avoid.

• If seizure occurs → protect airway, stay with client, document.

⭐ Seclusion & Restraints

Used ONLY when client is a danger to self or others and all less restrictive measures have failed.

Types

• Seclusion: Safe room.

• Physical restraint: Device limiting movement.

• Chemical restraint: Medication for dangerous behavior.

Risks

• Asphyxiation

• Strangulation

• Pressure injuries

• Pneumonia

• Incontinence

Legal Guidelines

• False imprisonment = restraining without consent or justification.

• PRN restraint orders NOT allowed.

• Provider must perform face‑to‑face assessment.

• Emergency: nurse may apply restraint → must obtain order within 1 hour.

• Order must include: reason, type, location, duration, behaviors requiring restraint.

• Time limits:

  • Adults: 4 hours

  • Ages 9–17: 2 hours

  • Under 9: 1 hour

• Max renewal: 24 hours.

Nursing Responsibilities

• Obtain provider order.

• Neuro checks q2h: circulation, sensation, mobility.

• Offer food, fluids, hygiene, elimination.

• Monitor vitals.

• ROM exercises.

• Pad bony prominences.

• Secure restraints to bed frame, NOT side rails.

• Use quick‑release knot.

• Allow room for two fingers between restraint & client.

• Never leave client unattended.

• Document before, during, after restraint use.

⭐ Fire Safety

RACE Sequence

R – Rescue clients A – Activate alarm C – Confine fire (close doors/windows, turn off oxygen/electrical devices) E – Extinguish if possible

PASS Sequence

P – Pull pin A – Aim at base S – Squeeze handle S – Sweep side to side

Fire Extinguisher Classes

• A: Combustibles (paper, wood, trash)

• B: Flammable liquids/gases

• C: Electrical fires

⭐ Environmental Safety (Home & Community)

Risk Factors

• Age

• Mobility

• Cognitive/sensory awareness

• Communication

• Environment

• Medical conditions

• Medications

Home Hazard Evaluation

Performed by nurse, PT, or OT.

⭐ Age‑Specific Safety Risks

Infants/Toddlers

• Aspiration

• Water safety

• Suffocation

• Poisoning

• Falls

• Motor vehicle injury

• Burns

Preschool/School‑Age

• Drowning

• Motor vehicle injury

• Firearms

• Unsafe play areas

• Burns

• Poisoning

Adolescents

• Motor vehicle injury

• Burns (sun exposure)

• Substance use

• Unsafe sex

• Mental health risks

• Internet/social media dangers

Young/Middle Adults

• Motor vehicle crashes

• Occupational injuries

• Alcohol misuse

• Suicide risk

Older Adults

• Falls

• Vision/hearing impairment

• Nocturia

• Cognitive changes

• Home modifications needed (lighting, remove rugs, assistive devices)

⭐ Additional Home/Community Risks

• Fires

• Passive smoking

• Carbon monoxide poisoning

• Food poisoning

• Natural/human‑made disasters

Fire Safety at Home

• Adequate smoke alarms & extinguishers

• Close windows/doors

• Crawl low under smoke

• “Stop, drop, roll” if clothing ignites

Home Oxygen Safety

• No smoking

• Keep oxygen away from heat sources

• Store cylinders safely

• Use grounded equipment

If you want, I can turn this into:

• Flashcards

• Fill‑in‑the‑blank review sheet

• NCLEX‑style practice questions

• A condensed 1‑page cheat sheet

Just tell me what format you want next.