Environment and Equipment Survey Notes

Environment and Equipment Survey

Common Patient Equipment

• IV pumps, poles, and tubing

• Oxygen

• Call lights

• Beds and siderails

• Overbed and bedside tables

• Catheter bags

• Chest tubes

• Sequential Compression Devices (SCDs)

• Compression stockings

• Nasogastric tubes

• Suction

• Linens

• Bracelets – ID band, allergy band, falls precautions

IV Pumps, Poles, and Tubing

• Insertion Site: Check the insertion site for any signs of infection, infiltration, or phlebitis.

• Pump:

  • Solution: Verify the correct solution is being administered.

  • Rate: Confirm the infusion rate matches the physician's order.

  • On/Off: Ensure the pump is functioning correctly and turned on.

  • Open Wires: Check for any exposed or damaged wires.

  • Alarms: Be aware of alarm settings and respond promptly to any alarms.

• Tubing:

  • Connected to Client?: Verify the tubing is properly connected to the patient's IV site.

  • Leaking?: Inspect the tubing for any leaks or breaks.

  • Touching Floor?: Ensure the tubing is not dragging on the floor to prevent contamination.

  • Tripping Hazard?: Assess if the tubing poses a tripping hazard, especially if the patient is getting out of bed.

Oxygen Safety

• Order:

  • Flow meter setting: Verify the flow meter is set to the prescribed flow rate.

  • Correct device: Ensure the appropriate oxygen delivery device (nasal cannula, face mask, etc.) is in use.

  • Correctly applied: Confirm the device is properly positioned on the patient.

  • Connected to O2 source: Check that the device is connected to a functioning oxygen source.

• Patient Teaching:

  • Proper placement of equipment: Educate the patient on how to correctly position the oxygen equipment.

  • Do not change settings: Instruct the patient not to adjust the oxygen settings.

• Skin Monitoring:

  • Monitor skin for dryness or breakdown: Regularly assess the patient's skin for any signs of irritation or breakdown due to the oxygen device.

• Tubing Safety:

  • Tripping hazard: Ensure the tubing is not a tripping hazard if draped across the floor.

  • Entanglement: Prevent the tubing from getting caught in bedrails.

• Canister Safety:

  • NEVER stand canister upright without support stand: Always use a support stand to prevent the canister from falling and causing injury.

  • Lay canister flat if no stand: If a stand is unavailable, lay the canister flat on the floor.

• FIRE Hazard:

  • No smoking: Oxygen supports combustion, so smoking is strictly prohibited.

  • Electrical sparks: Avoid electrical sparks near oxygen sources.

  • No petroleum products: Do not use petroleum-based products (e.g., Vaseline) around oxygen, as they are flammable.

  • Static: Minimize static electricity near oxygen sources.

Call Light Equipment

• Accessibility:

  • Call light within reach of client: Ensure the call light is easily accessible to the patient.

• Functionality:

  • Call light operating correctly: Verify the call light is functioning properly.

• Cord Safety:

  • Not draped across floor: Ensure the cord is not a tripping hazard.

  • Not caught in siderail: Prevent the cord from getting tangled in the siderails.

Beds, Siderails, and Alarms

• Bed Position:

  • Bed in lowest position: Keep the bed in the lowest position when a healthcare team member is not at the bedside to prevent falls, wheels locked.

• Siderails:

  • Side rails (how many up at one time?): Consider the number of siderails raised at one time.

  • All 4 rails up is considered a restraint, an order is needed for this: Raising all four siderails is considered a restraint and requires a physician's order.

• Bed Alarms:

  • Bed Alarms: Be aware of bed alarms that alert staff when a patient attempts to get out of bed.

  • Alarm Fatigue: Be cautious of alarm fatigue, which can lead to healthcare team members ignoring or turning off alarms.

Overbed and Bedside Table Safety

• Stability:

  • Rolling tables are not safe to lean on for support, do not use a table on wheels as a siderail: Caution patients against using rolling tables for support.

  • Tables need to be within reach

• Pinch Points:

  • Be careful not to pinch your fingers when raising or lowering overbed tables: Take care when adjusting overbed tables to avoid injury.

• Tipping:

  • Overbed tables can tip over easily

Urinary Catheter

• Position of Collection Bag:

  • Never hang the collection bag on a moveable part of the bed (siderails or the joint where the bed bends when the head is raised): This prevents kinks, accidental pulls, and inaccurate drainage measurement.

  • Collection bag should hang lower than the client’s bladder: This helps with gravity drainage and prevents backflow.

• Pulling Prevention:

  • Use a safety strap to secure catheter to client so if the tubing gets pulled on it is not pulled out of the client: Use securement devices to prevent accidental catheter removal.

• Leakage:

  • Catheter may need to be changed: If leakage is present, the catheter may need to be replaced.

  • Check that collection bag clamp is closed properly: Ensure the drainage bag is properly sealed.

  • Clean up spills immediately: Any urine spills should be cleaned promptly to prevent infections and odors.

Chest Tubes

• Position of Collection Container:

  • Always needs to sit upright: To ensure proper drainage and monitoring.

  • Needs to be secure so the container does not fall over: Prevents disruption of the system and potential complications.

  • Never raise the collection container above the height of the client’s lung: Prevents backflow of fluid into the pleural space.

• Suction Connection:

  • Is the suction set at the correct strength: Verify the suction level as prescribed by the healthcare provider.

• Pulling Prevention:

  • Be careful tubing is not pulling at the insertion site: Prevent accidental dislodgement or injury.

Sequential Compression Devices (SCDs) and Compression Hose

• Sequential Compression Devices (SCDs):

  • Compression hose SCDs – inflatable pads which are wrapped around client’s legs, pads inflate from ankle upward to assist blood back toward heart

  • Only use when client is sitting or laying down: SCDs are designed for use when the patient is not ambulating.

  • Be mindful of safety with cords and tubing: Ensure cords and tubing are not tripping hazards.

• Compression Hose:

  • Correct size – measure (diameter and height): Ensure proper fit for therapeutic effectiveness.

  • Positioning – do not allow wrinkles or rolling of stockings down: Maintain consistent compression.

  • Skin assessment – remove each shift to inspect skin: Monitor for skin irritation or breakdown.

  • Safety – slippery, always slippers or gripper socks if out of bed with hose on: Prevent falls due to slippery stockings.

Nasogastric Tube and Suctioning

• Position of Tube:

  • Tube should be taped to client’s nose and safety pinned to gown: Secure the tube to prevent dislodgement.

• Suction:

  • Is it ordered?: Verify the physician's order for suctioning.

  • Is it set correctly?: Ensure the suction is set to the prescribed level.

General Room Contents

• Linen:

  • Keep hampers emptied, do not place linens on floor: Maintain hygiene and prevent the spread of infection.

• Cards and Flowers:

  • Neat and out of the way: Reduce clutter and potential hazards.

• Food:

  • Remove old trays: Prevent bacterial growth and maintain a clean environment.