Safety and Situational Assessment

The Joint Commission

  • accrediting body that sets guidelines on healthcare safety

  • National Patient Safety Goals

Safety and Developmental Factors

  • neonates (newborns)

    • Concerns

      • infection

      • fall

      • SIDS

    • head support

    • car seat safety

    • empty crib

    • supervision

    • hand washing

    • back to sleep

  • infant/toddlers

    • choking

    • small objects

    • electrical outlets

    • supervision

    • in the bathtub

    • age appropriate toys

    • child-proofing the home

    • appropriate use of the crib

    • car seat

    • know poison control number

  • preschooler/school age

    • road safety

    • supervision

    • stranger danger and support social relationships

    • falls

    • cuts/injuries/burns

    • drowning

    • weapons

    • ingestion

    • broken bones

    • bullying

    • concussions

    • helmets anad seatbelts

    • fire safety

    • tub supervision

  • adolescent

    • sex

    • cyber safety

    • social groups

    • drugs

    • alcohol

    • driving

    • gun violence/weapons safety

    • bullying

  • adult/older adult

    • falls

    • disease

    • smoking

    • drinking

    • stress

    • elder abuse

    • domestic violence

    • motor vehicle accidents

Falls

  • second leading cause of unintentional injury

  • elderly and children at most risk

  • big deal in hospitals

    • nonslip socks

    • bed alarms

    • alarm fatigue

  • risk factors

    • weak bones

    • mobility issues

    • muscle weakness

    • gait and balance changes

    • cognitive and neurological disease

    • impaired communication

    • medications

  • prevention

    • risk assessment tool

      • done upon admission

      • change in condition

      • first time visiting

      • after a fall

      • daily in the hospital

    • fall risk scores

      • low risk - basic safety interventions

        • orient them to their surroundings

        • lowest bed position

        • locked bed

        • rails (2)

        • clean floor

          • declutter

      • medium risk

        • communicating with other staff members

        • help with activities of daily living

        • reorient them

        • physical therapy

        • occupational therapy - ADLs

        • everything from low risk

      • high risk

        • everything from low and medium risk

        • pair and chair alarms

        • one to one supervision

          • sitters

        • move to rooms closer to nurses station

        • gait belt

Restraints

  • soft wrist restraints

  • any form of equipment material or physical that limits mobility and they can not remove themselves

  • not the first line of defense

  • used after fall risk preventions

  • can cause emotional distress

    • aggressive behavior

  • need a reason to use

  • order from a provider

  • assessments

    • define how often they need to happen

  • behavioral

  • unconscious

  • meeting patient needs

    • toileting patients

    • feeding 

    • skin assessments

  • mitt - callie from greys

  • lap belt/buddy

Situational Awareness