Creating a Safe Healthcare Environment

• Maintaining a safe environment involves performing necessary nursing practices to ensure safety. The aim is to provide and maintain the safest environment possible.

Objectives

• The goal is to define a safe environment.
• The goal is to define patient safety.
• The goal is to evaluate fall risk.
• The aim is to understand the definition of infections.
• The aim is to grasp and employ skill steps related to infection prevention and control.
• The aim is to define the parameters of effective waste management.
• Standard steps include knowing basic isolation precautions.

Contents

• Essential topics are ensuring and maintaining a safe healthcare environment, providing and maintaining patient safety, fall prevention, and infection control and prevention.

Essence of Safe Environment

• It is an environment where individuals can carry out life's activities in a healthy way.
• The environment promotes a sense of security and safety.
• Healthcare providers create a healthy hospital environment.
• The primary principle of a healthy hospital environment is that it should “do no harm” to patients or employees.

Factors Affecting Health and Safety in Hospitals

• Chemical factors include substances like antiseptics, disinfectants, mercury, and latex.
• Physical factors: temperature (heat and humidity), lighting and noise.
• There are infectious factors like microorganisms and infectious disease.
• Ergonomic factors such as wet floors, inappropriate steps, benches, or seat heights.
• Psychosocial factors such as violence, anxiety, anger, stress, and job dissatisfaction.

Reducing Chemical Risks

• Personal protective equipment (PPE) such as gowns, gloves, goggles, and masks reduce the risk of contact with hazardous materials.
• Environments should be well-ventilated.
• Skin contacted by chemical substances is rinsed with plenty of water.
• Chemical substances should be used and prepared as instructed.
• Any side effects of drugs should be evaluated.
• Measures to prevent malpractice must be reinforced.

Reducing Physical and Ergonomic Risks

• Suppression of noise and limited loud talking helps prevent issues.
• Regular maintenance and lubrication of noise-producing machinery parts can limit disturbances.

Promoting Safety: General Initiatives:

• Every patient is to be informed about the hospital environment.
• Hospitals should evaluate and observe all possible security risks for each patient.
• Chemical, physical, infectious, ergonomic, and psychosocial risks should be minimized.
• Security measures should create an environment that benefits patients and staff.

Falls and Fall Prevention

• Fall risk is determined.
• The floor should be checked and kept as clear as possible to prevent slipping.
• Holding places such as toilets/bathrooms and stairs.
• A night light may be used to improve visibility and avoid falls and trips.

Hospital Room Features Optimizing Safety

• Windows should be closed for safety.
• Permission is needed to enter, along with appropriate lighting and cleaning.
• There should be no flowers.
• Consume no outside food and beverage.
• Room order is important for the patient's healing process.
• The patient should feel as safe as possible.
• Enter the room with permission.
• Knock on the door before entering.

Core Principles of a Physical Clinical Environment

• Cleanliness.
• Temperature and humidity.
• Proper lighting.
• Noise reduction.

Patient Room Considerations

• Patient rooms should not feature live or inanimate flowers.
• Rooms should be closed.
• Food and dirty goods should not clutter the patient room.

Patient Units

• Each unit is to contain a bed, drawer, call bell and light.
• An oxygen system is to be present in the room and is up to date
• The suction system should be checked regularly.
• Patient chair.
• Overbed table.

Hospital Bed Guidelines

• The following are required: Bed (mattress), pillows, pillowcases and intermediate sheets.
• Required sheet and safety: bed sheet, mattress protector, and blanket.

Purpose of Making Bed

• Beds that are well made help to prevent hospital infections, support a hygienic environment, and prevent transferring microorganisms.
• Proper bed maintenance presents skin sores.
• It ensures the patient's comfort and support psychological well-being.

Reducing Contamination.

• Wash hands with proper technique before and after any procedure.
• Contaminated surfaces are folded inwards.
• Clean and dirty items are kept apart.
• Any dirty items are to be kept away from uniforms.
• All dirty items are discarded in appropriate trolleys without touching the floors.

Patient Safety

• Preserving patient safety means protecting patients from mistakes and undesirable situations related to healthcare services.

Principles of Patient Safety

• Proper identification and verification of patient information.
• Secured data in health service delivery.
• Ensuring drug safety to prevent issues involving medication safety, surgical precautions, and transfusion protocols.
• Radiation safety.
• Prevent falls.

Verifying Identification and Information Integrity

• Healthcare teams are responsible for verifying the patient's wristband information.
• Data points such as patient name, protocol, patient's national ID number, allergies, and date of birth.

Ensuring Communication Security

• Healthcare security protects patients and data via real time communications.
• Timely, accurate, complete and clear communications prevents errors and ensures patient safety.

Drug Safety

• Drug safety includes monitoring the phases of production
• Includes the path to the point of use via monitoring long term effects until it is totally removed from the body.

Medication Errors

• Medication errors include giving the wrong drug, an incorrect dose, errors in application, and mistaken timing.
• There are cases involving the rate of medication
• There can be application errors where medication goes to the wrong patient.
• Patients may fail to receive the medicine on time.
• Failures to record the medication usage creates unsafe conditions.

Transfusion Safety

• Blood or blood product usage must be performed given scientific tests.
• Proceed without complications.

Ensuring Surgical Safety

• Surgical safety includes conducting procedures in accordance with proper organ systems
• A physician is responsible, nurses can assist when needed.

Radiation Protocol

• Radiation is the energy that moved through a medium via particles or electromagnetic waves.
• Protective equipment is a must. Patients must know where the beam will hit.
• Areas should be checked prior to radiation.
• All users must be informed of radiation risks in the medical area.
• Risks cause cancer.

Preventing Falls

• Institutes make patients aware of the risk.
• Instituions should know and provide precautions toward falling.
• Falls may result in permanent injury.
• Falls may include minor or major causes.

Fall Assessment

• Utilize Hendrich and Itaki scales to evaluate fall risks.
• A fall evaluation should occur during the first 12 hours of admission.
• Evaluation should be done when patients change areas, when they fall, and if there are physiological or cognitive changes in condition.

Fall Prevention Techniques

• Determine the patient's risk level and take appropriate related precautions.
• Prevent falls in hospitals with consistent monitoring and assessment to find causes.
• Provide signage of a patient at risk of falling throughout the facility.
• Make improvements.
• Identify risk groups and related precautions according to risk.
• Lowering bed heights and lifting bed borders at night also helps to prevent issues.
• Provide proper information to patients and relatives.
• Have non slip shoes.
• Have regular checkups.
• Handles are suggested for the patient's room to support safe movement.

Restrictive Devices: Guidelines

• Restrictive devices should not be deployed unless absolutely necessary.
• Use of such devices must not block the blood flow .
• Bone prominence considerations need to be made.
• Normal body limits should be recognized. Restrictive devices should be hidden a much as possible.
• They must be removed every 4 hours for exercise.

What is Infection?

• Infections refer to diseases passed by microorganisms.
• Pathogens lead to disease
• Nonpathogens do not cause disease under normal conditions.

The Chain of Infection

• The transfer of microorganism pathogens can vary due to changing environments and human impacts.

Infection Lifecycle

• Process begins when pathogens complete their tasks
• Incubation period
• Signs and symptoms
• Recovery

Nosocomial Factors

• Healthcare environments can cause further complications.
• Infections are often unnoticed.
• Infections come about after or during a hospital stay.
• Common for infection in healthcare to occur before, during or after checkups are finished.
• Infections occur within 30-90 days.

Infections: Timing

• At least 48–72 hours after admission.
• Ten days after discharge.
• A 30-day window after implantations, in most surgeries.
• Implants consider nosocomial issues within 90 day time-frame