44 Questions
What should you do if the tip of your cane wears down?
Replace the tip on the cane
What precaution should be taken when using public transportation?
Sit down, even if it means asking someone for their seat
What should be installed in the shower and near the toilet to improve safety?
Grab bars
What should be placed on the floor of the tub or shower?
Nonskid mat or decals
What is a recommended alternative to a loose soap bar in the shower?
Soap-on-a-rope or a suspended container of liquid soap
What should be used to prevent accidents when it is dark?
Flashlight or nightlight
What should be done to ensure pets do not pose a risk of tripping?
Make sure pets are not underfoot
What should be done immediately to prevent accidents?
Mop up spills immediately
What is the purpose of the Nursing Home Reform Law in relation to physical restraints and psychoactive drugs?
To ensure the resident's right to be free from physical restraints and psychoactive drugs imposed for discipline or convenience, and to only use restraints for the resident's physical safety with a physician's written order.
What are the circumstances under which restraints may be imposed on a resident?
To ensure the physical safety of the resident or other residents, and only upon the written order of a physician specifying the duration and circumstances.
What is the purpose of a protocol in the context of restraint use?
A plan or set of steps to follow when implementing an intervention, and in the case of restraint use, it must identify the criteria for application and discontinuation of restraints.
What nonphysical interventions are preferred over physical restraints?
Nonphysical interventions such as reorientation to place and circumstances, or 'time-out' in a quiet room, are preferred.
What must personnel attempt before using restraints on a client attempting to remove an endotracheal tube?
Personnel must first attempt less restrictive measures, such as having someone sit with the client, before using restraints.
What are some helpful devices used to prevent wandering in older adults with dementia?
Specially designed net with a stop sign, bells over doors, disguising exit doors, monitors, identification bracelets, alert/alarm devices, and GPS device
How can special environments be designed to prevent wandering in older adults with dementia?
Design hallways in a circle around nursing stations, allowing the older adult to walk while remaining in view of the nursing staff
Why is early identification important for preventing wandering in older adults with dementia?
Early identification allows proper precautions to be initiated
What program does the Alzheimer’s Association sponsor to facilitate the reporting and return of people with cognitive impairments who become lost?
Safe Return
What service may local police departments provide for older adults with dementia who are at risk of wandering?
Digital photography of the older adult and coded identification bracelets
Why is daily documentation of what a person is wearing helpful for preventing wandering in older adults with dementia?
It helps in identifying the client if they wander
What is the purpose of fitting clients with dementia with a global positioning satellite (GPS) device?
To facilitate locating a missing person
What are some examples of alert devices used to reduce the risk for wandering in older adults with dementia?
Bells over doors, alert/alarm devices, and GPS device
What is the purpose of using a nonskid mat or decals in the shower?
To prevent slipping
Why should a person use a flashlight or nightlight when it is dark?
To prevent accidents or falls
What is the purpose of using long-handled tongs instead of climbing on a chair to reach high objects?
To avoid straining the back
What is the purpose of fitting clients with dementia with a global positioning satellite (GPS) device?
To prevent wandering and assist in locating them if they become lost
Why should physical restraints be avoided in older adults who are confused or cognitively impaired?
To promote mobility and minimize the risk of injury
What is the purpose of using grab bars in the shower and near the toilet?
To provide support and enhance safety during toileting and bathing
Why should chemical restraints be used cautiously in managing clients' behavior or freedom of movement?
To prevent adverse effects on physical health and cognition
What must a physician do within 1 hour after a restraint is initiated?
Renew the medical order
What must be documented in the client's chart regarding a restrained client's condition?
Frequent and regular nursing assessments
What should the nurse record regarding nursing care for a restrained client?
Toileting, nutrition, and hydration
What is the intent of both the OBRA legislation and the TJC standards?
To promote restraint alternatives and eventually restraint-free client care
What is the purpose of the OBRA legislation and the TJC standards?
To provide protective or adaptive devices for client safety
What do both the OBRA legislation and the TJC standards aim to promote?
Restraint-free client care
What type of care should be recorded by the nurse while a client is restrained?
Toileting, nutrition, hydration, and range of motion
What should be present in the client’s chart regarding a restrained client’s condition?
Documented evidence of frequent and regular nursing assessments
What is expected from the nurse regarding nursing records for a restrained client?
Recording toileting, nutrition, hydration, and range of motion care
What is the main purpose of the Nursing Home Reform Law in relation to physical restraints and psychoactive drugs?
To ensure that residents are free from unnecessary physical restraints and psychoactive drugs
Under what circumstances may restraints be imposed on a resident according to the Nursing Home Reform Law?
To treat the resident's medical symptoms
What is the role of a protocol in the context of restraint use?
To specify the circumstances under which restraints are to be used
What is the preferred nonphysical intervention over physical restraints?
Reorienting a person to place and circumstances
During a TJC inspection, what does the accrediting team examine in relation to restraint use?
The agency's protocol for restraint use approved by the medical staff
In the case of a client attempting to remove an endotracheal tube, what must personnel first attempt before using restraints?
Less restrictive measures, such as having someone sit with the client
What is a protocol in the context of restraint use?
A plan or set of steps to follow when implementing an intervention related to restraint use
Study Notes
Safety Precautions
- If the tip of a cane wears down, it should be replaced to prevent accidents.
- When using public transportation, individuals should take precautions to avoid tripping or falling.
Bathroom Safety
- Installing grab bars in the shower and near the toilet can improve safety.
- Placing non-slip mats or decals in the shower can prevent slipping and falling.
- A shower chair or bench should be placed in the tub or shower to prevent falls.
Lighting and Accidents
- Using a flashlight or nightlight can prevent accidents when it's dark.
- Avoiding loose soap bars in the shower can prevent slipping and falling.
- Using a soap dispenser or soap on a rope is a recommended alternative to a loose soap bar.
Pet Safety
- Ensuring pets cannot pose a risk of tripping is important for safety.
Nursing Home Reform Law
- The Nursing Home Reform Law aims to prevent the misuse of physical restraints and psychoactive drugs.
- Restraints may be imposed on a resident only in certain circumstances, such as to ensure the resident's safety.
- A protocol is a standardized procedure for using restraints, and personnel must attempt nonphysical interventions before using restraints.
Wandering in Older Adults with Dementia
- Identifying older adults with dementia who are at risk of wandering is crucial for prevention.
- Designing special environments, such as those with circular paths and secure exits, can prevent wandering.
- The Alzheimer's Association sponsors a program to facilitate the reporting and return of people with cognitive impairments who become lost.
- Local police departments may provide a service for older adults with dementia who are at risk of wandering.
- Daily documentation of what a person is wearing can help prevent wandering.
Technology and Safety
- Fitting clients with dementia with a global positioning satellite (GPS) device can help track their location.
- Using alert devices, such as those that sound an alarm when a person exits a room, can reduce the risk of wandering.
Restraint Use
- Personnel must attempt nonphysical interventions before using restraints on a client attempting to remove an endotracheal tube.
- Chemical restraints should be used cautiously in managing clients' behavior or freedom of movement.
- A physician must evaluate the client within 1 hour after a restraint is initiated.
- The nurse must document the client's condition and nursing care in the chart.
OBRA Legislation and TJC Standards
- The intent of the OBRA legislation and the TJC standards is to promote liberty and safety for clients.
- The OBRA legislation and the TJC standards aim to promote care that respects clients' autonomy and dignity.
- Nurses must record detailed information about restrained clients' conditions and care.
Learn about practical tips to prevent falls and stay safe, including using assistive devices, modifying the home environment, and being cautious in various situations. This quiz provides valuable information for seniors and their caregivers to minimize the risk of falls and injuries.
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