NSG 3100 Patient Safety and Restraints PDF

RE EXCELLENCE PURE PURE PURE CALLING CALLING PURE PURENURSING DEDICATION PURE EXCELLEN NURSING PURE COMMITMENT PURE PURE Patient Safety and COMPASSION...

RE EXCELLENCE PURE PURE PURE CALLING CALLING PURE PURENURSING DEDICATION PURE EXCELLEN NURSING PURE COMMITMENT PURE PURE Patient Safety and COMPASSION PURE DEDICA NURSING Restraints PURE EXCELLENCE PURE COMPAS NSG 3100 PURE DEDICATION PURE PURE CALLING PURE PURE DEDICATION NURSING PURE EXCELLE NURSING PURE COMMITMENT PURE COMPASSION PURE E DEDICATION PURE PURE DEDICATION  PURE CALLING Age & Development ICATION ING PURE EXCELLENCE Lifestyle PURE Mobility & Health Status Sensory-Perceptual Alterations PURE DEDICATION NURSING Factors Affecting RE EXCELLENCE PURE Cognitive Awareness Emotional State Ability to Communicate Safety COMPASSION PURE DEDICATION Safety Awareness Environmental Factors E PURE Healthcare setting CALLING Workplace ICATION SING PURE EXCELLENCE Home Bioterrorism PURE Disaster Planning PURE DEDICATION Think-Pair-Share What are some factors that affect safety throughout the lifespan: Developing fetus Newborns/Infants Toddlers Pre-Schoolers Adolescents Older adults Risk Factor for Falls Poor Vision Cognitive Dysfunction Mobility restrictions Orthostatic Hypotension Urinary frequency Weakness from disease process or therapy Current medication regimen Sedatives, hypnotics, tranquilizers, narcotic analgesics, diuretics Universal Fall Precautions Familiarize the client with the environment Teach back use of call light Keep call light within reach Keep personal possessions within reach of the client Handrails in room, bathroom, hallway Bed in low position and locked Non-skid, well-fitting footwear Nightlights Keep floor clean and dry Keep areas uncluttered Seizure Precautions Pad the side rails Put oral suction equipment at bedside During Seizure Remain with client & call for assistance Do not restrain client If not in bed lower the client to the floor and pad surroundings for safety Turn the client to the lateral position if able Move items in environment to ensure there is no injury Loosen any restrictive clothing Do not put anything in the client’s mouth Provide O2 & suction as needed Prepare seizure medications Time and record movements of the seizure to report to MD Document the seizure in a timely manner after it occurs  PURE CALLING Fires & Burns ICATION ING PURE EXCELLENCE Poisoning PURE Carbon Monoxide Poisoning Suffocation (asphyxiation) or Choking PURE DEDICATION NURSING Environmental RE EXCELLENCE PURE Excessive Noise Electrical Hazards Hazards Firearms COMPASSION PURE DEDICATION Radiation E PURE Bioterrorism Attack CALLING Procedure/Equipment related accidents ICATION SING PURE EXCELLENCE PURE PURE DEDICATION Fire Considerations Check batteries in smoke detectors regularly to make sure they are working Keep a fire extinguisher in the kitchen and handy Don’t smoke inside. Only smoke outside of home Prevent Poisoning Store harmful agents away from children and place in locked cabinets Don’t store harmful agents in different containers or remove labels Teach children to never eat anything unknown to them (even stuff that occurs out in nature like plants, nuts, berries, mushrooms, etc.) Do not refer to medicine as “candy” or pretend false enjoyment when taking meds. Glamorizing medications can confuse children. Always read product labels before using Have poison control phone numbers on hand and available at all times. Concerned about poisonous plants: contact county’s cooperative extension agency  Store guns in locked cabinet without glass and keys need to be inaccessible by children Store bullets in a different location from the gun Tell children never to touch a gun or stay in a friend's house where guns are accessible Teach children to never point the barrel of a gun at anyone Gun Safety Ensure firearms are unloaded and action is open when handing to someone else Do not use firearms when impaired with alcohol or drugs When cleaning, remove all ammunition to another room Have regularly used firearms inspected at least every 2 years  PURE CALLING Check cords for fraying ICATION ING PURE EXCELLENCE Avoid overloading outlets with too many PURE appliances Use only grounded outlets and plugs PURE DEDICATION NURSING Reducing Electrical RE EXCELLENCE PURE Always pull a plug by firmly grasping the plug, not by the cord Hazards Never use appliances near sinks, COMPASSIONbathtubs, showers or other wet areas. PURE DEDICATION Keep cords and appliances out of reach of young children E PURE CALLING Protective covers over outlets ICATION SING PURE EXCELLENCE PURE PURE DEDICATION  PURE CALLING Landmark report released in 1999 by the ICATION ING PURE EXCELLENCEInstitute of Medicine “To Err is Human: Building a Safer Health System.” PURE Many healthcare related deaths that are preventable Medical PURE DEDICATION Errors are typically not the result of individuals, but a system or NURSING process error Errors / Encouraged reporting of errors without fear of retribution RE EXCELLENCE PURE Healthcare organizations need to promote a “culture of safety” by a Sentinel blame-free approach, transparency, and processes designed to prevent errors COMPASSION PURE DEDICATION “Near miss” reporting: an event or situation that did not produce Events client injury, but only because of chance (ex: put the wrong ID band on a client before surgery) E PURE CALLING ICATION SING PURE EXCELLENCE PURE PURE DEDICATION  PURE CALLING ICATION ING PURE EXCELLENCE PURE Medical PURE DEDICATION NURSING Errors / RE EXCELLENCE PURE Sentinel COMPASSION PURE DEDICATION Events E PURE CALLING ICATION SING PURE EXCELLENCE PURE PURE DEDICATION The National Patient Safety Goals Use data to set goals for improvement in safety Updated every year Covers various healthcare settings. Ie. Ambulatory Care Behavioral Health Hospitals Laboratories Nursing Care Centers Joint Commission Goals for Patient Safety Patient identification Improve communication Improve safety of using medications Reduce HCAIs Reduce risk of harm from falls Prevent pressure ulcers Identify safety risks in our client population Activity – Go to NPSG Get into groups: Go to the National Patient Safety Goals Look at the different environments and the goals Be prepared to discuss these goals with your colleagues  PURE CALLING Restrains are protective devices used to limit ICATION ING PURE EXCELLENCEthe physical activity of a client or a body part. PURE PURE DEDICATION There are 3 types of restraints NURSING Restraints PURE RE EXCELLENCE *Physical *Chemical *Seclusion COMPASSION PURE DEDICATION Two reasons for restraints E PURE CALLING 1. Avoid and/or prevent purposeful or ICATION SING PURE EXCELLENCE accidental harm to a client PURE 2. In order to provide medically necessary treatments PURE DEDICATION  PURE CALLING Restraints should be used as a last ICATION ING PURE EXCELLENCEresort PURE Used when less restrictive interventions have been determined to be ineffective PURE DEDICATION to protect client, staff, or others from NURSING RE EXCELLENCE PURE harm Must be discontinued at the earliest possible time COMPASSION PURE DEDICATION Restraints are used for 2 situations: 1. Nonviolent, non-self-destructive E PURE behavior (pulling out IV, pulling on CALLING ventilator tubing) ICATION SING PURE EXCELLENCE 2. Violent, self-destructive behavior PURE (harm to self, staff, or others) PURE DEDICATION  PURE CALLING Primary Care Physician (PCP) order must ICATION ING PURE EXCELLENCEinclude: Reason for restraints PURE Restraint Specific time frame (nurses may PURE DEDICATION remove sooner if behavior warrants NURSING Order RE Parameters EXCELLENCE PURE it) Type of restraint needed As needed (PRN) orders are not allowed COMPASSION PURE DEDICATION for restraints Restraint orders must be renewed every E PURE 24 hours CALLING There needs to be continuous ICATION SING PURE EXCELLENCE monitoring of patients in restraints PURE PURE DEDICATION  PURE CALLING Obtain informed consent ICATION ING PURE EXCELLENCE Get an order from PCP PURE Applying Apply the restraint to where the client can still move as freely as possible PURE DEDICATION NURSING Restraints RE EXCELLENCE PURE while remaining safe. Do not impede circulation Pad bony prominences COMPASSION PURE DEDICATION Always tie with a knot that will not tighten when pulled E PURE Never tie the restraint to the side rails! CALLING ICATION SING PURE EXCELLENCE Assess skin and need for restraints regularly PURE PURE DEDICATION