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1、Fundamental Concern of Nurses,Prevention of HarmHarm from accidents&injury-Prevent falls,fires,etcHarm by the spread of infection-Control infectious organisms,Safety Needs,To Meet Safety Needs of Patients consider:Physical Factors in EnvironmentPsychological StatePhysiologic State,Hospital Safety,Di
2、saster PlanningEmergency Codes-Code Red-Code Blue-Code PinkEmergency Nursing-CPR,Patient Safety,Factors Affecting SafetyAge&DevelopmentMobilityHealth StatusSensory-Perceptual Alterations,Cognitive AwarenessEmotional StateAbility to CommunicateSafety Awareness,Safe and Comfortable Environment,SpaceLi
3、ghtingTemperatureVentilationComfortable sound levelsFurniture:Bed SafetyFood and Water,Hazardous ProductsWaste ManagementOrganization of timePrivacyIndividualized CareInformation and TeachingSafety Precautions-fall prevention,Poor VisionConfusedDisorientedImpaired memoryImpaired gait/balanceDifficul
4、ty walkingDifficulty getting in and out of bed,Orthostatic hypotensionUrinary frequencyWeaknessMedications-sedatives,hypnotics,tranquilizers,narcotic analgesics,diuretics,Fall Risk Assessment,Mr.Jackson is a 73-yr-old stroke patient with recent mental status changes,admitted for prostate surgery.He
5、has right-sided weakness and has fallen once at home while trying to go to the bathroom.He has difficulty initiating a urinary stream,dribbling of urine,and nocturia.He has a history of hypertension,for which he takes hydrochlorothiazide(diuretic).,Fall Prevention,List specific interventions to ensu
6、re the Mr.Jacksons safety in the hospital?,Fall Prevention,Risk AssessmentIndicate fall risk on door&chartBed in low positionWheels lockedCall lightSide railsBed alarmsBedside commodeShower chair Night lightSitters,Room closer to nursing stationWater,tissues,bedpan within reachMonitor changes in cog
7、nitive statusEliminate clutterNon skid footwearAmbulatory devicesDangleSecure tubes,drains,If a Fall Occurs,Assess for injuryCheck vital signsAssist back to bed,if safeNotify MDMonitor frequentlyIncident Report,Fire Safety,A family member reports a lit cigarette dropped on the clients mattress,but t
8、hey were able to put out the small fire.What actions are needed to ensure the safety of the patients?,Fire Safety,Immediately Assess pts room-surface fire maybe out-smoldering inside mattressAssess pt for injuryCall for Help,Rescue patientsActivate the alarmContain fire-close doors-turn off oxygenEx
9、tinguish the fire,How To Use A Portable Fire Extinguisher,Remember the acronym“PASS”PPull the PinAAim at the base of the flamesSSqueeze the triggerSSweep from side to side,Fire Safety,Thorough assessment of patientsNotify physicianThank the familyReview“No Smoking Policy”Alternative means for smokin
10、g-nicorette gum,Electrical Safety,Equipment is checked by biomed deptPts personal devicesRead warning labelsNo smokingCheck for frayed electrical cordsAvoid overloading circuitsReport any shocks to biomed deptElectrical shock-turn off&remove source before touching pt,vital signs,skin for burns,notif
11、y MD.,Infections&Precautions,Infection Control,MicroorganismsBacteriaVirusesFungiParasites,Harmless OrganismsResident flora-E Coli(intestine)-Staph aureus(skin)Colonization-microorganisms become resident flora,Harmful Actions of Microorganisms,Infections or disease occur#of organism presentAbility o
12、f organism to cause diseasePersons immune systemLength of contact between person&organism,Risk Factors for Infection,AgeHeredityStressNutritionMedicationDiseases-burns,PVD,DM,Invasive techniques-surgical wounds-immunity-trachs,ventilators-foley cath-IV therapy-venipuncture sites-TPN-Implanted device
13、s,Chain of Infection,Infectious agent-The BugReservoir-Hiding PlacesPortal of Exit-Way out,Mode of transmission-Getting aroundPortal of entry-Way inSusceptible host-Another sick person,The Spread of Infection,An elderly pt,admitted with a GI disorder,is on bedrest and requires assistance with adls.T
14、he pt has frequent uncontrolled diarrhea stools and the nurse provided excellent care to maintain cleanliness and comfort.After one episode of cleaning the pt and changing the bed linen,the nurse went over to a second pt to adjust foley cath tubing.The nurses hands were not washed before assisting t
15、he second patient.,Spread of Infection,Infectious agent-E ColiReservoir-Large IntestinePortal of Exit-FecesMode of transmission-Contaminated handsPortal of entry-foley cath tubingSusceptible host-elderly,chronic illness,foley cath,Breaking the Chain,A patient assigned for morning care has an open wo
16、und on her left lower leg.The wound is draining and when last cultured,the organism MRSA was identified.What steps would you take to break the chain of infection while changing the patients bed.,Breaking the Chain,Infectious agent-MRSAReservoir-infected wdPortal of exit-Break the chain-Handwashing,g
17、loves,handle linen properlyMRSA is commonly transferred on the hands of the nurse by indirect contact.,Nosocomial Infections,Drug Resistant OrganismsClostridium difficile(C Diff)Methicillin-resistant Staph aureus(MRSA)Vancomycin-resistant enterococcus(VRE)C DiffMRSA,Nosocomial Infections,Urinary Tra
18、ct-E Coli-Poor cath careSurgical Site-Enterococcus-Improper dsg changePOOR HAND HYGIENEAPPLIES TO ALL,Bloodstream-Staph aureus-Improper IV site carePneumonia-Pseudomonas-Improper suctioning technique,Preventing Nosocomial Infections,Controlling Microorganism in the Environment,Medical Asepsis Clean
19、techniqueLimit#,growth,&transmission of microorganismsHandwashingBarrier techniquesEnvironmental cleaning,Surgical Asepsis Sterile techniqueCompletely free of microorganisms,Transmission Based Precautions,Infected or colonizedAirborne(measles,TB)-Private neg airflow room 6 air exchanges/hr-MaskDropl
20、et(pneumonia,meningitis)-Private room/mask 3 ft from ptContact-gloves/gown-Direct(kissing,bathing,toughing)-Indirect(instruments,needles,dressing)Protective Isolation,Safety of Healthcare Workers,Occupational Safety andHealth Administration(OSHA)Federal AgencyDept of LaborSafe environment for all wo
21、rkersViolations-Fines,Hospital SpecificSafety needlesSharp containersExposure to TB,Hep B,HIV,RadiationLatex allergiesPPEElectrical,Isolation&PPE,Latex Allergies,Assess for allergies to avocados,bananas,kiwi or chestnuts for cross sensitivity to latexS/S of latex allergy-Contact dermitis-Facial swel
22、ling,itching,hives,rhinitis,eye symptoms-Potentially dangerous bronchospasms,generalized edema,difficulty breathing,cardiac arrestLatex cart at bedside,Latex Allergy Precautions,Mrs.Smith tells you she has allergic reactions when she eats bananas,seafood,eggs.Based on this information what would you ask Mrs.Smith,and what actions would you take?,Isolation Room,Isolation CartIsolation SignsEquipmentDonning PPERemoving PPE,Psychological Interventions,Explain isolation procedureEncourage verbalization of feelingsBe empathicPermit visitorsSupport coping mechanismsVisit pt,
