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Safety/Hygiene

Safety/Hygiene

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Safety/Hygiene

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  1. Safety/Hygiene NURS 1510

  2. Why Patient Safety? • According to the Institute of Medicine, 44,000 – 98,000 people die each year because of “preventable” medical errors • Most often these deaths result from a combination of errors and oversights by several people, and not simply o person’s error=Procedural errors • The most common error involve medications

  3. The Joint Commission 7 National Patient Safety Goals • 1. Patient identification: Improve the accuracy of patient identification: • 2 identifiers: name band + DOB • 2. Communication: improve the effectiveness of communication among caregivers: VO or PO note “read Back” Standardize abbreviations to be used

  4. continued • Improve the safety of using high-alert medications: Remove concentrated meds from client care units Standardize and limit the number of drug concentrations available per organization

  5. Continue • 4. Eliminate Wrong: eliminate wrong-site, wrong-patient, wrong procedure or surgery Create and use pre-op verification process, checklists, to confirm that appropriate documents are available Implement a process to mark the surgical site and involve client in the marking process

  6. Continue • Improve the safety of using infusion pumps: • Ensure free-flow protection on all general-use and PCA IV pumps by the organization • Improve the effectiveness of clinical alarm systems: • Implement reg preventive maintenance and testing of alarm systems • Assure alarms to be activated and audible

  7. continue • Infection control: • Handwashing and reporting nosocomial infections • Reporting deaths from nosocomial infections

  8. Safe Environment • Primary responsibility as a nurse is to protect client from harm • Safe environment includes: • Comfortable • Private • Low risk of infection • Low risk of injury • Low risk of undesirable effects of RX, TX

  9. Risk in HCO • Falls account for 90% of all reported incidents in hospitals • Hip Fx results in more hospital admissions than any other injury • Client- inherent accidents: accidents other than falls. Cuts, burns, seizure with injury • Procedure-Related accident: caused by HCO, med errors, contamination of equipment or wound

  10. Continued • Improper performance of nursing procedure • Equipment-related incidents: result from the malfunction or improper use of medical equip-electrocution and fire. • Mark faulty equipment • Place in designated place • Call bio-med

  11. Environmental Hazards • Oxygen-furnace malfunction leading to carbon monoxide. Gas binds with hemoglobin reducing available O2 to tissues • Nutrition-poor food handling and storage may lead to food poisoning, Hep A. • Temperature-exposure to extremes temperature=accidental hypothermia or heat exhaustion

  12. Hazards • MVA leading cause of death f/u by falls, poisonings, drowning, fires and burns. • Common Hazards in the home include: • Inadequate lighting • Clutter • Others: • Lack of security • Pathogens, carcinogens, sanitation and pollution

  13. Risk Factors • Developmental age: infant, toddler, preschooler need supervision hi risk for accidents • School age sports injuries • Adolescents have risk taking behaviors • Adults life style concerns: alcohol, stress • Older adults physiological changes of age, medications, other illnesses. The older, the greater the incidents of falls

  14. Other Risk Factors • Impaired mobility • Sensory impairments • Cognitive impairments • Safety awareness-placing meds out of reach of young children, maintaining smoke, CO2 detectors, furnace checks, wearing seat belts, etc

  15. Your Role to Improve Patient Safety • Consider your action and how they affect patient safety • Don’t leave products behind • Evaluate products before purchasing (avoid look a likes) • Know how to use products, equipment, etc • Don’t misuse containers • Stay alert for things that do not seem right • Take appropriate steps to address the problem • Trust your instincts and don’t make assumptions • Listen to patients as they express a problem and communicate it effectively

  16. Patient Safety • Healthcare is a complex system • Everyone makes errors or has near misses • Promote learning • Identify why key systems, processes, or procedures are in place, learn them and follow through correctly consistently

  17. Specific Safety Concerns • Falls • Physical / chemical restraint (see handout) • Bed/chair alarms • Side rails • Fire RACE: Rescue, Alarm, Confine, Extinguish or Evacuate • Code-BLS (see Alegent handout)

  18. Factors influencing hygiene practices • Body Image • Economics • Level of Knowledge • Socio-economic variables • Personal preferences • Physical condition • Age • Gender

  19. Nurse will always • Practice Standard precautions • Utilize safety practices • Provide privacy • Maintain body warmth –use bath blanket • Promote independence

  20. Measures to Promote Client’s personal hygiene • Oral hygiene: cleanse teeth of food particles, plaque & bacteria • Massage gums to prevent periodontal ds • Moisturize oral mucosa • Improve sense of taste • Enhances client’s sense of well being • Palm dentures to clean

  21. Eyes • Note drainage • Soak gently with H20 if crusted • Wipe from inner to outer canthus EARS Note drainage Ear wax (cerumen) DO NOT use cotton tipped applicators

  22. Goal of skin care • Maintain integrity • Control body odors • Improves self image • Promotes relaxation • Daily cleanse folds and peri area

  23. Feet • Observe for dryness, inflammation • Corns, calluses • Clean toenails carefully • Dry thoroughly • DO NOT cut corns or calluses • Use lotion

  24. Nails • File nails • Greenish-black indicates fungus growth • Note ingrown nails or thickened nails • DO NOT cut nails of diabetics • If ordered to cut nails in general population soak for 20 min to soften prior to cutting

  25. Pericare • Clean to soiled (outer to inner) • Front to back • Retract foreskin in uncircumcised male • Replace foreskin over glans after rinsing and drying • Rinse and dry area well

  26. Back Massage • Promotes relaxation • Stimulates circulation • Opportunity to inspect skin • Relieves muscle tension • Promotes comfort

  27. Types of baths • Complete bedbath Partial • Self with help –sponge bath • Shower Chair-shower • Tub-often avoided post-op • Tipid Sitz • Aveeno / oatmeal therapeutic