Safety and Body Mechanics

1. Safety and Body Mechanics Chapter 6 100% Pass rate

2. Bellwork • Abbreviations • Complete the “B” abbreviations

3. Falls Causes: unsafe environment, loss of abilities, diseases, medications, loss of vision, gait or balance problems, weakness, paralysis, and disorientation Prevention: • Clear walkways. • Use rugs or mats with nonslip backing. • Have residents wear nonskid, sturdy shoes. • Residents should not wear clothing that is too long.

4. Fall prevention (cont’d): • Keep frequently-used personal items, including call lights, close. • Answer call lights promptly. • Clean up spills. • Report loose handrails immediately. • Mark hazardous areas. • Improve lighting. • Lock wheelchairs and move footrests out of the way. • Lock bed wheels.

5. Fall prevention (cont’d): • Return beds to lowest positions. • Get help. • Offer help with eliminations regularly and respond to requests immediately. • Leave furniture in same place. • Pay attention to residents at risk for falls. • Never try to catch a falling resident. • Report all falls to the nurse.

6. Burns/Scalds Causes: dry heat (irons, stoves, other electric appliances), wet heat (hot water or other liquids, steam), or chemicals (lye, acids) Prevention: • Check water temperature. • Report frayed cords or appliances that look unsafe. • Communicate about hot liquids. • Pour hot drinks away from residents. • Keep hot drinks away from edges of tables. Use lids. • Make sure residents are sitting before serving hot drinks. • Monitor heat-producing equipment.

7. Journal Resident Identification Cause: not identifying resident properly Prevention: • Identify each resident before care or assisting with meals. • Check IDs. • Call resident by name.

9. Choking Causes: weakened, ill, or unconscious residents; residents with swallowing problems Prevention: • Eat sitting upright. • Follow orders for special diets and thickened liquids

10. Poisoning Cause: ingesting harmful substances such as cleaning products, paints, medicines, toiletries, or glues Prevention: • Lock these products away from confused residents or those with limited vision. • Do not leave cleaning products in rooms. • Investigate any unusual odors. • Post Poison Control Center number.

11. Cuts/Abrasions Cause: sharp objects Prevention: • Put sharp objects away after use. • Take care when transferring residents. • Push wheelchairs forward.

12. NAs should remember these general safety guidelines, as well: • Do not run. • Keep paths clear. • Wipe up spills immediately. • Discard trash properly. • Follow instructions and ask questions as needed. • Report injuries immediately. • If you see a suspected hazard among a resident’s possessions, report it to the nurse.

13. 2. List safety guidelines for oxygen use The following are important guidelines for oxygen safety: • Post No Smoking and Oxygen in Use signs. Do not allow smoking around oxygen equipment. • Remove fire hazards. Report to nurse if resident does not want a fire hazard removed. • Do not allow open flames around oxygen (this includes burning candles, lighting matches, and using lighters). • Do not use an extension cord with an oxygen concentrator.

14. Guidelines for oxygen safety (cont’d): • Do not place electrical cords or oxygen tubing under rugs or furniture. • Avoid using fabrics such as nylon and wool. • Report skin irritation from cannula or face mask. • Do not use any petroleum-based products on resident or on any part of the cannula or mask. • Learn how to turn oxygen off in case of fire if facility allows this. Never adjust oxygen setting.

15. The Safety Data Sheet (SDS) • Is required by OSHA for all hazardous chemicals • Details ingredients, dangers, safe handling, storage, disposal, and emergency response procedures • Some facilities may use a toll-free number to access SDS information • Must be accessible in work areas for all employees

17. 3. Explain the Safety Data Sheet (SDS)

18. 4. Restraints Restraints were used in the past for the following reasons: • Keep person from wandering • Prevent falls • Keep person from hurting self or others • Keep person from pulling out tubing

19. NAs must know this about restraints: • They were often overused by caregivers, and residents were injured. • LTC facilities are now prohibited from using restraints unless they are medically necessary. • It is against the law for staff to apply restraints for convenience or discipline.

21. Critical thinking activity In which of these situations can a restraint be used? A facility is understaffed one day and so residents are restrained to make sure they do not hurt themselves while they wait for care. A resident has frightened an NA with repeated hostile behavior. A doctor has ordered a restraint for a resident. Food is slow to come out so residents are placed in geri-chairs with the trays snapped in place while they wait to prevent wandering.

22. Problems Associated with Restraint Use • Pressure ulcers • Pneumonia • Risk of suffocation • Reduced blood circulation • Stress on the heart • Incontinence • Constipation • Muscle atrophy (weakening or wasting away of the muscle) • Loss of bone mass • Poor appetite and malnutrition

23. Depression and/or withdrawal • Sleep disorders • Loss of dignity • Loss of independence • Stress and anxiety • Increased agitation (anxiety, restlessness) • Loss of self-esteem • Severe injury • Death

24. Restraint Alternatives • Improve safety measures and lighting. • Keep call light within reach and answer call lights immediately. • Ambulate the person when he or she is restless. • Provide activities for those who wander at night. • Encourage activities and independence. • Give frequent help with toileting. • Offer food or drink. Offer reading materials. • Distract or redirect interest. • Decrease the noise level. Use relaxation techniques. • Reduce pain levels through medication. Report complaints of pain immediately. • Provide familiar caregivers and increase number of caregivers. • Use a team approach. • Use special types of pads, belts, chairs, and alarms.

26. 7. Describe guidelines for what must be done if a restraint is ordered NAs must remember these guidelines regarding restraints: • Make sure there is a doctor’s order for restraint use and that it is in the care plan. • Make sure you have been trained on how to apply the restraint. • Follow manufacturer’s instructions. • Make sure restraint is not too tight. You should be able to place your hand in a flat position between the resident and the restraint. • Be sure not to catch breasts or skin in restraint. • Place call light within reach. Answer call lights immediately. • Document properly.

27. When a Resident is Restrained The resident must be checked at least every 15 minutes. At regular, ordered intervals, the following must be done: • Release the restraint or discontinue use. • Offer help with elimination. Check for episodes of incontinence and provide care. • Offer fluids and food. • Check for and report signs of skin irritation immediately. • Check for and report signs of swelling immediately. • Reposition the resident. • Ambulate resident if able.

28. Body Alignment 8. Explain the principles of body mechanics

29. NAs should remember the following points about their base of support: • Wide base is more stable. • Stand with legs shoulder-width apart. NAs should remember the following points about alignment: • Try to keep the body in alignment, with two sides of the body as mirror images of each other. • Keep object close when carrying or lifting. • Point feet and body toward the direction you are moving. • Avoid twisting at waist.

30. NAs should remember the following points about their center of gravity: • When standing, weight is centered in pelvis. • Low center provides greater base of support. • Bend knees when lifting, lowering center. • NAs should remember the following points about the principle of fulcrum and lever: • Arm is lever. • Elbow is fulcrum. • Rest object against forearm, shortening the lever and making object easier to lift.

31. The following steps demonstrate applying the principles of body mechanics to lifting a heavy object from the floor: • Spread feet apart. • Bend knees. • Use muscles in thighs, upper arms, and shoulders. • Pull object close to body. • When standing up, push with hip and thigh muscles.

32. Lifting Heavy Objects from the Floor

33. The following techniques will help an NA use proper body mechanics: • Assess the situation first. Clear the path and remove obstacles. • Use both arms and hands to lift, push, or carry objects. • When lifting a heavy object from the floor, spread your feet shoulder-width apart. Bend your knees. Raise your body and the object together. • Hold objects close to you when you are lifting or carrying them. • Push or slide objects, rather than lifting them. • Avoid bending and reaching as much as possible.

34. Techniques for proper body mechanics (cont’d): • If you are making an adjustable bed, adjust the height to a safe working level, usually waist high. • When a task requires bending, use a good stance. Bend your knees to lower yourself (squat), rather than bending from the waist. • Do not twist when lifting or moving an object. Instead, turn your whole body, pivoting with your feet instead of twisting at the waist. Your feet should point toward what you are lifting or moving. • Get help from coworkers when possible for lifting or helping residents.

35. Techniques for proper body mechanics (cont’d): • Talk to residents before moving them. Agree on a signal. Lift or move on three so that everyone moves together. • To help a resident sit up, stand up, or walk, place your feet shoulder-width apart. Place one foot in front of the other, and bend your knees. Your upper body should stay upright and in alignment. • Never try to catch a falling resident. If the resident begins to fall, assist her to the floor. • Report to the nurse any task you feel that you cannot safely do.

37. 10. Identify major causes of fire and list fire safety guidelines NAs should remember these guidelines for fire safety: • Never leave smokers unattended. Make sure ashtrays do not contain hot ashes before emptying them. • E-cigarettes should only be charged using the appliance supplied by the manufacturer. • Report frayed or damaged cords. • Report if fire alarms and exit doors are blocked. • Know how to use fire extinguishers: • Pull the pin. • Aim at the base of fire when spraying. • Squeeze the handle. • Sweep back and forth at the base of fire.

38. 10. Identify major causes of fire and list fire safety guidelines Guidelines for fire safety (cont’d): • In case of fire, use RACE: • Remove anyone from danger if you are not in danger. • Activate alarm or call 911. • Contain fire if possible by closing . • Extinguish, or fire department will extinguish. • Know evacuation plan. • Stay calm. Do not panic. • Follow directions of fire department. • Know which residents need one-on-one help. • Know differing abilities of residents.

39. Guidelines for fire safety (cont’d): • Remove blockage from windows or doors. • Do not get into elevators. • Stay low in a room to escape a fire. • Check for heat coming from doors before opening. • Stop, drop, and roll if clothing catches fire. • Use damp covering over mouth and nose. • Leave building if possible, then move away from it.