1. Safety

2. NURSE’S RESPONSIBILITY
It is the nurse’s
responsibility to assess
each patient for real and
potential risks associated
with safety and include
injury prevention in each
client’s plan of care. Injuries
and accidents can be
minimized with appropriate
assessment, precaution,
planning, intervention, and
evaluation.

3. BASIC NEEDS
Consider the following:
 Physiologic needs sufficient amounts of:
 Oxygen – The Client requires adequate oxygen
for cell metabolism, this can be decreased by air
pollution or disease like lung disease
 Carbon Monoxide poisoning would also result
inadequate oxygen
 Nutrition – the correct amount of calories, protein,
carbohydrates, fats, vitamins and minerals to
avoid over or underweight and deficiencies
 Temperature – temperature that are either too hot
or two cold pose threats to clients in hypo or
hyperthermia
 Humidity – too much humidity can make it difficult
to breath and too little can result in dryness

4. PHYSICAL HAZARDS
 Lighting needs to be sufficient so the client can see where they are stepping and
potential obstacles
 Obstacles are objects which can trip clients like light cords, step stools, area
rugs
 Bathroom hazards result when clients attempt to get in and out of the bathtub or
toilet resulting in falling
 Security hazards occur when intrusion threatens a client

5. TRANSMISSION OF PATHOGENS
 Immunizations stop the
transmission
 Hand washing breaks the
chain of infection
 Asepsis maintains sterility of
essential patient care supplies
to prevent infection
 Personal Protection
Equipment when used
correctly decreases the
transmission of germs from
client to client and client to
care provider

6. TRANSMISSION CONTINUED
 Cleanliness should be maintained daily
and between clients so pathogens do not
have an opportunity to grow
 Isolation precautions should be adhered
to so pathogens do not migrate from one
client to the next
 Infection Control initiatives should be
adhered to minimize nosocomial
infections

7. POLLUTION
 Air –including passive exposure to
smoke can promote disease
 Land through improper disposal of waste
and use of pesticides which threaten to
make clients ill
 Water from recreation emissions from
water craft along with agricultural,
industrial, and improper disposal of
human waste
 Noise with exposure to sounds like
traffic, lawn mowers jet plans elevate
blood pressure and result in loss of sleep

8. DEVELOPMENTAL FACTORS
 Safety concerns vary by type
and incidence according to
developmental level.
 The nurse must evaluate the
specific age of any client to
ensure the developmental and
actual ages are consistent.
 Groups include Infant/toddler,
Preschooler, School-age child,
adolescent, adult and older
adult.

9. INFANT AND TODDLER
 Choking – they are curious
and put most things in their
mouths to explore.
 Falling- they are initially
unsteady on their feet as
they learn to walk, once
toddlers they climb and
wander to explore their
world.

10. OLDER ADULT
Physiological changes associated with aging place
the older adult at risk of injury which include
decreased muscle strength, joint immobility's, slowing
reflexes, decreased ability to respond to multiple
stimuli, sensory loss like hearing and vision.

11. OLDER ADULT
These physiological changes increase risk for:
 Falls
related to these factors, most common
cause of accidents after the age of 50
 Area rugs leads to tripping or sliding
 Inadequate lighting where they are unable to see
obstacles and trip
 Electrical cords that get tangled in their feet
 Urgency to get to the bathroom for elimination
 Burns related to leaving the stove on or slow
reactions

12. MORSE FALL SCALE
Tool used to assess if a client is at risk of falling.
 1. Does the person have a history of falling?
 2. Does the person have more than one medical
diagnosis?
 3. Does the person use ambulatory aids like crutches
or a walker?
 4. Does the person have an IV or saline lock?
 5. Is the person’s gait normal or stooped or
otherwise impaired?
 6. What is the person’s mental status? Disoriented?

13. TJC PATIENT SAFETY INITIATIVES
 Body site marking for operative site
while the patient is awake by the
surgeon to avoid wrong site surgery
 “Time out "when all members of the
surgical or procedural team must stop
and acknowledge the right patient, right
side, right procedure
 Medication reconciliation to review all
medications and supplements the
patient is taking so the provider takes a
comprehensive look
 Aggressive Hand Hygiene to avoid
infections
 Needless systems to avoid needle stick
of health care providers

14. RACE – FIRE RESPONSE
 R – rescue and remove
clients in immediate
danger of fire
 A – activate alarm
 C – confine the fire –
close doors and windows
and turn off oxygen
 E – extinguish fire using
fire extinguisher or
escape

15. SPEAK-UP
 A patient safety campaign by TJC to decrease
medical errors
 S- Speak –up if you have questions or concerns
 P- Pay attention to the care you are receiving
 E- Educate yourself about your situation
 A- Ask a trusted person to be your advocate
 K- Know your medications
 U-Use a hospital, clinic, care center that is surveyed
and meets high standards
 P-Participate in all of the decisions about your
treatment

16. USE OF RESTRAINTS
 Restraint – anything used to restrict freedom of
movement or access to a person’s body
 Potentially very dangerous, patients injured or strangled
getting tangled in restraint– Avoid use unless client at risk
of injury
 Least restrictive measures – many types select the
restraint that limits their movement the least while keeping
them safe
 All restraints require a physician order
 The physician order must be renewed at least every 24
hours
 The nurse must assess the patient and document every 2
hours
 Behavioral restraint use more restrictive with every 15
minute assessment and documentation

17. EQUIPMENT-RELATED ACCIDENTS
Appropriate use of equipment should
include:
 Thorough knowledge from
training how to use it
 Ensure it is properly inspected
 Ensure it is functioning properly
 In the event it is not functioning
properly remove it from service
and tag it
 Make sure the client’s room is
free from clutter and equipment
not in use is removed promptly

18. NEVER EVENTS LISTED
 Foreign objects left in a patient after surgery
 Air embolism
 Administration of the wrong kind of blood
 Severe pressure ulcers
 Falls and trauma
 Infections related to urinary catheters
 Infections associated with intravenous catheters
 (continue on next slide)

19. NEVER EVENTS CONTINUED
 Symptoms resulting from poorly controlled
blood sugar levels
 Surgical site infections following certain
elective procedures (orthopedic and bariatric)
 Deep vein thrombosis or pulmonary
embolism following total knee or hip
replacement

20. SAFETY AT ALL TIMES!