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1、Fundamental Concern of NursesPrevention of Harm Harm from accidents&injury-Prevent falls,fires,etc Harm by the spread of infection-Control infectious organismsSafety NeedsTo Meet Safety Needs of Patients consider:Physical Factors in Environment Psychological State Physiologic StateHospital SafetyDis
2、aster Planning Emergency Codes -Code Red -Code Blue-Code Pink Emergency Nursing-CPRPatient SafetyFactors Affecting Safety Age&Development Mobility Health Status Sensory-Perceptual Alterations Cognitive Awareness Emotional State Ability to Communicate Safety AwarenessSafe and Comfortable Environment
3、Space Lighting Temperature Ventilation Comfortable sound levels Furniture:Bed Safety Food and Water Hazardous Products Waste Management Organization of time Privacy Individualized Care Information and Teaching Safety Precautions-fall prevention Poor Vision Confused Disoriented Impaired memory Impair
4、ed gait/balance Difficulty walking Difficulty getting in and out of bed Orthostatic hypotension Urinary frequency Weakness Medications-sedatives,hypnotics,tranquilizers,narcotic analgesics,diureticsFall Risk Assessment Mr.Jackson is a 73-yr-old stroke patient with recent mental status changes,admitt
5、ed for prostate surgery.He 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 spec
6、ific interventions to ensure the Mr.Jacksons safety in the hospital?Fall Prevention Risk Assessment Indicate fall risk on door&chart Bed in low position Wheels locked Call light Side rails Bed alarms Bedside commode Shower chair Night light Sitters Room closer to nursing station Water,tissues,bedpan
7、 within reach Monitor changes in cognitive status Eliminate clutter Non skid footwear Ambulatory devices Dangle Secure tubes,drainsIf a Fall Occurs Assess for injury Check vital signs Assist back to bed,if safe Notify MD Monitor frequently Incident ReportFire Safety A family member reports a lit cig
8、arette dropped on the clients mattress,but they 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 mattress Assess pt for injury Call for Help Rescue patients Activate the a
9、larm Contain fire-close doors-turn off oxygen Extinguish the fireHow To Use A Portable Fire ExtinguisherRemember the acronym“PASS”PPull the Pin AAim at the base of the flames SSqueeze the trigger SSweep from side to sideFire Safety Thorough assessment of patients Notify physician Thank the family Re
10、view“No Smoking Policy”Alternative means for smoking-nicorette gumElectrical Safety Equipment is checked by biomed dept Pts personal devices Read warning labels No smoking Check for frayed electrical cords Avoid overloading circuits Report any shocks to biomed dept Electrical shock-turn off&remove s
11、ource before touching pt,vital signs,skin for burns,notify MD.Infection ControlMicroorganisms Bacteria Viruses Fungi ParasitesHarmless Organisms Resident flora-E Coli(intestine)-Staph aureus(skin)Colonization-microorganisms become resident floraHarmful Actions of MicroorganismsInfections or disease
12、occur#of organism present Ability of organism to cause disease Persons immune system Length of contact between person&organismRisk Factors for Infection Age Heredity Stress Nutrition Medication Diseases-burns,PVD,DM Invasive techniques-surgical wounds-immunity-trachs,ventilators-foley cath-IV therap
13、y-venipuncture sites-TPN-Implanted devicesChain of Infection Infectious agent-The Bug Reservoir-Hiding Places Portal of Exit-Way out Mode of transmission-Getting around Portal of entry-Way in Susceptible host-Another sick personThe Spread of Infection An elderly pt,admitted with a GI disorder,is on
14、bedrest and requires assistance with adls.The 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 nurs
15、es hands were not washed before assisting the second patient.Spread of Infection Infectious agent-E Coli Reservoir-Large Intestine Portal of Exit-Feces Mode of transmission-Contaminated hands Portal of entry-foley cath tubing Susceptible host-elderly,chronic illness,foley cathBreaking the Chain A pa
16、tient assigned for morning care has an open wound 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-MRSA Reservoir-infected wd Portal of exit-Break the chain-Handwashing,gloves,handle linen properly MRSA is commonly transferred on the hands of the nurse by indirect contact.Nosocomial InfectionsDrug Resistant Organisms Clos