Transcript Document 7114542

Basic Nursing: Foundations of
Skills & Concepts
Chapter 20
SAFETY/HYGIENE
Safety
The number one priority in providing client
care.
 Prevention is the key to safety.
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Factors Affecting Safety
Age.
 Lifestyle.
 Sensory and Perceptual Alterations.
 Mobility.
 Emotional State.
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Causes of Accidents in the
Health Care Setting
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Client behavior accidents (e.g. poisoning, burns, selfinflicted cuts and bruises).
Therapeutic procedure accidents (medication errors,
falls during transfers, contamination of sterile
instruments or wounds, etc.).
Equipment accidents (malfunctioning or improper use of
medical equipment).
Hygiene

The science of health.
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Promotes cleanliness, provides for
comfort and relaxation, improves selfimage, promotes healthy skin.
Factors Influencing Hygiene
Body Image.
 Social and Cultural Practices.
 Personal Preferences.
 Socioeconomic Status.
 Knowledge.
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Cultural Considerations and
Hygiene
Some cultures do not permit women to
immerse their bodies in water during
menstruation for fear they will drown.
 In North America, people typically bathe
daily and use deodorants.
 In Europe, many people do not bathe
daily or use deodorants.
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Nursing Process: Assessment
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What things do you do to
stay healthy?
Do you need assistance
with bathing and
dressing?
Do you regularly visit the
eye doctor and dentist?
Do you floss regularly?
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Do you wash your hands
before preparing food?
Do you keep meats and
dairy products
refrigerated before
using?
Is there a smoke detector
or fire extinguisher in
your home?
Assessment: Appraisals
Nurses will assess clients for risk with two
main tools:
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Skin Integrity Risk Appraisal.
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Fall Risk Appraisal.
Nursing Diagnosis
After data collection and analysis, the main
nursing diagnoses that relate to safety
and hygiene deficits are:
Injury, Risk for.
 Risk for.
 Self-Care Deficits.
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7 Subcategories of Risk
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Aspiration, Risk for.
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Trauma, Risk for.
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Disuse Syndrome, Risk
for.
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Latex Allergy Response.
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Latex Allergy Response,
Risk for.
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Poisoning, Risk for.
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Suffocation, Risk for.
Self-Care Deficit
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A condition that exists when an individual
is not able to perform one or more
activities of daily living.
Implementation and Hygiene

Implementation involves continual
assessment of client health risks and
prioritization of such nursing interventions
as:
Administration of prescribed medications.
 Provision of balanced nutritional intake.
 Promotion of adequate rest and exercise.
 Teaching client about health hazards.
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Reducing the Risk for
Client Falls
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Orienting the client to
the environment and
the call system.
Providing ambulatory
aids (e.g. wheelchair or
walker).
Placing personal
belongings and call
light within easy reach.
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Proper supervision.
Keeping hospital beds
in the lowest position
and side rails up.
Using nonslip mats and
rugs.
Illuminating the
environment.
Nursing Interventions and
Prevention of Falls
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Specific nursing interventions aimed at
preventing falls include:
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Wiping up spills.
Encouraging use of side rails.
Applying restraints.
Encouraging use of assistive devices for walking.
Using proper body mechanics.
Ensure adequate lighting.
Removing obstacles.
Restraints

Protective devices used to limit the
physical activity of a client or to
immobilize a client or extremity.
Types of Restraints

Physical (reduces the client’s movement
through the application of a device).
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Chemical (medications used to control a
client’s behavior).
Acceptable Reasons for
Restraints
They are a legitimate part of the medical
treatment.
 All other interventions have been tried
first.
 Other disciplines have been consulted for
assistance with the problem.
 Supporting documentation has been
provided.
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Key Elements of Restraint
Documentation
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Reason for the restraint.
Method of restraint.
Explanation given to
client and family.
Date and time of and
client’s response.
Duration.
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Frequency of observation
and client’s response.
Safety.
Assessment of continued
need.
Client outcome.
Assistive Devices for Walking
Canes.
 Crutches.
 Walkers.
 Wheelchairs.
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Using Proper Body Mechanics
The safest way of lifting and moving things
is to use these principles of body
mechanics:
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Center of gravity (pelvic area).
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Base of support (the feet).
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Body alignment.
Fire Prevention
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Nursing interventions aimed at preventing
or reducing risk of fire include:
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Clearly marking fire exits.
Knowing locations and operation of fire extinguishers.
Practicing fire evacuation procedures.
Posting emergency phone numbers.
Keeping open spaces and hallways clear of clutter.
Checking wiring.
Educating clients about fire hazards.
Reducing Exposure to
Radiation
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Minimizing the time spent in contact with radiation
source.
Maximizing distance from radiation source.
Using appropriate radiation shields.
Monitoring radiation exposure with a film badge.
Labeling all potentially radioactive material.
Never touching dislodged implants or body fluids of
person receiving radiation therapy.
Nursing Interventions and
Hygiene
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Providing clean bed
linen.
Reducing noise pollution.
Providing for client’s
bathing needs.
Offering back rubs.
Providing perineal care.
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Providing foot and toenail
care.
Oral care.
Hair care.
Eye, ear and nose care.
Bathing Clients
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Bathing of clients is an essential
component of nursing care that falls into
two general categories:
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Cleansing baths (Shower bath, tub bath).
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Therapeutic baths (hot, warm, cool, tepid; soak or
sitz; oatmeal, cornstarch, or sodium bicarbonate).
Providing Oral Care
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Common problems occurring in the oral
cavity include:
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Bad breath (halitosis).
Cavities (dental caries).
Plaque.
Periodontal disease (pyorrhea).
Inflammation of the gums (gingivitis).
Inflammation of the oral mucosa (stomatitis).