Course Book : #115 - Preventing Accidents and Injuries

Fall Prevention in Healthcare Facilities

Author: Monica Oram, RN, BSN

Upon completion of this course the reader will be able to achieve the following objectives:

  1. Identify the five most common types of accidents

  2. Understand guidelines to prevent injuries

  3. Understand fire safety, and RACE

  4. Understand safety related to sharps and biohazard materials

  5. Understand personal safety suggestions to keep you safe

 

FIVE Most Common Accidents

 

The five most common accidents are:

  1. Falls

  2. Burns

  3. Choking

  4. Cuts

  5. Poisoning

 

 

FALLS

The majority of accidents within a healthcare setting are related to falls. Older people are more seriously injured by falls due to their frailness, and brittle bones. Conditions that raise the risk of falls include loss of vision, gait and balance disturbance, weakness, paralysis, or partial paralysis, medications, disorientation, and call lights that are not answered in a timely manner.

Environmental factors also contribute to falls and injury which include poor lighting, cluttered spaces, rugs in the floor, exposed electrical cords, slippery floors, uneven floors, and stairs.

Guidelines to prevent falls include:

  1. Respond to call bells in a timely manner

  2. Clear all pathways from cluttered objects

  3. Be very careful on waxed floors and areas where non skid carpet is not present

  4. Immediately clean up spills

  5. Offer trips to the bathroom often… most falls occur when the patient is trying to go to use the bathroom.

6. Add additional lighting when needed.

Falls, (which many result in fractured hips) are the number one reason for admission to a nursing home. Falls and injuries have risen to an alarming rate. Most falls occur without warning and may lead to a decline in independence and mobility. Older persons tend to heal slowly and therefore injuries are more serious.

 

Caregivers play a significant role in preventing falls and injuries. Preventing an injury will prevent hospitalization, reduce nursing home admissions, reduce risk of premature death and lower cost of medical care.

PHYSICAL PROBLEMS:

  • Elderly and frail

  • Injuries from previous falls

  • Recovering from hip or knee replacement

  • Recovering from acute illness requiring bedrest

  • hemi paresis or weakness on one side of the body

  • Drop in blood pressure when standing up

  • Diabetics ( due to neuropathy and decreased feeling and sensation in lower extremities)

  • Poor nutrition

  • Lack of exercise contributing to increased weakness

  • Trouble sleeping

  • Visually impaired

  • Osteoporosis

  • Reduced mobility

  • Unsteady gait

  • Urinary incontinence or urinary frequency

 

Most falls happen as the patient is on the way to the bathroom unassisted.

 

Many elderly individuals live alone or have altered mental status such as impaired judgment or dementia.

Certain medications can pose a hazard in balance and ability to move about safely.

 

 

 

 

 

 

Normal Changes in Aging

  • Change in vision

  • Changes in hearing

  • Changes in visual perception

  • Changes in nervous system

  • Changes in Cardiovascular system

 

There are medical conditions that can increase the risk for falls in the elderly. The following conditions may affect a person’s stability:

  • Cardiovascular changes- congestive heart failure ( CHF), angina, hypertension

  • Parkinson disease- weakened muscles, fatigue, shuffling gait, tremors, dementia

  • Stroke- partial weakness or paralysis on one side of the body, loss of vision in one eye or both, dementia, inner ear problems

  • Musculoskeletal problems- osteoporosis, arthritis, hip fractures, hip or knee replacements

  • Metabolic problems- Diabetes, hypoglycemia, electrolyte imbalances

  • Heart Attack

  • Syncope ( fainting episodes)

 

 

Falls can result in broken bones, head injuries, and soft tissue injuries.

 

Pulmonary Embolism is a life threatening condition that can result in death. A pulmonary embolism is a blood clot that gets into the main artery of the lung. Pulmonary embolism occurs in about 15% of all people who die from a fall and its related injuries.

 

People who are confined to bed are now at an even greater risk of developing other complications such as immobility, hypothermia related to decreased activity and bedrest, dehydration, pressure ulcers, and pneumonia.

 

Falls can be devastating because they trigger fear, anxiety, pain and depression.

 

 

 

 

BURNS

Burns can be caused by stoves and electrical appliances in a persons home. Hot water, heating devices contribute substantially to the number of burns each year. Small children, older adults or people with loss of sensation are at a higher risk for burns. Burns are extremely painful and can cause a persons health condition to deteriorate depending on the person’s prior physical state of health.

 

Follow these guidelines to protect against burns:

  • Always check water temperature before giving a bath or shower

  • Check for proper temperature of hot water applications such as hot packs

  • Water should not be over 110 degrees Fahrenheit

  • Wrap electrical heating pads inside approved covers before placing directly to patient skin

  • Keep space heaters away from client’s bed or curtains.

  • Report frayed electrical cords or unsafe equipment immediately.

  • Do not leave a resident unattended near a radiator or furnace

  • Use caution with hot beverages. Spills can cause serious burns.

  • Roll up sleeves to prevent and avoid loose clothing from getting near stove burners.

  • Remember that many older people are forgetful and can leave appliances on when not in use, posing a serious accident waiting to happen.

 

Remember that if a burn occurs, cool the burn with lots of cold water. Apply burn creams or aloe ONLY to a first degree superficial burn. If it is blistered or beyond only a slight redness, never apply ice, or burn creams to the area.

For more on burns, enroll in a red cross first aid class.

 

Poisoning

Most Homes contain many harmful substances that could be ingested and cause great harm to the client. These include cleaning products, paint, medications, toiletries, and glue. Items that would not be a hazard to an oriented person can be potentially fatal to a confused person.

Follow these guidelines to prevent against poisoning:

  • Store harmful products in separate places from confused patients.

  • Keep the poison control number near the phone

  • Check dates on foods and products to make sure they are fresh

  • Make sure there is adequate ventilation when using chemicals and products.

  • Lock up harmful products in special cabinets and out of reach of children and confused adults.

 

 

CUTS

 

Cuts typically occur in the kitchen or bathroom. Follow these guidelines when caring for a cut.

  • Keep sharp objects out of the reach of children and confused adults.

  • Lock sharp objects away from a resident who is confused or has dementia.

  • If you are preparing food, cut away from yourself, not towards yourself. Keep your fingers out of the way.

  • Know first aid for cuts. Apply pressure, stop the bleeding, cleanse with soap and water, apply antibiotic ointment and bandage with band aid or similar dressing.

 

CHOKING

 

One of the most common emergencies is choking. Choking can occur while eating, talking, drinking, or swallowing medications. People who are weak, ill, or unconscious can choke on their own saliva. A person’s tongue can also get in the way and become swollen and obstructed in the patient’s airway.

  • Have your resident eat in an upright position to avoid choking

  • Offer thickened liquids when appropriate per MD recommendation for those with swallowing deficits.

  • Assist with feeding slowly, don’t force them to eat fast.

  • Cut food into small pieces

  • Make sure dentures are in and in place properly.

  • Be observant for any swallowing deficits a resident may have.

 

Fire Safety

 

There are many potential causes of a fire in a facility. Some examples are careless smoking, frayed or damaged electrical cords, space heaters, overloaded electrical plugs, oxygen use, careless cooking, and flammable liquids carelessly handled.

 

Follow these simple guidelines to protect against fire:

 

  • Discourage careless smoking and no smoking in bed, or resident rooms.

  • Turn off space heaters when no one is around, do not use while sleeping, or unattended. Use caution around stoves.

  • Be sure the smoke alarms work

  • Have fire extinguishers on hand and ready for immediate use.

 

Tips for the home:

  • Don’t leave the dryer running while you are away… lint can catch fire

  • Stay in or near the kitchen when food is cooking or if you are baking

  • Store potholders, dish towels, and other flammable kitchen items away from the stove.

 

Oxygen use posed a serious fire risk. Follow these guidelines for oxygen safety:

  • Post NO SMOKING signs where oxygen is in use.

  • Remove any electrical equipment such as electrical razors, hair dryers, radios, televisions, from area where oxygen is being used.

  • Remove any flammable items from areas of where oxygen is being used.

  • Never allow a resident or client to be near any kind of open flame like a gas stove, candle, lighters or matches with Oxygen in use.

  • Do not use wool, nylon, or any other synthetic material around oxygen, it can cause static electric sparks and be a potential fire hazard.

  • Remove any smoking materials from the residents room.

 

In case of fire, know where and how to use a fire extinguisher properly. Know the location of fire alarms. Understand the acronym RACE

R= Rescue

A= Alarm

C=Contain

E= Extinguish or evacuate

 

Fire safety rules:

  • Stay low in a room when trying to get out of a smoke filled area.

  • Block doorways to prevent smoke from entering other rooms

  • Cover face to decrease smoke inhalation

  • If clothing is on fire, stop, drop, and smother out the fire.

  • If a door is closed, feel for heat before opening the door.

  • Never use an elevator in the event of a fire.

 

Sharps Containers

 

Sharps containers are the containers in which we place sharp objects.

Used razors, needles and other sharp object must be placed in a sharps box for proper disposal. Some guidelines to consider are:

  • Never touch the sharps container without wearing gloves

  • When dropping a sharp object into the container, keep your fingers OUT OF the opening to the container.

  • Never use a sharps box that is more than 2/3 full. If you must carry the box, wear gloves, and carry it by the bottom, and make sure it is sealed closed to prevent spillage if dropped.

  • Wash your hands after disposing items in a sharps box

 

Biohazard containers

 

Biohazard containers are the containers n which we place contaminated items such as anything that is contaminated with blood or body fluids. Do not place anything sharp in a biohazard container. This will include soiled dressings. DO NOT PLACE LINEN IN A BIOHAZARDOUS RED BAG, (unless it is your facility policy to do so) Red bags mean “Burn it” and any linen in a red bag should be disposed and incinerated, not taken to laundry and washed. There should be yellow bags, or melt away bags for this purpose, not red bags.

 

The following guidelines should be used in regards to biohazard containers:

  • Drop anything contaminated with infectious waste in these containers.

  • Do not put sharps in the biohazard container

  • Always wear gloves when putting items in a biohazard container

  • When disposing items into the container, keep your hands above the opening to the container

  • Never push items down in the container

  • Dispose of gloves and wash your hands immediately after disposal

 

Personal Safety Tips for traveling to and from work

 

Personal safety is something we should all be concerned about. To often we take too much for granitite, and are not very observant to our surroundings.

All activities have risks associated with them.

It is useful to assess the risks involved and take precautions that increase your personal safety. When traveling to and from work, make sure you are aware of what is around you.

 

  • Park in well lit areas, as close to where you are going as possible.

  • Leave valuables at home. Take with you only necessary items.

  • Lock your doors, both when driving and when you park the car.

  • Walk purposely and confidently. Look as though you know where you are going.

  • Carry your keys in your hand, and be ready to unlock your car before you approach the vehicle.

  • Do not sit in your car, even with the doors locked. Leave or get out as soon as you are in the car.

  • Avoid unsafe areas after dark

  • Don’t travel alone if at all possible

  • As for an escort to your vehicle if leaving work at night, or if you are not parked close to the facility.

 

Summary

 

This basic course is intended to enlighten the reader to quick tips in patient and personal safety. To learn more enroll in a first aid course through your local red cross chapter. Be observant and be safe on and off the job.

 

References:

 

Mosby Publishing

Nurse Assistant Training Modules

2002

 

Family Medical And Health Guide

Consumer Guide

2001

Fall Prevention in Healthcare Facilities

Author: Monica Oram, RN, BSN

Upon completion of this course the reader will be able to achieve the following objectives:

  1. Identify the five most common types of accidents

  2. Understand guidelines to prevent injuries

  3. Understand fire safety, and RACE

  4. Understand safety related to sharps and biohazard materials

  5. Understand personal safety suggestions to keep you safe

 

FIVE Most Common Accidents

 

The five most common accidents are:

  1. Falls

  2. Burns

  3. Choking

  4. Cuts

  5. Poisoning

 

 

FALLS

The majority of accidents within a healthcare setting are related to falls. Older people are more seriously injured by falls due to their frailness, and brittle bones. Conditions that raise the risk of falls include loss of vision, gait and balance disturbance, weakness, paralysis, or partial paralysis, medications, disorientation, and call lights that are not answered in a timely manner.

Environmental factors also contribute to falls and injury which include poor lighting, cluttered spaces, rugs in the floor, exposed electrical cords, slippery floors, uneven floors, and stairs.

Guidelines to prevent falls include:

  1. Respond to call bells in a timely manner

  2. Clear all pathways from cluttered objects

  3. Be very careful on waxed floors and areas where non skid carpet is not present

  4. Immediately clean up spills

  5. Offer trips to the bathroom often… most falls occur when the patient is trying to go to use the bathroom.

6. Add additional lighting when needed.

Falls, (which many result in fractured hips) are the number one reason for admission to a nursing home. Falls and injuries have risen to an alarming rate. Most falls occur without warning and may lead to a decline in independence and mobility. Older persons tend to heal slowly and therefore injuries are more serious.

 

Caregivers play a significant role in preventing falls and injuries. Preventing an injury will prevent hospitalization, reduce nursing home admissions, reduce risk of premature death and lower cost of medical care.

PHYSICAL PROBLEMS:

  • Elderly and frail

  • Injuries from previous falls

  • Recovering from hip or knee replacement

  • Recovering from acute illness requiring bedrest

  • hemi paresis or weakness on one side of the body

  • Drop in blood pressure when standing up

  • Diabetics ( due to neuropathy and decreased feeling and sensation in lower extremities)

  • Poor nutrition

  • Lack of exercise contributing to increased weakness

  • Trouble sleeping

  • Visually impaired

  • Osteoporosis

  • Reduced mobility

  • Unsteady gait

  • Urinary incontinence or urinary frequency

 

Most falls happen as the patient is on the way to the bathroom unassisted.

 

Many elderly individuals live alone or have altered mental status such as impaired judgment or dementia.

Certain medications can pose a hazard in balance and ability to move about safely.

 

 

 

 

 

 

Normal Changes in Aging

  • Change in vision

  • Changes in hearing

  • Changes in visual perception

  • Changes in nervous system

  • Changes in Cardiovascular system

 

There are medical conditions that can increase the risk for falls in the elderly. The following conditions may affect a person’s stability:

  • Cardiovascular changes- congestive heart failure ( CHF), angina, hypertension

  • Parkinson disease- weakened muscles, fatigue, shuffling gait, tremors, dementia

  • Stroke- partial weakness or paralysis on one side of the body, loss of vision in one eye or both, dementia, inner ear problems

  • Musculoskeletal problems- osteoporosis, arthritis, hip fractures, hip or knee replacements

  • Metabolic problems- Diabetes, hypoglycemia, electrolyte imbalances

  • Heart Attack

  • Syncope ( fainting episodes)

 

 

Falls can result in broken bones, head injuries, and soft tissue injuries.

 

Pulmonary Embolism is a life threatening condition that can result in death. A pulmonary embolism is a blood clot that gets into the main artery of the lung. Pulmonary embolism occurs in about 15% of all people who die from a fall and its related injuries.

 

People who are confined to bed are now at an even greater risk of developing other complications such as immobility, hypothermia related to decreased activity and bedrest, dehydration, pressure ulcers, and pneumonia.

 

Falls can be devastating because they trigger fear, anxiety, pain and depression.

 

 

 

 

BURNS

Burns can be caused by stoves and electrical appliances in a persons home. Hot water, heating devices contribute substantially to the number of burns each year. Small children, older adults or people with loss of sensation are at a higher risk for burns. Burns are extremely painful and can cause a persons health condition to deteriorate depending on the person’s prior physical state of health.

 

Follow these guidelines to protect against burns:

  • Always check water temperature before giving a bath or shower

  • Check for proper temperature of hot water applications such as hot packs

  • Water should not be over 110 degrees Fahrenheit

  • Wrap electrical heating pads inside approved covers before placing directly to patient skin

  • Keep space heaters away from client’s bed or curtains.

  • Report frayed electrical cords or unsafe equipment immediately.

  • Do not leave a resident unattended near a radiator or furnace

  • Use caution with hot beverages. Spills can cause serious burns.

  • Roll up sleeves to prevent and avoid loose clothing from getting near stove burners.

  • Remember that many older people are forgetful and can leave appliances on when not in use, posing a serious accident waiting to happen.

 

Remember that if a burn occurs, cool the burn with lots of cold water. Apply burn creams or aloe ONLY to a first degree superficial burn. If it is blistered or beyond only a slight redness, never apply ice, or burn creams to the area.

For more on burns, enroll in a red cross first aid class.

 

Poisoning

Most Homes contain many harmful substances that could be ingested and cause great harm to the client. These include cleaning products, paint, medications, toiletries, and glue. Items that would not be a hazard to an oriented person can be potentially fatal to a confused person.

Follow these guidelines to prevent against poisoning:

  • Store harmful products in separate places from confused patients.

  • Keep the poison control number near the phone

  • Check dates on foods and products to make sure they are fresh

  • Make sure there is adequate ventilation when using chemicals and products.

  • Lock up harmful products in special cabinets and out of reach of children and confused adults.

 

 

CUTS

 

Cuts typically occur in the kitchen or bathroom. Follow these guidelines when caring for a cut.

  • Keep sharp objects out of the reach of children and confused adults.

  • Lock sharp objects away from a resident who is confused or has dementia.

  • If you are preparing food, cut away from yourself, not towards yourself. Keep your fingers out of the way.

  • Know first aid for cuts. Apply pressure, stop the bleeding, cleanse with soap and water, apply antibiotic ointment and bandage with band aid or similar dressing.

 

CHOKING

 

One of the most common emergencies is choking. Choking can occur while eating, talking, drinking, or swallowing medications. People who are weak, ill, or unconscious can choke on their own saliva. A person’s tongue can also get in the way and become swollen and obstructed in the patient’s airway.

  • Have your resident eat in an upright position to avoid choking

  • Offer thickened liquids when appropriate per MD recommendation for those with swallowing deficits.

  • Assist with feeding slowly, don’t force them to eat fast.

  • Cut food into small pieces

  • Make sure dentures are in and in place properly.

  • Be observant for any swallowing deficits a resident may have.

 

Fire Safety

 

There are many potential causes of a fire in a facility. Some examples are careless smoking, frayed or damaged electrical cords, space heaters, overloaded electrical plugs, oxygen use, careless cooking, and flammable liquids carelessly handled.

 

Follow these simple guidelines to protect against fire:

 

  • Discourage careless smoking and no smoking in bed, or resident rooms.

  • Turn off space heaters when no one is around, do not use while sleeping, or unattended. Use caution around stoves.

  • Be sure the smoke alarms work

  • Have fire extinguishers on hand and ready for immediate use.

 

Tips for the home:

  • Don’t leave the dryer running while you are away… lint can catch fire

  • Stay in or near the kitchen when food is cooking or if you are baking

  • Store potholders, dish towels, and other flammable kitchen items away from the stove.

 

Oxygen use posed a serious fire risk. Follow these guidelines for oxygen safety:

  • Post NO SMOKING signs where oxygen is in use.

  • Remove any electrical equipment such as electrical razors, hair dryers, radios, televisions, from area where oxygen is being used.

  • Remove any flammable items from areas of where oxygen is being used.

  • Never allow a resident or client to be near any kind of open flame like a gas stove, candle, lighters or matches with Oxygen in use.

  • Do not use wool, nylon, or any other synthetic material around oxygen, it can cause static electric sparks and be a potential fire hazard.

  • Remove any smoking materials from the residents room.

 

In case of fire, know where and how to use a fire extinguisher properly. Know the location of fire alarms. Understand the acronym RACE

R= Rescue

A= Alarm

C=Contain

E= Extinguish or evacuate

 

Fire safety rules:

  • Stay low in a room when trying to get out of a smoke filled area.

  • Block doorways to prevent smoke from entering other rooms

  • Cover face to decrease smoke inhalation

  • If clothing is on fire, stop, drop, and smother out the fire.

  • If a door is closed, feel for heat before opening the door.

  • Never use an elevator in the event of a fire.

 

Sharps Containers

 

Sharps containers are the containers in which we place sharp objects.

Used razors, needles and other sharp object must be placed in a sharps box for proper disposal. Some guidelines to consider are:

  • Never touch the sharps container without wearing gloves

  • When dropping a sharp object into the container, keep your fingers OUT OF the opening to the container.

  • Never use a sharps box that is more than 2/3 full. If you must carry the box, wear gloves, and carry it by the bottom, and make sure it is sealed closed to prevent spillage if dropped.

  • Wash your hands after disposing items in a sharps box

 

Biohazard containers

 

Biohazard containers are the containers n which we place contaminated items such as anything that is contaminated with blood or body fluids. Do not place anything sharp in a biohazard container. This will include soiled dressings. DO NOT PLACE LINEN IN A BIOHAZARDOUS RED BAG, (unless it is your facility policy to do so) Red bags mean “Burn it” and any linen in a red bag should be disposed and incinerated, not taken to laundry and washed. There should be yellow bags, or melt away bags for this purpose, not red bags.

 

The following guidelines should be used in regards to biohazard containers:

  • Drop anything contaminated with infectious waste in these containers.

  • Do not put sharps in the biohazard container

  • Always wear gloves when putting items in a biohazard container

  • When disposing items into the container, keep your hands above the opening to the container

  • Never push items down in the container

  • Dispose of gloves and wash your hands immediately after disposal

 

Personal Safety Tips for traveling to and from work

 

Personal safety is something we should all be concerned about. To often we take too much for granitite, and are not very observant to our surroundings.

All activities have risks associated with them.

It is useful to assess the risks involved and take precautions that increase your personal safety. When traveling to and from work, make sure you are aware of what is around you.

 

  • Park in well lit areas, as close to where you are going as possible.

  • Leave valuables at home. Take with you only necessary items.

  • Lock your doors, both when driving and when you park the car.

  • Walk purposely and confidently. Look as though you know where you are going.

  • Carry your keys in your hand, and be ready to unlock your car before you approach the vehicle.

  • Do not sit in your car, even with the doors locked. Leave or get out as soon as you are in the car.

  • Avoid unsafe areas after dark

  • Don’t travel alone if at all possible

  • As for an escort to your vehicle if leaving work at night, or if you are not parked close to the facility.

 

Summary

 

This basic course is intended to enlighten the reader to quick tips in patient and personal safety. To learn more enroll in a first aid course through your local red cross chapter. Be observant and be safe on and off the job.

 

References:

 

Mosby Publishing

Nurse Assistant Training Modules

2002

 

Family Medical And Health Guide

Consumer Guide

2001

Fall Prevention in Healthcare Facilities

Author: Monica Oram, RN, BSN

Upon completion of this course the reader will be able to achieve the following objectives:

  1. Identify the five most common types of accidents

  2. Understand guidelines to prevent injuries

  3. Understand fire safety, and RACE

  4. Understand safety related to sharps and biohazard materials

  5. Understand personal safety suggestions to keep you safe

 

FIVE Most Common Accidents

 

The five most common accidents are:

  1. Falls

  2. Burns

  3. Choking

  4. Cuts

  5. Poisoning

 

 

FALLS

The majority of accidents within a healthcare setting are related to falls. Older people are more seriously injured by falls due to their frailness, and brittle bones. Conditions that raise the risk of falls include loss of vision, gait and balance disturbance, weakness, paralysis, or partial paralysis, medications, disorientation, and call lights that are not answered in a timely manner.

Environmental factors also contribute to falls and injury which include poor lighting, cluttered spaces, rugs in the floor, exposed electrical cords, slippery floors, uneven floors, and stairs.

Guidelines to prevent falls include:

  1. Respond to call bells in a timely manner

  2. Clear all pathways from cluttered objects

  3. Be very careful on waxed floors and areas where non skid carpet is not present

  4. Immediately clean up spills

  5. Offer trips to the bathroom often… most falls occur when the patient is trying to go to use the bathroom.

6. Add additional lighting when needed.

Falls, (which many result in fractured hips) are the number one reason for admission to a nursing home. Falls and injuries have risen to an alarming rate. Most falls occur without warning and may lead to a decline in independence and mobility. Older persons tend to heal slowly and therefore injuries are more serious.

 

Caregivers play a significant role in preventing falls and injuries. Preventing an injury will prevent hospitalization, reduce nursing home admissions, reduce risk of premature death and lower cost of medical care.

PHYSICAL PROBLEMS:

  • Elderly and frail

  • Injuries from previous falls

  • Recovering from hip or knee replacement

  • Recovering from acute illness requiring bedrest

  • hemi paresis or weakness on one side of the body

  • Drop in blood pressure when standing up

  • Diabetics ( due to neuropathy and decreased feeling and sensation in lower extremities)

  • Poor nutrition

  • Lack of exercise contributing to increased weakness

  • Trouble sleeping

  • Visually impaired

  • Osteoporosis

  • Reduced mobility

  • Unsteady gait

  • Urinary incontinence or urinary frequency

 

Most falls happen as the patient is on the way to the bathroom unassisted.

 

Many elderly individuals live alone or have altered mental status such as impaired judgment or dementia.

Certain medications can pose a hazard in balance and ability to move about safely.

 

 

 

 

 

 

Normal Changes in Aging

  • Change in vision

  • Changes in hearing

  • Changes in visual perception

  • Changes in nervous system

  • Changes in Cardiovascular system

 

There are medical conditions that can increase the risk for falls in the elderly. The following conditions may affect a person’s stability:

  • Cardiovascular changes- congestive heart failure ( CHF), angina, hypertension

  • Parkinson disease- weakened muscles, fatigue, shuffling gait, tremors, dementia

  • Stroke- partial weakness or paralysis on one side of the body, loss of vision in one eye or both, dementia, inner ear problems

  • Musculoskeletal problems- osteoporosis, arthritis, hip fractures, hip or knee replacements

  • Metabolic problems- Diabetes, hypoglycemia, electrolyte imbalances

  • Heart Attack

  • Syncope ( fainting episodes)

 

 

Falls can result in broken bones, head injuries, and soft tissue injuries.

 

Pulmonary Embolism is a life threatening condition that can result in death. A pulmonary embolism is a blood clot that gets into the main artery of the lung. Pulmonary embolism occurs in about 15% of all people who die from a fall and its related injuries.

 

People who are confined to bed are now at an even greater risk of developing other complications such as immobility, hypothermia related to decreased activity and bedrest, dehydration, pressure ulcers, and pneumonia.

 

Falls can be devastating because they trigger fear, anxiety, pain and depression.

 

 

 

 

BURNS

Burns can be caused by stoves and electrical appliances in a persons home. Hot water, heating devices contribute substantially to the number of burns each year. Small children, older adults or people with loss of sensation are at a higher risk for burns. Burns are extremely painful and can cause a persons health condition to deteriorate depending on the person’s prior physical state of health.

 

Follow these guidelines to protect against burns:

  • Always check water temperature before giving a bath or shower

  • Check for proper temperature of hot water applications such as hot packs

  • Water should not be over 110 degrees Fahrenheit

  • Wrap electrical heating pads inside approved covers before placing directly to patient skin

  • Keep space heaters away from client’s bed or curtains.

  • Report frayed electrical cords or unsafe equipment immediately.

  • Do not leave a resident unattended near a radiator or furnace

  • Use caution with hot beverages. Spills can cause serious burns.

  • Roll up sleeves to prevent and avoid loose clothing from getting near stove burners.

  • Remember that many older people are forgetful and can leave appliances on when not in use, posing a serious accident waiting to happen.

 

Remember that if a burn occurs, cool the burn with lots of cold water. Apply burn creams or aloe ONLY to a first degree superficial burn. If it is blistered or beyond only a slight redness, never apply ice, or burn creams to the area.

For more on burns, enroll in a red cross first aid class.

 

Poisoning

Most Homes contain many harmful substances that could be ingested and cause great harm to the client. These include cleaning products, paint, medications, toiletries, and glue. Items that would not be a hazard to an oriented person can be potentially fatal to a confused person.

Follow these guidelines to prevent against poisoning:

  • Store harmful products in separate places from confused patients.

  • Keep the poison control number near the phone

  • Check dates on foods and products to make sure they are fresh

  • Make sure there is adequate ventilation when using chemicals and products.

  • Lock up harmful products in special cabinets and out of reach of children and confused adults.

 

 

CUTS

 

Cuts typically occur in the kitchen or bathroom. Follow these guidelines when caring for a cut.

  • Keep sharp objects out of the reach of children and confused adults.

  • Lock sharp objects away from a resident who is confused or has dementia.

  • If you are preparing food, cut away from yourself, not towards yourself. Keep your fingers out of the way.

  • Know first aid for cuts. Apply pressure, stop the bleeding, cleanse with soap and water, apply antibiotic ointment and bandage with band aid or similar dressing.

 

CHOKING

 

One of the most common emergencies is choking. Choking can occur while eating, talking, drinking, or swallowing medications. People who are weak, ill, or unconscious can choke on their own saliva. A person’s tongue can also get in the way and become swollen and obstructed in the patient’s airway.

  • Have your resident eat in an upright position to avoid choking

  • Offer thickened liquids when appropriate per MD recommendation for those with swallowing deficits.

  • Assist with feeding slowly, don’t force them to eat fast.

  • Cut food into small pieces

  • Make sure dentures are in and in place properly.

  • Be observant for any swallowing deficits a resident may have.

 

Fire Safety

 

There are many potential causes of a fire in a facility. Some examples are careless smoking, frayed or damaged electrical cords, space heaters, overloaded electrical plugs, oxygen use, careless cooking, and flammable liquids carelessly handled.

 

Follow these simple guidelines to protect against fire:

 

  • Discourage careless smoking and no smoking in bed, or resident rooms.

  • Turn off space heaters when no one is around, do not use while sleeping, or unattended. Use caution around stoves.

  • Be sure the smoke alarms work

  • Have fire extinguishers on hand and ready for immediate use.

 

Tips for the home:

  • Don’t leave the dryer running while you are away… lint can catch fire

  • Stay in or near the kitchen when food is cooking or if you are baking

  • Store potholders, dish towels, and other flammable kitchen items away from the stove.

 

Oxygen use posed a serious fire risk. Follow these guidelines for oxygen safety:

  • Post NO SMOKING signs where oxygen is in use.

  • Remove any electrical equipment such as electrical razors, hair dryers, radios, televisions, from area where oxygen is being used.

  • Remove any flammable items from areas of where oxygen is being used.

  • Never allow a resident or client to be near any kind of open flame like a gas stove, candle, lighters or matches with Oxygen in use.

  • Do not use wool, nylon, or any other synthetic material around oxygen, it can cause static electric sparks and be a potential fire hazard.

  • Remove any smoking materials from the residents room.

 

In case of fire, know where and how to use a fire extinguisher properly. Know the location of fire alarms. Understand the acronym RACE

R= Rescue

A= Alarm

C=Contain

E= Extinguish or evacuate

 

Fire safety rules:

  • Stay low in a room when trying to get out of a smoke filled area.

  • Block doorways to prevent smoke from entering other rooms

  • Cover face to decrease smoke inhalation

  • If clothing is on fire, stop, drop, and smother out the fire.

  • If a door is closed, feel for heat before opening the door.

  • Never use an elevator in the event of a fire.

 

Sharps Containers

 

Sharps containers are the containers in which we place sharp objects.

Used razors, needles and other sharp object must be placed in a sharps box for proper disposal. Some guidelines to consider are:

  • Never touch the sharps container without wearing gloves

  • When dropping a sharp object into the container, keep your fingers OUT OF the opening to the container.

  • Never use a sharps box that is more than 2/3 full. If you must carry the box, wear gloves, and carry it by the bottom, and make sure it is sealed closed to prevent spillage if dropped.

  • Wash your hands after disposing items in a sharps box

 

Biohazard containers

 

Biohazard containers are the containers n which we place contaminated items such as anything that is contaminated with blood or body fluids. Do not place anything sharp in a biohazard container. This will include soiled dressings. DO NOT PLACE LINEN IN A BIOHAZARDOUS RED BAG, (unless it is your facility policy to do so) Red bags mean “Burn it” and any linen in a red bag should be disposed and incinerated, not taken to laundry and washed. There should be yellow bags, or melt away bags for this purpose, not red bags.

 

The following guidelines should be used in regards to biohazard containers:

  • Drop anything contaminated with infectious waste in these containers.

  • Do not put sharps in the biohazard container

  • Always wear gloves when putting items in a biohazard container

  • When disposing items into the container, keep your hands above the opening to the container

  • Never push items down in the container

  • Dispose of gloves and wash your hands immediately after disposal

 

Personal Safety Tips for traveling to and from work

 

Personal safety is something we should all be concerned about. To often we take too much for granitite, and are not very observant to our surroundings.

All activities have risks associated with them.

It is useful to assess the risks involved and take precautions that increase your personal safety. When traveling to and from work, make sure you are aware of what is around you.

 

  • Park in well lit areas, as close to where you are going as possible.

  • Leave valuables at home. Take with you only necessary items.

  • Lock your doors, both when driving and when you park the car.

  • Walk purposely and confidently. Look as though you know where you are going.

  • Carry your keys in your hand, and be ready to unlock your car before you approach the vehicle.

  • Do not sit in your car, even with the doors locked. Leave or get out as soon as you are in the car.

  • Avoid unsafe areas after dark

  • Don’t travel alone if at all possible

  • As for an escort to your vehicle if leaving work at night, or if you are not parked close to the facility.

 

Summary

 

This basic course is intended to enlighten the reader to quick tips in patient and personal safety. To learn more enroll in a first aid course through your local red cross chapter. Be observant and be safe on and off the job.

 

References:

 

Mosby Publishing

Nurse Assistant Training Modules

2002

 

Family Medical And Health Guide

Consumer Guide

2001