ENVIORNMENTAL SAFTY

FIRE SAFTY:

• keep open space free of clutter
• clearly mark fire exit.
• Know the location fire alarm exit and extinguisher

Priority action   in the event of fire.      

Remember mnemonic RACE 

• R –rescue( remove all  client from the of fire)
• A– alarm (activate the fire alarm)
• C– confirm (close door and windows  for prevent spreads .)
• E– extinguish (extinguish the fire by using the extinguisher)

USING FIRE EXTINGUISHER

Remember mnemonic  PASS.

1. P– pull the pin
2. A– aim at the base of fire.
3. S-squeeze the handle.
4. S-sweep the fire from side to side

• Know the Tel no: for reporting fire
• Never use elevator in the event of fire.
• Turn off oxygen and appliance in the event of fire, if the client is on life support maintain the client respiratory status manual with an AMBU  bag until the client is moved away
• Ambulated client can be directed to walk by them self to a safe area and in some cases may be able to assist in moving client  in wheel chair.
• Bed ridden client are moved from the seen of fire by structure, their beds, or wheel chair.

ELECTRICAL SAFETY

• Electrical equipments must be maintain in good working order.

• Use a 3 pronged electrical code
• any electrical equipments that a client bring in to the health care facility  must to be inspect for safely  prior to use.
• check electrical code for exposed or damaged wire.
• avoid over loading any circuit .
• never operate unfamiliar equipments
• never run electrical wiring under carpet.
• never pull a plug by using the cord, always grasp the plug itself.
• never use electrical appliance near sink bathtub, or other water source.
• always disconnect the plug from the outlet before cleaning the equipments
• If a client has electrical shock turn of the electricity before touching the client.

RADIATION SAFTY

RESTRAIN:   protective device is used to limit the physical activity of a client, or to immobilize a client, or an extremity.

TYPES:

• mechanical (physical): restrict movement through the application of a device
•  Chemical restrain:  medication given to inhibit a specific behavior or movement.

Nurses  Responsibility:

• when restrains are necessary physician order should state type identify specific client behavior and identify a limited time frame of use
• before putting the patient on restrain take physician order and consent from relatives.
• Secure restrain to the bed frame not to the side rails.
• Keep 2 finger birth distance between the restrain and patient body to maintain intact skin.
• asses skin integrity neuro vascular and circulatory status every 30 minutes and release the restrain to permit muscle exercise.
• documentation points with the use of restrain
  • Reason for restrain
  • method of restrain
  • date and time of application of restrain
  • Duration of restrain and clients responds.
  • assessment of continued need for restrain
  • evaluation of client responds

MEASURES  TO PREVENT FALLS

• assess the client risk for fall
• assign the client at risk for falling to room near the nursing station
• Alert all personal to the client risk for falling.
• Orient the client to physical surrounding instructs the client seek assistance when getting up.
• Explain use of call bell system.
• keep the bed in low position with Side rails up
• it required lock all beds wheel chair and structure
• keep personal items with in the reach
• eliminate obstruction in the client room
• Provide adequate lightening.
• reduce bathroom hazard
• maintain client toileting schedule throughout the day

POISIONING

• ­any substance that impairs health or destroys life when ingested, inhale ,or otherwise absorbed by the body.
• Specific antidote or treatment is available for only some type of poison.
• Poison can impair respiratory, circulatory CNS, hepatic, GI, and renal system of the body.
• poison control center phone NO should be visible on the telephone itself so when poisoning occur call poisoning control center immediately

Nurses Responsibility

• Remove an obvious material from mouth, eyes, or body area immediately.
• Identify the type and amount of substance ingested
• If victim vomit or vomiting is induced save the vomits and deliver it to the poison control centre and if require shift the patient to emergency department
• Vomiting is never induce following ingestion lye (alkali),household cleaner or petroleum product
• Vomiting is never induce in a unconscious client
• Put NGT tube and give gastric lavage ,
• Give anti dote if possible

NOSOCOMICAL INFECTION(hospital acquired infection)

• Infection acquired in a hospital or other health care facility that where not present at the time of admission
• Illness impair the body’s normal defense mechanism
• The hospital environment provides exposure to a variety of organism that the client has not been exposed to in the past, the client has not develop resistance to these organism.
• Infections can be transmitted by health care personal who fail to practice proper hand washing procedure.

STANDARD PRECAUTION

• must be practiced with all client in any setting
• promote hand washing and use of gloves, masks, gown, caps, shoe, eye protection for the client with contact infection

NURSES RESPONSIBILITY

• Handle all blood and body fluid from all client as if they were contaminated
• Hands are washed between client contact, After contact with blood ,body, fluid, , excretion, after contact with equipments or article contaminated by them and immediately after gloves, are removed.
• gloves are worn when blood, body, fluid, secretion execration, non intact skin or contaminated items are touch.
• Mask, eye, protection or face shield are worn if client care activity May generate splash or spray of blood or body fluids.
• gown are worn if soiling of clothing from blood or body fluids wash hand after removing the gown
• Contaminated linen is placed in leak proof bags and handles to prevent skin exposure.
• All sharp instruments and needles are discard in a puncher resistance contained

TRANSMISSION BASED PRECUTION

 AIR BONE  PRECAUTION

ex: measles, chickenpox, vairzella zoster, open TB

NURSES RESPONSIBILITY

1. single room maintain under pressure, door kept closed, expect when some one entering or exiting the room
2. maintain negative air flow pressure in the room with a minimum of 6 to 12 air exchange per hours.
3. wear mask or Respiratory protection device
4. place a mask on the client when the client is out of the room, client leaves the room only if necessary

DROPLET PRECAUTION

Ex: mums, pertusis, scarlet fever, streptococcus, pharngitis, rubella, diphtheria.

NURSES  RESPONSIBILITY

1. Provide private room or share the client.
2. use of a mask
3. instruct pt not to spit here and there
4. dispose saliva properly
5. Place a mask on the client when the client is out of the room.

CONTACT PRECAUTION

Ex: chickenpox, scabies, varisella, zoster, her per simpler, entire pathogen, RSV (respiratory synsytial virus)

NURSES RESPONSIBILITY

1. provide private room or cohort the client
2. use of gloves and gown by health care personal when in contact with client.