Safety Concerns
Throughout the Lifespan
Safety
Freedom from psychological and physical
injury
 A basic human need that must be met
 Nurse must assess environment for safety
hazards
 Maintain safe environment for clients
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Environmental Safety
Basic Needs
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Oxygen
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Nutrition
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Temperature and
Humidity
Environmental Safety
Physical Hazards
Lighting
 Obstacles
 Bathroom hazards
 Security
 Home Hazard Assessment (P&P pg. 968,
Box 37-2)
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Environmental Hazards
Transmission of Pathogens
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Pathogen: Any microorganism capable of
producing an illness
Medical asepsis
Immunizations
Standard precautions (transmission of HIV,
Hepatitis)
Nosocomial Infections
Contact Isolation
STD’s
Adequate disposal of human waste, insect,
rodent control
Environmental Safety
Pollution
Pollutant: harmful chemical or waste
material discharged into water, soil, air
 Air pollution
 Water pollution
 Noise pollution
 Terrorism/Bioterrorism
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Safety Risks at Developmental
Stages
Infant-Preschooler: Injuries, accidents
 School-Age: Stranger adduction, sportrelated injuries, bicycle injuries,
 Adolescent: Smoking, drug and alcohol
use, MVA, STD’s
 Adult: MVA, smoking related disorders.
Stress
 Older Adult: Physiologic changes increase
risk for falls, MVA’s, home injuries
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Individual Risk Factors
Lifestyle
 Impaired Mobility
 Sensory or Communication Impaired
 Lack of safety awareness
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Safety Risks in Hospital
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Preventing Falls/Pressure Ulcers
Client-Inherent Accidents (Seizures)
Procedure-related accidents (surgery, chest tube
& catheter insertions, med/IV errors)
Equipment-related Accidents (electrical hazards,
fires from faulty equipment)
Preventing Nosocomial Infections
Preventing Medication Errors
Recognizing changes in client condition
National Patient Safety
Initiatives
Joint Commission National Patient
Safety Goals
 Institute for Healthcare Improvement
“5 Million Lives” Campaign
 The Leapfrog Group
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Joint Commission National
Patient Safety Goals
Improve the accuracy of patient identification
 Improve the effectiveness of communication among
caregivers
 Improve the safety of using medications
 Reduce the risk of health care-associated infections
 Accurately and completely reconcile medications
 Reduce the risk of patient harm from falls
 Encourage patients’ active involvement in their own
care as a patient safety strategy
 The organization identifies safety risks inherent in its
population
 Improve recognition and responses to changes in a
patient’s condition
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The Leapfrog Group
Reduce preventable medical mistakes and
improve the quality and affordability of
health care
 Encourage health providers to publicly
report their quality outcomes so
consumers can make informed choices
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IHI “5 Million” Lives Campaign”
Deploy rapid response teams
 Deliver reliable evidence-based care for
acute MI
 Prevent adverse drug events
 Prevent central line infections
 Prevent surgical-site infections
 Prevent ventilator-associated pneumonia
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Safety and the Nursing Process
Assessment
 Nursing Diagnosis
 Planning
 Implementation
 Evaluation
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Implementation
Health Promotion (wearing seat belts, use
of car seats, bike helmets, participation in
wellness programs)
 Developmental Interventions:
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Infant, Toddler, Preschooler
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School-Age
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Adolescent
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Adult
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Implementation
Older Adult
Reduce the risk for falls and other injuries
 Compensate for physiological changes
related to aging
 MVA prevention (Safe driver tips,
eyesight/hearing issues)
 Burn and scald prevention
 Pedestrian accidents (wear reflectors, walk
on sidewalks, cross at light)
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Environmental Interventions
General Preventive Measures: Meet client
needs (Oxygen, nutrition/fluids,
temperature)
 Medical Asepsis
 Isolation Precautions
 Environmental lighting
 Security measures and concerns
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Specific Safety Concerns
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Falls (Fall Assessment Tool)
Restraints and bed alarms
Side rails, bed height, bed and wheelchair locks
Fires
Poisonings
Electrical Hazards
Seizures
Radiation