1.1.3 Safety Measures

Student Objectives:

● Discuss the importance of safety in the long-term care facility.

● Demonstrate/Act out unsafe behaviors and situations.

● Describe physical changes that may be associated with aging that increase the risk of accidents.

● Identify physical changes that are beyond the resident’s control.

● Recognize safety hazards and describe how to maintain environmental safety

in the long- term care facility.

● Describe how to lock out unsafe or broken equipment.

● Describe the procedure to follow for reporting incidents and accidents.

● Describe the importance of Material Safety Data Sheets (MSDS), where they are located, and how they are used in your facility.

● Demonstrate proper use response to a resident’s call signal following facility policy.

● Demonstrate correct identification of resident prior to giving care following facility policy and resident’s plan of care.

● Describe different types of oxygen delivery.

● State safety precautions to take when oxygen is in use.

● Identify measures to prevent fires according to facility policy.

● In your facility, locate the emergency fire and disaster plans, emergency exits, alarm system, and fire extinguishers.

Safety is Everyone’s Concern

1. Some older individuals may not realize that some activities may be harmful to them.
2. The most common cause of accidents for LTC residents is falls.
3. Communicate with residents about his/her safety while maintaining his/her right to choices about his/her care and activities.
4. The resident has the right to a safe environment.
5. Think about safety first when you enter an area and last when you leave the area.

6. Safety is integrated throughout this course.

Physical Changes in Residents that Increase Risks

1. Decreased vision.
2. Impaired hearing.
3. Tremors or shaking.
4. Dizziness when position is changed from lying to sitting or sitting to standing. 5. Slower reflexes.
6. Mental changes such as forgetfulness or confusion.
7. Weakness due to illness, injury, or shrinking of unused muscles.

Providing a Safe Environment

1. Recognize and report unsafe conditions that nurse aides are unable to correct.
2. Keep hallways and resident rooms clean, dry, and free of obstacles.
3. Keep equipment and supplies on one side of the hallway so that residents have an unobstructed path
4. Pick up any objects on the floor
5. Wipe spills immediately and place a wet floor sign
6. Keep beds in prescribed position and wheels locked.
7. Follow facility policy for use of side rails.
8. Maintain adequate lighting.
9. Report all equipment not in proper working order and use it according to facility policy and manufacturer’s directions. Unsafe or broken equipment should be identified and removed from service according to facility policy.
10. Properly transport residents according to his/her plan of care. Properly transport equipment according to facility policy and manufacturer’s recommendation.
11. Instruct residents to use handrails.
12. Check soiled linen for sharp or misplaced articles.
13. Set brakes on wheelchairs during transfers or when parking the chair.
14. 14.Keep all chemicals in locked area legibly labeled and in their original container. Do not store chemicals in the same area as food products.
15. Keep hazardous materials, sharp objects and plants away from confused residents.
16. Ensure appropriate footwear is worn by staff and residents.
17. Provide call signals to all residents and remind resident to call for help.
18. Always identify residents before beginning care.
19. Follow recommended safety precautions for all procedures.
20. Report any change in condition such as loss of appetite.
21. Keep resident’s preferred belongings within easy reach.
22. Avoid the use of any clothing that could cause residents to trip.
23. Use shower chairs in showers. Do not transport resident in shower chair or leave unattended in tub or shower.

Accidents and Incidents

1. “Incident” – An occurrence or event that interrupts normal procedures or precipitates a crisis
2. “Accident” – An unexpected, undesirable event
3. Role of the nurse aide in recognizing and reporting incidents and accidents
4. Unsafe or broken equipment should be “locked out” so that it cannot be used. The person who discovers broken equipment should “tag” is following facility policy.
5. The Hazardous Communication Employee Right to Know program is designed to make employees aware of the proper uses and hazards of chemicals in the workplace.

Answering Call Signals

1. Ensure that all residents have access to a call signal at all times and know how to use it.
2. The call signal may be the resident’s only means of getting help in an emergency.
3. Know and follow facility policy for using call signals.In general, all staff are responsible for answering call signals, even if it’s not his/her assigned resident.
4. Know the various signals for resident rooms, bathrooms, etc. in your facility.
5. Know how to turn call signals off/on.
6. Know timelines for answering call signals.
7. Proper responses when answering call signals.

Identifying Residents

1. Resident identification systems: A. Identification bands
   B. Name on door
   C. Pictures
2. D. Sensor bracelets for residents that wander
3. Follow facility policy and procedure for identifying residents.

Oxygen Safety

1. Types of oxygen delivery systems and how they are used: A. Cannula
2. B. Mask
3. Know the liter flow ordered by the doctor, monitor liter flow when in the room and notify nurse of incorrect liter flow.
4. Safety precautions when oxygen is used:
   1. Post oxygen signs on door, over bed and follow facility policy.
   2. Check with nurse before using electrical equipment such as razors, fans, radios, televisions.
   3. Never use flammable liquids such as nail polish remover.
   4. Be sure that the oxygen cylinder is secured on base and/or chained to a carrier or wall.
   5. Immediately report smoking/smoking materials when oxygen is in use.
   6. Use only cotton blankets – not wool or synthetic.
   7. If tank is empty report to nurse.

Fire Prevention and Safety

1. Fire Prevention
   1. Supervise smoking in designated areas/monitor for smoking materials in rooms.
   2. Allow no open flames near oxygen.
   3. Report frayed wiring or faulty electrical equipment.
   4. Report concerns of overloaded electrical outlets.
2. Fire emergency rules
   1. Stay calm and do not panic, run or scream.
3. Follow the steps of RACE:
   1. a. R = Remove all residents from the immediate vicinity of the fire. b. A = Activate the alarm system.
      c. C = Contain the fire and smoke by closing all doors and windows. d. E = Extinguish the fire, if it is small enough to contain.
4. Remove combustible supplies and equipment from hallways.
5. Remember that smoke kills. In a smoke-filled area, stay close to the floor because smoke rises.
6. Know facility policy regarding fire emergency rules.

Natural Disasters

1. Tornado
2. Hurricane
3. Other natural disasters
4. Other Safety Regulations
   1. The Safe Medical Device Act of 1991 requires that the Food and Drug Administration (FDA) be notified of any death or serious injury caused by any type of medical device.
   2. The Texas Concealed Handgun Law prohibits carrying a concealed weapon in a hospital, nursing home or other health care facility.