Transcript Chapter 17 Safety

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Injury: an act that results in harm
Macroenvironment: elements in the larger world that
affect groups of people or entire populations
Microenvironment: the immediate surroundings with
which a person closely interacts
Restraint: anything that restricts movement; can be
physical or chemical
 Older adults face hazards as
 Risks are compounded by
any other adults
• Age-related factors reducing their capacity to
protect themselves
• Increased vulnerability to safety hazards
 Nursing assessment includes a review of risks to
safety
 Interventions necessary to address threats to
safety, life, well-being
 Injury
rate for older adults falls in midrange for all
age groups
 Older women have higher rate of injuries than other
adult female age groups
 Accidents rank sixth leading cause of death
 Falls leading cause of injury-related death
 Threefold greater risk of nosocomial pneumonia;
gastroenteritis caused by Salmonella; urinary tract
infections higher
 Environment:
• Microenvironment: immediate surroundings
• Macroenvironment: elements in larger world
 Promote
continued development, stimulation,
satisfaction enhancing psychological well-being
 Assessment of environment: realistic to fulfill
needs
 Older
adults need safe, functional, comfortable,
personal, and normalizing environment to
compensate for limitations
 Considerations: lighting, temperature, colors,
scents, floor coverings, furniture, sensory
stimulation, noise control, bathroom hazards, and
psychosocial factors
 Light
profound effect on visibility
• Function
• Orientation
• Mood and behavior
 Diffuse lighting (several) are better than bright
light
 Nightlights: soft red light in bedroom (improves
night vision)
 Exposure to natural light-to maintain body
rhythms
 Older
adults have lower than normal body
temperatures
 Decreased natural insulation
 Maintaining adequate environmental temperature
is significant
 Recommended room temperature is 75°F: lower
temperature leads to hypothermia
 Hyperthermia can also create a problem,
although not as significant a problem
Is the following statement True or False?
Room temperatures less than 70°F can lead to
hypothermia in an older adult.
True
The older the person is, the narrower the range of
temperatures tolerated without adverse reactions.
Recommended room temperature for the older adult
should not be lower than 75°F.
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Red, yellow, and white
• Can be stimulating and increase pulse, blood pressure,
and appetite
Blue, brown, and earth tones
• Can be relaxing
Orange
• Can stimulate appetite
Violet
• Can decrease appetite
Green
• Can give a sense of well-being
Black and gray
• Can be depressing
 Therapeutic
scents or aromatherapy
• Use of essential oils
• Pathophysiology of aromatherapy
 Essential oils: used in baths, compresses,
rubbing, and massaging
 Like topical medications: produce physiological
effects
 Carpeting: sound
absorber but can cause
problems
• Static electricity and cling
• Difficult wheelchair mobility
• Cleaning
• Odors
• Pests
 Scattered rugs or area rugs can cause falls
 Furnishings
should be
• Appealing
• Functional
• Comfortable
 Chairs
correct height with arm rests
 Upholstery should be easy to clean
 Tables and bookcases should be sturdy
 Create
an environment pleasing to senses
• Textured walls
• Soft blankets
• Pictures, wall hangings
• Plants, flowers
• Coffee brewing, perfumes, oils
• Birds and pets
• Soft music
 Interventions for those who are bedbound
 Physiologic
and emotional effects of sound
 Sounds can create difficulties for older adults
 Effect of environmental sounds
 Noise control begins with the design of the
building, landscape, and other devices
 Intercoms and paging systems disruptive
 Safety
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measures
Lighting-small light at all times
Floor surface-nothing left on floor
Faucets-lever shaped, color coded
Tubs and shower stalls-nonslip surfaces, grab
bars
Toilets-grab bars, raised seat attachment
Electrical appliances-use with caution
 Risk
for burn injury common home hazard
 Kitchen fires: unattended pots on stove
 Careless disposal of matches or cigarettes
 Space heaters should have automatic
shut-off
 Fireplaces can cause fires: chimney cleaning
 Feelings
and behavior influenced by individual’s
environments
 Need for own space
 Need for privacy and personal space
 Potential for invasion of privacy and personal
space when one is dependent and ill
Placement of chairs to facilitate social activity
would best be accomplished by
a. Four chairs together in a small room
b. A cluster of chairs in an area where there is
activity
c. Chairs close to a patient’s bed
d. Several chairs near the end of a hallway
b.
A cluster of chairs in an area where there is
activity
The placement of chairs in clusters or in busy but
not heavily trafficked areas is conducive to
interaction and involvement with a larger world.
 One third of adults 75+ fall each year
 20% of hospital and 40% of nursing home
admissions related to falls
 Risks for falls: improper use of mobility aids,
medications, postural hypotension, environmental
hazard, and caregiver-related factors
 Prevention of falls: use of prescribed
eyeglasses, change position slowly, proper use of
canes and walkers, use of handrails and grab
bars, litter-free floors, adequate lighting, and
regular medication review
 Nursing
assessment for prevention
• Regular inspection for and correction of
environmental hazards
• Medication review
• Programs to prevent falls
 Nursing assessment after fall
• Keep immobile until full examination
 Nonuse of physical and chemical restraints
standard practice
Which of the following statements is FALSE related
to the use of restraints with the older adult
population?
a. Nonuse of physical restraints can cause injury
b. Use of restraints can be reduced without the effect of
injury
c. Restraints can be physical or chemical
d. One-to-one supervision is an alternative to restraint
use
a.
Nonuse of physical restraints can cause injury
Evidence now exists that the use of physical
restraints can be significantly reduced without
increasing staffing or injuries; therefore, nonuse of
physical and chemical restraints is a standard that
nurses should promote in all settings.
 Prevention
of injury is essential
 Reducing hydration and nutrition risks
 Addressing risks associated with sensory deficits
• Vision
• Hearing
• Taste and smell
• Touch
 Slower
response and reaction times safety hazard
 Slower movement and poor coordination
 Poor judgment
• Denial or lack of awareness of limitations
 Monitor body temperature
 Prevent infection
 Suggest sensible clothing
 Use medications cautiously
 Avoid crime
 Promote safe driving
 Promote early detection of problems
 Address risks associated with functional
impairment
Is the following statement True or False?
Rather than cease driving altogether, some older
adults may find it useful to restrict their driving
to daylight hours, noncongested areas, and good
weather.
True
Nurses should assist older drivers in identifying risks
to safe driving and encourage them to evaluate their
continued ability to drive safely. Modifications can be
made that allow older adults to continue to be safe
drivers.