N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide Chapter Seven: Environmental Concerns Environmental hazards are among the leading causes of injury and death in the United States. Motor vehicle and firearm accidents, burns, poisonings, and ingestion of foreign objects are hazards that the nurse must understand in order to prevent or minimize injury. 7.1 Environmental Safety Hazards Physical Hazards Many common physical hazards are present in the patient's home and in the healthcare environment. The astute nurse will evaluate both environments to minimize these hazards: • Unsecured rugs: Particularly for the elderly, scatter rugs are a potential fall hazard. The individual can trip or slip on the rugs because they are not secured to the floor. The nurse should question the patient about the home environment and should recommend removal of any unsecured rugs for patients at risk for falling. • Wet floors: Freshly washed or waxed floors are a potential hazard for any patient. When possible, wet floors should be closed off to prevent falls. • Bed height: The nurse must ensure that all beds are left in the lowest position possible to allow the patient to safely get out of the bed. The patient's feet should be touching the floor when the patient is sitting on the side of the bed. When appropriate, bed side rails should be used to prevent falls. The nurse must be aware of facility policies concerning the use of side rails. • Patient footwear: For patients at high risk for falls, appropriate footwear can help lower the risk. Patients should be advised to wear non-slip footwear when ambulating. Any patient at risk for falls should be advised to wear shoes with low heels. • Protective equipment: The nurse must encourage the use of helmets, pads, children's car seats, and seatbelts to protect against environmental injuries. • Home wiring: The patient and family should be advised to inspect all the cords and plugs in the home to ensure that fire hazards do not exist. Overloaded plugs are also an environmental hazard. • Furniture: Furniture should be arranged to provide clear walkways. Any rolling furniture should be removed or the patient should be advised to avoid using the furniture for support during ambulation. • Lighting: Room lighting should be maximized to allow the individual to clearly seeany possible hazards in the environment. • Equipment: Patient care equipment, such as crutches and walkers, should be inspected to ensure that the items are in good and functional condition. • Firearms: In the home, unsecured firearms can be an obvious hazard. All the weapons and ammunition should be kept in a locked cabinet and stored unloaded. Anyone keeping firearms in the home must be educated about the appropriate weapon safety. Chemical Hazards Chemical hazards that may be in an individual's environment include medications, disinfectants, paint, carbon monoxide, and pesticides. The young and elderly are particularly at risk for poisoning. The family should post the number for a poison control center. If poisoning is suspected, the patient

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