Introduction to Client Safety

Our Role as Nurses

Utilize critical thinking skills, and the nursing
process, to assess the client and the
environment for hazards that threaten safety,
and planning and intervening to make sure
our patient is safe.
(Potter & Perry, p. 812)
Scientific Knowledge Base
• Safety in health care settings
▫ Reduces the incidence of illness and injury
▫ Prevents extended length of treatment/stay
▫ Improves or maintains functional status
▫ Increases client’s sense of well-being

• A safe environment
▫ Includes meeting clients’ needs
▫ Reduces transmissions of pathogens
▫ Maintains sanitation, reduces pollution
 Basic Human Needs
Oxygen Nutrition
 Low concentration  Proper storage
 High concentration  Proper refrigeration

 Carbon monoxide  Preparation area

Temperature Humidity
 Normal  Comfort zone 60% to
 Hyperthermia 70%
 Hypothermia  Liquefies secretions

 Improves breathing
Nursing Knowledge Base
• Client safety includes knowledge of:
▫ Developmental levels
▫ Mobility, sensory, and cognitive status
▫ Lifestyle choices
▫ Special risks found in
health care settings
 Risks in Health Care Agencies

• Medication errors- 60% of all errors

• Infection, pressure ulcers and failure to dx &
tx
• Falls-over 65 accounts for 1.8 million ER visits
• Client-inherent accidents
• Procedure-related accidents
• Equipment-related accidents
Nine Life-Saving Safety Solutions
1. Be aware for look-alike or sound alike medications
2. Use patient identification
3. Communication during patient handover
4. Perform correct procedure at correct body site
5. Control concentrated electrolyte solutions
6. Ensure medication accuracy at transitions in care
7. Avoid catheter and tubing misconnections
8. Do not reuse single-use injection devices
9. Improve hand hygiene to prevent healthcare
associated infections
Critical Thinking
• In client safety, critical thinking is an
ongoing process.
• Utilize standards developed by American
Nurses Association and The Joint
Commission.
• Use the nursing process when planning
care.
• ASSESS, ASSESS, Assess!
 Falls
• Prevention is the key!!!!!!!
• Close supervision—Hourly rounds
• Place call light, belongings, urinal within
reach
• Upper Side rails UP
• Bed in lowest position
• Lock wheels on W/C, beds, and gurney
• Stay with someone who is not stable
• Clear clutter
• Non-slip slippers/shoes
• Assess for Risk for Falls daily
Pressure Ulcers
• Braden Scale daily
• Turn & reposition frequently
• Relieve pressure areas
• Prevent shearing
• Reduce moisture—keep skin clean/dry
• Encourage good nutrition
• Avoid diapers
 Restraints
• Must be part of medical tx—order q 24hrs
• All less restrictive interventions tried first
• Others must be consulted—contact family
• Supporting & ongoing documentation—q 1-2h
• Ensure ties are easily undone via clips or
using a quick release “knot”
Ties must have slip knots and be attached
to the bed frame not the side rails or part of
bed that moves when HOB is elevated
Safety and the Nursing Process

• Assessment—Nursing history, environmental

assessment, risk assessment
• Nursing Diagnosis-Risk for injury
• Planning -- set goals/outcomes, priorities (how
to keep the patient safe)
• Implementation- Wellness promotion/changes
• Evaluation—did it meet goals? Make changes as
necessary. Reassess.
You
Are
responsible
for the safety
of your
patient!