RACE
R: Remove from danger
A: Alarm and report
C: Contain; close doors
E: Extinguish
PASS
P: Pull
A: Aim
S: Squeeze
S: Sweep
Causes of hospital fires
Varied, but top:
- cooking equipment
- clothes
Nurse’s responsibility for fire safety
- know fire alarm location and system
- know placement of equipment
- know fire exits
- know types of extinguishers and their uses
HAIs
5% of admitted patients contract an HAI due to immune system weak, etc.
Some of most common HAI types
- CRBIs (Catheter related bloodstream infections)
- HAP (Healthcare-Associated Pneumonia) aka VAP (ventilator-associated pneumonia)
- SSIs (Surgical Site Infections)
- CLABSIs (Central line-associated bloodstream infections)
- CDIs (Clostridium Difficile-Associated Infections) C-Diff
Top pathogen causing HAIs
Coagulase-negative Staphylococci
-15% of HAIs
Wrong site surgery
- Wrong patient
- Wrong body part
- Right patient, wrong surgery
UP developed to help prevent these mistakes
Nursing interventions for clients at risk for injury
nurses play a vital role in promoting patient safety through education and preventative intervention
Nurses help the patient and family accomplish the following:
- identify environmental hazards in home and community
- demonstrate safety practices appropriate to the home, health care agency, community, and workplace
- demonstrate safe childrearing practices or lifestyle practices
3 Types of restraints
Chemical
Physical
Seclusion
Restraints can either be for…
nonviolent/non self-destructive (med/surg)
violent/self-destructive (behavioral)
Last resort restraint
Physical
- must assess them
- must have MD/ARNP/PA order
- always try least invasive first
Types of physical restraints
- limb
- belt
- mitt/hand
Alternatives to restraints
- more staff observation
- beds lowest position
- distraction and/or redirection technique
- transfer room closer to nurses station
- involve family during visitation
- monitor meds; lower sedatives
- removable lap tray on wheelchair
- use rocking chair to expend energy
- picture of loved one or personal item in room with patient
How long is a non-violent restraint order good for?
max 24 hours
How long is a violent restraint order good for?
max 4 hours
How often do you monitor violent restraint patients?
continuous, every 15 mins and mandatory minimum every hour by RN
How often do you monitor nonviolent restraint patients?
every 2 hours and mandatory minimum every 4 hours by RN
Trial releases
prohibited
PRN restraint orders
prohibited
If you remove restraint and walk away from patient
need a new order; old one is cancelled and you cannot re apply restraints
If you remove restraint while performing a procedure or hygiene and do not walk away from the patient
you may re apply without a new order; current order still valid
Legal implications
- restrict individual’s freedom
- standards and laws limit the use
