NATCEP Day EightNATCEP Day Eight

General Safety Practices and Procedures

General Safety Practices and Procedures

ObjectivesObjectives

• Identify safety concerns in LTCFs• Identify safety precautions that help to prevent

residents from falls– SKILL: Walking an Unsteady Resident

• Identify safety precautions the STNA should know to help prevent resident falls from beds, chairs and wheelchairs

• Identify precautions the STNA should take to prevent residents from being burnedIdentify the safety precautions the STNA should take to help prevent the resident from choking

• Identify safety concerns in LTCFs• Identify safety precautions that help to prevent

residents from falls– SKILL: Walking an Unsteady Resident

• Identify safety precautions the STNA should know to help prevent resident falls from beds, chairs and wheelchairs

• Identify precautions the STNA should take to prevent residents from being burnedIdentify the safety precautions the STNA should take to help prevent the resident from choking

ObjectivesObjectives

• Demonstrate the steps of the abdominal thrust procedure (Heimlich maneuver)– SKILL: Abdominal Thrust on Conscious Victim

• Identify measures the STNA should take to prevent ingestion of harmful substances

• Identify measures the STNA should take if a resident ingests a harmful substance

• Identify measures to protect resident from elopement and other potential harm

• Demonstrate the steps of the abdominal thrust procedure (Heimlich maneuver)– SKILL: Abdominal Thrust on Conscious Victim

• Identify measures the STNA should take to prevent ingestion of harmful substances

• Identify measures the STNA should take if a resident ingests a harmful substance

• Identify measures to protect resident from elopement and other potential harm

Why Safety Precautions?Why Safety Precautions?

• Mental Confusion– Alzheimer’s

• A neurological illness that affects older adults, is the result of abnormal changes in brain tissue. Can only be diagnosed by autopsy

– Dementia• The loss of cognitive function that interferes with

routine personal, social, and occupational activities

• Impaired Mobility• Diminished Senses

• Mental Confusion– Alzheimer’s

• A neurological illness that affects older adults, is the result of abnormal changes in brain tissue. Can only be diagnosed by autopsy

– Dementia• The loss of cognitive function that interferes with

routine personal, social, and occupational activities

• Impaired Mobility• Diminished Senses

• Encourage residents to wear shoes or slippers with non-skid soles.

• Avoid long gowns or robes that may trip the resident.

• Encourage the use of hand rails.• Ensure residents have non-skid tips on

canes, walkers and chair legs.

• Encourage residents to wear shoes or slippers with non-skid soles.

• Avoid long gowns or robes that may trip the resident.

• Encourage the use of hand rails.• Ensure residents have non-skid tips on

canes, walkers and chair legs.

Preventing FallsPreventing Falls

• Check with charge nurse before applying skin lotions, bath oils or powders. – Make resident’s skin, equipment and

floors (such as tubs) slippery• Use assistive devices for residents

with limited mobility.– shower chairs– raised toilet seats– grab bars

• Check with charge nurse before applying skin lotions, bath oils or powders. – Make resident’s skin, equipment and

floors (such as tubs) slippery• Use assistive devices for residents

with limited mobility.– shower chairs– raised toilet seats– grab bars

Preventing FallsPreventing Falls

• Keep traffic areas clear of objects and furniture.

• Observe resident frequently.• Instruct resident to call for assistance

using the signaling device.• Answer call lights promptly.

• Keep traffic areas clear of objects and furniture.

• Observe resident frequently.• Instruct resident to call for assistance

using the signaling device.• Answer call lights promptly.

Preventing FallsPreventing Falls

• Encourage resident to wear clean, appropriate eyewear.

• Always follow plan of care for resident-specific needs.

• Always follow manufacturer’s instructions & facility policies for use of all equipment.

• Encourage resident to wear clean, appropriate eyewear.

• Always follow plan of care for resident-specific needs.

• Always follow manufacturer’s instructions & facility policies for use of all equipment.

Preventing FallsPreventing Falls

• Lock wheels on bed or wheelchair when transferring.

• Transport resident in a bed, geriatric chair or wheelchair carefully.– Slowly approach corners with resident facing

front (forward)

• Use gait (transfer) belt if appropriate.• Place a mattress on the floor per care plan &

facility policy.• Use caution with tubing.

• Lock wheels on bed or wheelchair when transferring.

• Transport resident in a bed, geriatric chair or wheelchair carefully.– Slowly approach corners with resident facing

front (forward)

• Use gait (transfer) belt if appropriate.• Place a mattress on the floor per care plan &

facility policy.• Use caution with tubing.

Preventing Falls from Beds, Chairs or Wheelchairs

Preventing Falls from Beds, Chairs or Wheelchairs

Preventing BurnsPreventing Burns

• Assist the resident when giving a hot liquid to drink.

• Check water temperature before placing under the shower or in a tub.

• Never leave the resident unattended in shower/tub.

• Assist the resident when giving a hot liquid to drink.

• Check water temperature before placing under the shower or in a tub.

• Never leave the resident unattended in shower/tub.

Preventing BurnsPreventing Burns

• Supervise residents when they smoke.• Enforce restricted smoking areas for

residents, visitors and staff.• Monitor carefully any equipment that

produces heat when in use. – May have decreased sensation – May not feel skin is being burned

• Be aware of potential hazards– Chemical agents

• Secure hazardous materials in locked cabinets

• Supervise residents when they smoke.• Enforce restricted smoking areas for

residents, visitors and staff.• Monitor carefully any equipment that

produces heat when in use. – May have decreased sensation – May not feel skin is being burned

• Be aware of potential hazards– Chemical agents

• Secure hazardous materials in locked cabinets

Preventing ChokingPreventing Choking

• Make sure the resident has received the accurate and appropriate diet.

• Check with the nurse before changing the diet or offering other foods.

• Assure that food is cut or chopped in small enough pieces for the resident to swallow.

• Feed the resident slowly, alternating food and liquids.

• Make sure the resident has received the accurate and appropriate diet.

• Check with the nurse before changing the diet or offering other foods.

• Assure that food is cut or chopped in small enough pieces for the resident to swallow.

• Feed the resident slowly, alternating food and liquids.

Preventing ChokingPreventing Choking

• Allow time to chew and swallow.• Check care plan:

– Swallowing or restorative dining program?– If on a swallowing program

• know program• be trained on the technique required

– i.e. modified diet

• Stop feeding immediately if any problems arise; notify the nurse.

• Allow time to chew and swallow.• Check care plan:

– Swallowing or restorative dining program?– If on a swallowing program

• know program• be trained on the technique required

– i.e. modified diet

• Stop feeding immediately if any problems arise; notify the nurse.

How To Recognize ChokingHow To Recognize Choking

Managing ChokingManaging Choking

Preventing PoisoningPreventing Poisoning

• Never leave harmful or potentially harmful substances at the bedside or in unlocked areas.

• Remove Styrofoam and plastic wrap from the trays of confused residents.

•  Monitor the use and placement of household plants- many are poisonous.

• Never leave harmful or potentially harmful substances at the bedside or in unlocked areas.

• Remove Styrofoam and plastic wrap from the trays of confused residents.

•  Monitor the use and placement of household plants- many are poisonous.

Suspect Poisoning?Suspect Poisoning?

• Identify the ingested substance, if possible.

• Notify the charge nurse immediately.

• Identify the ingested substance, if possible.

• Notify the charge nurse immediately.

ElopementElopement

• Defined as– Wandering from a supervised environment

• Always know where the resident is!• Know facility policies and procedures.• Report immediately when a resident is

missing

• Defined as– Wandering from a supervised environment

• Always know where the resident is!• Know facility policies and procedures.• Report immediately when a resident is

missing

StairwellsStairwells

• Keep doors to stairwells closed at all times.

• Know facility policy on stairwell use.– Know when stairwells are to be utilized– Follow facility policy regarding helping

residents down the stairs– Use a two-person chair-lift to carry

resident down the stairs if indicated

• Keep doors to stairwells closed at all times.

• Know facility policy on stairwell use.– Know when stairwells are to be utilized– Follow facility policy regarding helping

residents down the stairs– Use a two-person chair-lift to carry

resident down the stairs if indicated

Two-Person CarriesTwo-Person Carries

• Four-Handed Seat– Carrying conscious & alert victims

moderate distances. – Victim must be able to

• stand unsupported • hold themselves upright during transport.

• Four-Handed Seat– Carrying conscious & alert victims

moderate distances. – Victim must be able to

• stand unsupported • hold themselves upright during transport.

Two-Person CarriesTwo-Person Carries

• Four-Handed Seat– Position hands as indicted.– Lower seat and allow victim to sit.– Lower seat using legs, not back.– When victim is in place, stand using legs,

keeping back straight.

• Four-Handed Seat– Position hands as indicted.– Lower seat and allow victim to sit.– Lower seat using legs, not back.– When victim is in place, stand using legs,

keeping back straight.

Two-Person CarriesTwo-Person Carries

Two-Person CarriesTwo-Person Carries

• Two-Handed Seat– Carrying victim longer distances.– This technique can support an

unconscious victim.

• Two-Handed Seat– Carrying victim longer distances.– This technique can support an

unconscious victim.

Two-Person CarriesTwo-Person Carries

• Two-Handed Seat– Pick up victim by having both rescuers

squat down on either side of victim.– Reach under victim's shoulders & under

their knees.– Grasp other rescuer's wrists.– From squat, with good lifting technique,

stand.– Walk in direction that victim is facing.– Position hands as indicted.

• Two-Handed Seat– Pick up victim by having both rescuers

squat down on either side of victim.– Reach under victim's shoulders & under

their knees.– Grasp other rescuer's wrists.– From squat, with good lifting technique,

stand.– Walk in direction that victim is facing.– Position hands as indicted.

Two-Person CarriesTwo-Person Carries

Use of AlarmsUse of Alarms

• Facility-wide alarms– Fire– Tornado

• Personal Protective alarms• When you hear - ACT!

• Facility-wide alarms– Fire– Tornado

• Personal Protective alarms• When you hear - ACT!