The Aide's Role in Safety in the Home Cindy Morgan, RN, MSN, CHC, CHPN Association for Home & Hospice Care of North Carolina Objectives What does safety mean? List safety hazards/concerns encountered in the home Strategies to address safety hazards/concerns
What is Safety? To be able to have control of recognized hazards to achieve an acceptable level of risk. Patient safety-preventing injury/harm to the patient Home safety protecting the resident from external harm Internal installations- are the conditions inside the home safe-ie, appliances, throw rugs, stairs, fire alarms Staff safety- preventing injury/harm to oneself during the delivery of patient care
Where do Our Patients Reside? House
Apartment Condo Assisted Living Skilled nursing facility Hotel Nursing homes Falls Most falls occur at home (60.2%) Falls are a leading cause of death and the most frequent cause of emergency
department (ED) visits for injury among people aged 65 years and older Facts about Falls One out of five falls causes a serious injury such as broken bones or a head injury. Each year, 2.5 million older people are treated in emergency departments for fall injuries More than 95% of hip fractures are caused by falling, usually by falling sideways. Falls are the most common cause of traumatic brain
injuries (TBI). Direct medical costs for fall injuries are $34 billion annually Safety Hazards in the Home Falls STAIRS Stable Handrails Lighting Gates or doors for children and elder adults if
applicable to the situation Safety Hazards in the Home Falls Bathroom Slippery/wet floors- secure rugs to keep water from pooling Safety rails in shower & bathtub Safety mats or non-skid surface in shower Grab bars for commode
Safety Hazards in the Home Falls
Other Parts of Home Steps when ramp needed Unstable outdoor steps Clutter in passage ways Throw rugs Unsecured cords across floors Pets Patient Activity to Prevent Falls Begin an exercise program to improve your leg strength & balance
Talk to nurse about medicines Get annual eye check-ups Maintain clear pathways in house for walking Remove throw rugs/secure to floor with no-slip backs or secured to floor Lighted areas for getting up at night Bedside commodes if needed for safety at night Take Away Falls
Falling once doubles the patients chances of falling again Every 20 minutes an older adult dies from a fall in the United States This is a very real problem for our older adults Talking about falls & educating them may save a patient from a fall, and possible injury. Fire: Statistics to share Older adults face the greatest relative risk of dying in a fire. In 2013, older adults:
Represented 14 percent of the United States population but suffered 36 percent of all fire deaths. Had a 2.5 times greater risk of dying in a fire than the total population. Ages 85 and over were 3.6 times more likely to die in a fire than the total population. Safety Hazards in the Home Fire
Clutter Incorrect wattage of light bulbs Lack of attention to something cooking in the kitchen Extension cords Frayed cords/chewed cords Outlet overload Covered by a rug, or carpet: can heat up over time Safety Hazards in the Home Fire
Put something flammable near something hot Unattended candles left burning Inappropriate use of fireplace or wood heater Cigarettes left burning Unattended Fall asleep
Oxygen Use in the Home We all know we have to have Oxygen to live. People with healthy lungs can breathe in enough Oxygen for their bodies to function properly. When lungs functions become impaired then supplemental Oxygen may become necessary. Oxygen is a safe, nonflammable gas, but it does support combustion, meaning materials burn more readily in its presence.
Oxygen Use in the Home 7% of all victims who died in fires caused by smoking were using medical oxygen. The National Ethics Committee reported that when a fire occurs and home oxygen is involved, it is usually caused by smoking. 89% of deaths related to fire and home oxygen use are caused by smoking according to the CDC
Oxygen Safety Tips Oxygen canisters should be kept at least 5-10 feet away from gas stoves, lighted fireplaces, woodstoves, candles or other sources of open flames. Do not use electric razors while using oxygen. (These are a possible source
of sparks) Do not use oil, grease or petroleum-based products on the equipment. Do not use it near you while you use oxygen. These materials are highly flammable and will burn readily with the presence of oxygen Avoid petroleum-based lotions or creams, like Vaseline, on your face or upper chest Post signs in every room where oxygen is in use. Make sure that absolutely NO SMOKING occurs in the home or in the car when oxygen is in use Oxygen Safety cont.
Secure an oxygen cylinder to a solidly fixed object to avoid creating a missile out of the tank Use caution with oxygen tubing so you do not trip over it
Be familiar with the equipment and the safety checks established by the medical equipment provider. Do not try to repair broken equipment on your own. Make sure smoke detectors in the home are working. Have a fire extinguisher available in the home as well. Create and practice an escape and rescue plan in the event of a fire. Notify the local fire department, gas and electric companies and telephone company when home oxygen therapy is started. Request a "priority service listing." -COPD Foundation
ALERT SMOKING WHILE USING OXYGEN IS EXTREMELY DANGEROUS Safety Hazards in the Home Burns May be caused from: Fireplace
Oxygen & smoking Ovens. Hot pots on the stove Coffee cups Hot tap water Steam from microwaved foods Safety for the Aide in the Home Setting Common injuries of healthcare workers in the home setting are strains, sprains and other
musculoskeletal injuries that are related to moving or lifting patients. Why? The home setting is unique to the patient Lack of equipment- adjustable beds and lifting equipment Most Aides work solo in the home setting CDC Cautions Recipe for Injury Moving patients without help
Cramped quarters Without assistive equipment Prevention: Using equipment & methods to decrease strain & increase safety when lifting and moving patients Ergonomic Assistive Devices Hoist Equipment to lift a patient when they do not have the strength to stand and walk on their own. Rolling toileting & shower chair Grab Bars
Adjustable beds Elevated toilet seats Slip sheets Gait belts- assist with steadying gait When Ergonomic Equipment Not Available Stand as close to the patient as possible to avoid reaching, bending & twisting. To avoid rotating the spine, make sure one foot is in the direction of the move
Keep your knees bent and feet apart Use gentle rocking motions to assist a patient as they are trying to make lateral movements in the bed When Ergonomic Equipment Not Available When pulling a patient up from an adjustable bed, lower the head of bed until flat or down. Raise the patients knees & have them push. Dont stand in one place. Move around the
bed to get in best possible position using a safe posture instead of bending, stretching & reaching. KNOW WHEN TO ASK FOR HELP!!! Activity You arrive at the home of a new patient today. She is a stroke patient with who has lost all ability to do their bath. She weighs 260 pounds and cannot help at all with bath. She is in a small room and a regular full size bed. What is the best approach to care for her and
protect yourself? Important Reminder!!! Brochures that may be shared with Patients Falls Stay Independent Brochure: http://www.cdc.gov/steadi/pdf/stay_independent_brochure-a.pdf
Has a self assessment for fall risk What You can Do to Prevent Falls: http://www.cdc.gov/steadi/pdf/what_you_can_do_brochure-a.pdf These brochures are available in English and Spanish Oxygen Tips Medical Oxygen Safety: www.nfpa.org/education The Aides Role
Assess the Home Environment for hazards that could cause injury to the patient Inform your supervisor of the hazard If appropriate, educate the patient and family about the safety hazard you have noted Be a role model safety comes first! The Aides Role Sharing information helps patients and families make informed decisions. It is important to remember we may not agree
with their decision. It is important to document the information shared. Resources Causes of Serious Burns. Retrieve from: http:// www.sixwise.com/newsletters/05/03/29/the-top-10-causes-of-serious-burns-to-people-and-pets-in-the-h ome.htm
Fire safety outreach materials for older adults. Retrieved from https://www.usfa.fema.gov/prevention/outreach/older_adults.html Important Facts about Falls. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
Oxygen Therapy Safety Tips: Preventing Fires. Retrieved from http://www.webmd.com/lung/copd/safety-tips-for-using-oxygen. Strains, Sprains & Pains in Home Healthcare : Working in an Uncontrolled Environment. Retrieved from http://blogs.cdc.gov/niosh-science-blog/2010/04/16/homehealthcare/
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