01 Maintaining a Safe Environment
Summary
TLDRThis video script discusses the importance of maintaining a safe environment for vulnerable individuals such as elderly patients with dementia or those with learning disabilities. It emphasizes the role of nurses in assessing risks, planning safety measures, and evaluating their effectiveness. The script also covers the National Institute for Health and Clinical Excellence's guidelines for risk assessment of venous thromboembolism (VTE) and the need for health education to promote safety and prevent accidents. It highlights the significance of considering psychological, sociological, and cultural aspects in patient care, ensuring a holistic approach to maintaining safety.
Takeaways
- 🏠 Independent adults are generally responsible for assessing and preventing accidents in their home environment.
- 👨⚕️ Nurses play a crucial role in assessing the physical environment for risks and planning safety measures for patients who cannot safeguard themselves.
- 👵 Elderly patients with dementia or those with learning disabilities often rely on nurses to ensure their safety.
- 📚 The nursing care plan is instrumental in maintaining a safe environment for patients like Sumera, who has a history of falls and confusion.
- 🩸 The National Institute for Health and Clinical Excellence (NICE) provides guidelines for risk assessment of venous thromboembolism (VTE) for patients admitted to hospitals.
- 🚫 If Sumera was on anticoagulants, they would be stopped during treatment for a subdural hematoma, which could increase the risk of developing a thrombosis.
- 🌟 Nurses are encouraged to use evidence-based practice in delivering care and assessments, as highlighted by a NICE campaign aimed at healthcare professionals.
- 🧠 Psychological factors, such as a patient's ability to interpret their environment and feel safe, are important in maintaining a safe environment.
- 👪 Sociocultural aspects, including a patient's family dynamics and societal roles, are considered when planning for a safe discharge and home environment.
- 📈 NICE's campaign on strategy, policy, and commissioning aims to delay or prevent the onset of dementia, disability, and frailty by promoting awareness and healthy lifestyles.
Q & A
What is the primary role of nurses in maintaining a safe environment for patients?
-Nurses play a crucial role in assessing the physical environment for risks, planning safety measures, and evaluating the effectiveness of those measures for patients who are unable to safeguard their own safety.
Why are patients with cognitive impairments or dementia particularly at risk in their home environment?
-Patients with cognitive impairments or dementia may lack the ability to assess their environment for hazards and prevent accidents, making them reliant on nurses for safety assessments and measures.
What is the significance of the activity of daily living (ADL) in maintaining a safe environment for patients?
-The ability to perform ADLs is an indicator of a patient's capacity to maintain a safe environment. Patients who struggle with ADLs may require supervision and assistance to ensure their safety.
What is the role of the National Institute for Health and Clinical Excellence (NICE) in patient safety?
-NICE provides guidelines and risk assessments, such as for venous thromboembolism (VTE), to help healthcare professionals make informed decisions and implement appropriate safety measures for patients.
How often should patients be reassessed for VTE risk according to NICE guidelines?
-Patients should be reassessed for VTE risk within 24 hours of admission and whenever there is a change in their clinical situation.
What are the steps involved in assessing a patient's risk for VTE?
-The steps include assessing all admitted patients for mobility, reviewing patient-related factors against thrombosis risk, and considering additional risks as appropriate.
How does a patient's history of falls and head injury, like Sumera's, impact her ability to maintain a safe environment?
-A history of falls and head injury can impair a patient's physical and cognitive abilities, reducing their capacity to recognize and respond to hazards, thus increasing their need for supervision and support.
What are the psychological factors that nurses should consider when assessing a patient's ability to maintain a safe environment?
-Psychological factors include the patient's emotional state, cognitive abilities, spiritual beliefs, and their perception of safety in their environment.
How can a patient's sociocultural background affect their ability to maintain a safe environment?
-A patient's sociocultural background can influence their expectations, values, and beliefs about safety, as well as their ability to perform ADLs and adapt to changes in family dynamics and roles.
What strategies does NICE recommend to healthcare professionals to delay or prevent the onset of dementia, disability, and frailty?
-NICE recommends strategies such as raising awareness, promoting healthy lifestyles, leading by example, and interventions related to alcohol, diet, physical activity, and tobacco use.
Why is it important for nurses to involve the patient's family in the care planning process?
-Involving the family ensures that the patient's needs are met effectively, helps alleviate stress, and allows for better support and understanding of the patient's condition and limitations.
Outlines
🏥 Patient Safety and Risk Assessment
This paragraph discusses the importance of maintaining a safe environment for patients, particularly those with cognitive impairments such as learning disabilities or dementia. It highlights the role of nurses in assessing risks, planning safety measures, and evaluating their effectiveness. The admission booklet's role in assessing a patient's orientation, history of confusion, and recent falls is emphasized. The National Institute for Health and Clinical Excellence's (NICE) guidelines for risk assessment of venous thromboembolism (VTE) are outlined, including steps for assessing mobility, reviewing patient-related factors for thrombosis and bleeding risks, and the importance of evidence-based practice in healthcare delivery.
🧠 Physical, Psychological, and Sociocultural Factors in Patient Safety
The second paragraph delves into the physical, psychological, and sociocultural aspects affecting a patient's ability to maintain a safe environment. It focuses on Sumera, a patient with a head injury, and how her physical health, including her disorientation and confusion, impacts her ability to prevent falls and maintain personal safety. The psychological impact of her condition on her feelings of safety and the need for additional support are discussed. Sociocultural factors consider Sumera's roles as a wife and grandmother and how her hospitalization affects family dynamics and the potential need for external support upon discharge. The importance of involving the family in care planning and the impact of societal and cultural expectations on a patient's independence are also highlighted.
🚑 Comprehensive Care for Patient Safety
The final paragraph summarizes Sumera's needs in maintaining a safe environment, emphasizing her reliance on assistance for activities of daily living (ADLs) and health education regarding smoking and alcohol consumption. It addresses the necessity of nursing interventions to reduce her anxiety and assist with reorientation. The importance of keeping Sumera's family informed and involved in her care is stressed, along with the potential need for external support post-discharge. The paragraph concludes with a reference to a NICE campaign aimed at healthcare professionals, focusing on strategies to delay or prevent the onset of dementia, disability, and frailty, and the role of nurses in promoting healthy lifestyles and providing guidance on supportive services.
Mindmap
Keywords
💡Safety Checks
💡Cognitive Ability
💡Activities of Daily Living (ADLs)
💡Venous Thromboembolism (VTE)
💡Health Educators
💡Disorientation
💡Psychological Factors
💡Sociocultural Aspects
💡Evidence-Based Practice
💡Risk Assessment
Highlights
Importance of maintaining a safe environment for independent adults.
Nurses' role in assessing risks for patients unable to safeguard their own safety.
Sumera's admission following a fall and head injury.
Risk assessment for venous thromboembolism (VTE) according to NICE guidelines.
The three-step process for assessing VTE risk in patients.
Consideration of additional risks beyond the standard VTE risk factors.
Impact of anti-coagulants on the risk of thrombosis during treatment for subdural hematoma.
The role of health educators in promoting evidence-based practice in care and assessments.
Campaign by NICE to delay or prevent onset of dementia, disability, and frailty.
Physical factors affecting Sumera's ability to prevent falls and maintain physical safety.
Psychological factors and the importance of feeling safe in a patient's environment.
Sociocultural aspects and their impact on maintaining a safe environment for Sumera.
Involvement of Sumera's family in her care plan to ensure safety upon discharge.
The need for outside agencies or family members to assist with household chores and responsibilities.
Sumera's inability to maintain a safe physical environment due to disorientation and confusion.
Health education needed for Sumera regarding smoking and excessive alcohol consumption.
Assistance required for Sumera to maintain a safe psychological environment.
The importance of keeping Sumera's family informed and involved in her hospital care.
Transcripts
[Music]
[Music]
maintaining a safe environment
independent adults can assess the
environment for risks and prevent
accidents in the home identifying
hazards to health and preventing them
from happening
ability to perform safety checks
however not all patients have the
cognitive ability to perform these
safety checks
and are unable to safeguard their own
safety affecting those with a learning
disability or elderly patients with
dementia generally
patients unable to maintain their
personal safety rely on nurses to assess
their physical environment for risks
plan for safety measures and evaluate
the safety measures put in place
the activity of daily living of
maintaining a safe environment can be
allocated to samira in the ascii
and the nurse can examine sumera's
ability to complete this aol
the nursing care plan developed can help
maintain a safe environment for her
in the admission booklet it addresses
the orientation status history of
confusion and whether she has had any
falls lately
sumera has had false and in fact was
admitted following a fall and the head
injury she sustained
national institute for health and
clinical excellences risk assessment for
venus thromboembolism
vte
all patients should be risk assessed on
admission to hospital
patients should be reassessed within 24
hours of admission and whenever the
clinical situation changes
step 1
assess all patients admitted to hospital
for level of mobility
all surgical patients and all medical
patients with significantly reduced
mobility should be considered for
further risk
assessment step 2 review the patient
related factors shown on the assessment
sheet against thrombosis risk
taking each box that applies
any tick for thrombosis risk should
prompt
thormbrofrofilaxis according to nice
guidance
the risk factors identified are not
exhaustive
clinicians may consider additional risks
in individual patients and offer thomas
prophylaxis as appropriate
step 3 review the patient related
factors shown against bleeding risk and
tick each box that applies more than one
box can be ticked any tick should prompt
clinical staff to consider if bleeding
risk is sufficient to procure
pharmacological intervention
guidance on thrombopro
phylaxis is available at
national institute for health and
clinical excellence 2010 linear
thromboembolism
reducing the risk of venous
thromboembolism
deep vein thrombosis and pulmonary
embolism in patients admitted to
hospital
nice clinical guideline 92 london
national institute for health and
clinical excellence
if sumira was on any anti-coagulants
they would be stopped while being
treated for a subdural hematoma which
could increase
risk of developing a thrombosis
as health educators nurses must use
evidence-based practice in our delivery
of care and assessments
as health
educators nurses must use evidence-based
practice in our delivery of care and
assessments
a campaign aimed at healthcare
professionals by nice national institute
for clinical excellence was published on
second august 2018.
strategy policy and commissioning to
delay or prevent onset of dementia
disability and frailty
here are the following themes to delay
or prevent onset of dementia disability
and frailty
raise awareness
promote healthy lifestyles lead by
example in the public sector
alcohol diet physical activity tobacco
interventions
physical or biological factors affecting
maintaining a safe environment
this considers the overall health of
current illness or injury of an
individual
these physical factors will be affected
by the bleed on her brain how this
injury impairs her physically and any
other factors affecting her ability to
prevent falls ultimately to maintain her
own physical safety
sumira's ability to recognize her body's
physical needs to sustain itself such as
good nutrition and sleep may also be
affected
while sumera is disoriented and confused
after her head injury she has a greatly
reduced ability to assess her
environment for hazards
she usually walks with a walking aid and
has a history of falls
sumera is confused and may not be able
to recognize hazards and safe boundaries
she will need supervision to maintain
her safety when mobilizing
sumera may experience problems
completing adls such as washing and
dressing due to confusion
she may require supervision to ensure
that she is able to complete these
activities
she has a habit of drinking excess
alcohol and this could lead to further
hazardous situations smoking cigarettes
could also pose a fire risk
psychological factors of maintaining a
safe environment
considers the impact of not only emotion
but cognition spiritual beliefs and the
ability to understand
in assessing sumera's ability to
maintain a safe environment physically
remember ropa's advice that we should
consider the psychological and
sociological aspects of maintaining a
safe environment
ropa defines the psychological aspect of
this aol as a feeling of being safe a
person who is independent in this aol
can interpret their environment
recognize and quantify hazards and feel
safe if there is no threat
whereas a patient who is confused may
need additional support to feel safe as
they are unable to interpret their
environment
for example if a call bell rings on the
ward an independent person understands
there is nothing to worry about but a
disoriented patient may feel anxious or
alarmed as they fail to make sense of
the sound
she may require additional psychological
support in this area to relieve her
anxieties and help reorientate her
sociocultural aspects of the aol
maintaining a safe environment
this considers the impact of society and
culture experienced by the individual
firstly it is concerned with viewing
sumera as a whole person who has the
responsibilities of being a wife and a
grandmother
her confused condition may affect her
ability to function as normal in these
family roles and change family dynamics
as a result
her hospitalization may affect her
ability to perform household tasks she
would normally do and therefore her
family should be involved in the plan of
care
this will also help alleviate stress so
meera may fail due to her limited
abilities and help her family to
understand and support her effectively
upon discharge
also you should consider that her family
may be struggling with her reduced
abilities as samira had the role of
housewife looking after the home and
family and this will be a huge change
for everyone especially for herself and
her husband
after discussing these issues it may
become apparent her husband and family
cannot perform the tasks she is usually
responsible for therefore
outside agencies either family members
or friends and may become involved in
these household chores and
responsibilities
this can all be discussed with her and
her husband during the care planning
phase to ensure safety is maintained for
sumera on discharge
roper 2002 says of social culture
cultural factors that the impact of
society and culture experienced by the
individual
expectations and values based on
perceived or actual social class or
status or related to the individual's
perceived or actual health or ability to
carry out activities of daily living
culture within this factor relates to
the beliefs expectations and values held
by the individual both for themselves
and by others pertaining to their
independence in and ability to carry out
activities of daily living
summary of sumira's ability to maintain
a safe environment
sumera is unable to maintain a safe
physical environment she is disoriented
confused and at risk of falls
she will need assistance to achieve the
adls of mobilizing washing and dressing
eating drinking and elimination
she needs health education in the areas
of smoking and excess alcohol
consumption
she is unable to maintain the safety of
dependence
sumera needs assistance to maintain a
safe psychological environment as she is
disorientated anxious and will need
nursing interventions to reduce anxiety
and gently assist her with reorientation
sumira's family are anxious and
concerned and need to be kept informed
on her hospital care
ildioski if you have not been able to
discuss these aspects of maintaining
safety during assessment you can plan
for that discussion to take place with
sumera and her husband you can verbalize
this
a campaign aimed at healthcare
professionals by nice national institute
for clinical excellence was published on
second august 2018.
strategy policy and commissioning to
delay or prevent onset of dementia
disability and frailty
here the following themes to delay or
prevent onset of dementia disability and
frailty are set out
raise awareness
promote healthy lifestyles lead by
example in the public sector alcohol
diet physical activity tobacco
interventions
so we as nurses are expected to promote
healthy lifestyle choices and give
guidance about services that can support
them
[Music]
you
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