Safety Checks

Patient room
1. Bag and mask
2. Suction equipment
3. Bed alarms on
4. Bed in lowest position
5. Siderails up (always 2, never 4)
6. Call light and useful items in reach
Precautions
1. Appropriate signs in place
2. Protective equipment accessible
  1. Standard -> gloves
  2. Contact -> gloves and gowns
  3. Droplet -> masks
  4. Airborne -> negative airflow equipment/masks
Oxygen
1. Hook up and cannula available
2. Turned on and hooked up correctly if needed
3. Is patient wearing correctly?
4. Check every time!
Monitors
1. Telemetry
  1. Patches on
  2. Check batteries
2. Pulse oximetry
  1. Probe secured
  2. Parameter check
Patient transfers
1. Get help if needed (assess the situation)
2. Check and adjust lines and tubes
3. Clear a path
4. Appropriate equipment
  1. Gait belts
  2. Transfer equipment
  3. Slippers/ gripper socks
Medication administration
1. Five rights
  1. Right patient
  2. Right med
  3. Right dose
  4. Right route
  5. Right time

Assessment

When to check for safety
1. Beginning of shift/shift change -> bedside report
  1. Assess the room
  2. Visualize the patient
  3. Review orders
  4. Ask questions!
2. New admission -> prepare room before patient comes
3. Patient rounding

Therapeutic Management

Something not right or out of place -> fix it!
Someone forgets something? Connects wrong? -> kindly tell them!

Nursing Concepts

Clinical Judgement
1. Assess the patient and environment for safety
Communication
1. Nurse to nurse, nurse to patient
Patient-Centered Care
1. Assess patient needs
2. Review orders

Patient Education

Introduce self
Tell them what you’re doing
They will be glad that you care!

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Transcript

Hey guys! Welcome to the lesson where we will talk about safety checks. We will begin by talking about the patient room.

So it is super important to make sure that certain things are in place and available in your patient rooms for safety. Check and make sure that each of your rooms has a bag and mask for the case of an emergency situation where your patient stops breathing. Make sure that the suctioning equipment is available and hooked up correctly. Check that the bed is in the lowest position and that the alarm is on to prevent falls. The alarm may not be necessary for every patient, but follow your organization’s guidelines and nurse judgment. Make sure that the top two side rails are also up to protect the patient from rolling out of the bed. I always keep two up, but you can never have all four up because that is considered a restraint. Keep the patient’s call light within reach, along with any other useful items like the urinal. Next, let’s move on to precautions.

Make sure that you know what types of precautions your patients should be on so that you can ensure that the appropriate signs are in place and the needed equipment is accessible. If your patient doesn’t have any special precautions, then they are standard precautions. Make sure the gloves are stocked in the room for you to use when needed. If your patient has a disease requiring contact precautions like CDIFF for example, make sure the gloves and gowns are stocked for use before you enter the room. If your patient has an illness requiring droplet precautions like mycoplasma pneumonia, stock up the masks to protect yourself. For airborne patients, make sure that the negative airflow is working and that the appropriate masks and equipment are available. Okay, now we will move on to oxygen.

Now, all patient rooms should have the oxygen equipment available to be used. If your patient is on oxygen, check that it is turned on and hooked up correctly. Make sure the prongs are in the patient’s nose if they are wearing a nasal cannula, they can move aside easily on wiggly patients. Always check your patient’s oxygen every time you go in their room. Now let’s move on to monitors.

Your patient’s telemetry patches and batteries should be checked when you are in the room to save an extra trip. The pulse oximetry probe should be secured on the finger or forehead and changed at least daily. Make sure that the parameters are set up appropriately for your patient using your nursing judgment on what their oxygen level and pulse may be. Next, we will talk about safety with patient transfers.

Make sure that any time you plan to transfer a patient, you assess the situation to determine if you will need an extra hand or two. Check the lines and tubes to prevent falls and damage to devices like IVs, catheters, or g-tubes. Make sure there is a clear path to walk to where you need to go. Check that the appropriate equipment is stocked in the room like the gait belt, slippers or gripper socks, and any other transfer equipment that you might need like an assist device. Now let’s move on to medication administration safety.

Every time that you give any medication, you have to make sure that you follow the five rights which are right patient, right medication, right dose, right route, and the right time. If any of these are missed, and error could be made affecting the safety of your patient. Next, let’s explore when to check for safety.

There is no wrong time to perform a safety check on your patient, but here are some ideas to keep you on track. At the beginning of your shift while getting bedside report, you can assess the room and visualize the patient, their lines, and equipment. Review the orders on the patient and ask any questions you have! Whenever I have a new admission coming, I prepare the room before they get there but placing any equipment or signs that I might need. I usually do this after I receive a report from the ED so that I have all the information that I need. Patient rounding is also a great time to check for safety.

It’s important to mention that if you find something out of place, fix it! If you took over a patient and the previous nurse forgot something important, fix it and KINDLY tell them. We all make mistakes, but it is helpful to educate each other to prevent future mistakes.

Alright guys, let’s review the key points on safety checks. Always assess your patient’s room to make sure they have a bag and mask, suction equipment, bed alarms on and in the lowest position, side rails up and a call light in reach. Also, make sure that the appropriate precautions are in place. Ensure that the oxygen is available and hooked up correctly along with other equipment like telemetry and pulse oximetry. Assess how the patient may transfer and keep the gait belt, slippers, and moving equipment available for use. Always follow the five rights when giving medications, right patient, right med, right dose, right time, and right route. Remember, there is no wrong time to check for safety, and if something is wrong, fix it!

Okay, guys, that’s it on safety checks. Now go out and be your best self today, and as always, happy nursing!