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Ryerson University

Module One – Protection and Safety Part 1: Accidents and their Prevention 1. Explain the falls risk assessment tools. You circle risk factors listed on the tool; each carrying a certain numeric risk weight. After going through the list the scores are tallied. Totals scores totalling 15 or greater indicate high risk and a necessity for preventive measures to be in place.  help determine specific needs and targeting interventions to prevent falls  client is asked about their history of falls, and other risk factors are considered (like age, if they can ambulate independently, etc)  a client’s risk of falling increases as the number of risk factors increases  initial and daily assessments of fall risk are important in identifying clients at risk of falling 2. Identify how data from falls risk assessment can be used to design falls prevention programs. Potter and perry, p. 814-816, p. 806 The purpose of such tools is to identify clients that are more susceptible to falls and aid in planning interventions and care to minimize the risks before an incident occurs. The Specific factors that contribute to a client's risk can be identified and used in client education in order to assist them with adjusting to specific conditions/needs. Additionally changes to the environment can be made as well to reduce the risk of falls.  They can be used to identify factors leading to falls…fall precautions based on those can be implemented (can be environmental interventions, health promotion, developmental interventions) Part 2: Prevention and Control of Infection 1. Explain the role of vaccines in the prevention of infection and personal responsibility in relation to infection at work including agency specific guidelines. Immunization is the process by which resistance to an infectious disease is produced or augmented. - active immunity: acquired by injecting a small amount of attenuated (weakened) or dead organisms or modified toxins from organism (toxoids) into the body. - Passive immunity: occurs when antibodies produced by other persons or animals are introduced into a person’s bloodstream for protection against a pathogen Immunization is the primary prevention. Potter and perry, p. 649 box 33-8…..also page. 341, 902 Immunization boosts a potential host’s defenses against infection. They act by exposing the immune system to inactivated forms of a pathogen, which leads to an immune response and the creation of antibodies and their memory cells to defend against future encounters of the same pathogen. As nurses, we are often in contact with clients that are at risk for acquiring infections – whether they are immunocompromised or have acute conditions that lower natural defenses. For this reason it is important for nurses to follow agency policy with immunization in order to provide safe and effective care to clients, in addition to protecting ourselves. 2. Define and explain H1N1, SARS, C-Difficile, ESBL, MRSA, VRE, TB in relation to: a. history of exposure, H1N1: first encountered in 2009 SARS: originated from animals, first human cases in Canada in March 2003; more prevalent since b. mode of transmission (i.e. airborne, droplet & contact), H1N1: droplet/indirect/direct contact. SARS: droplet contact. C-Difficile: direct contact. Extended Spectrum Beta-Lactamase: direct contact, vehicle. MRSA: direct & indirect contact. Vancomycin-Resistant Enterococci: indirect contact. TB: airborne. c. laboratory screening tests, H1N1: rRT-PCR Swine Flu Panel. SARS: RT-PCR. Results are presumptive until 2 panel is confirmed positive. C-Difficile: Stool culture test, antigen detection for C dif, toxin testing. Extended Spectrum Beta-Lactamase: microdilution and disk diffusion screening tests. MRSA: cefoxitin disk screen test, the latex agglutination test for PBP2a, or a plate containing 6 μg/ml of oxacillin in Mueller-Hinton agar supplemented with NaCl (4% w/v; 0.68 mol/L) as alternative methods of testing for MRSA. Specimen collection by nasal swab. VRE: stool culture test, anal swab. Once enterococcus is confirmed a MIC test is performed to determine vancomycin resistance. TB: mantoux skin test or blood test; chest x-ray if live vaccine was used on client. d. the implications for health care personnel, clients, and visitors in both hospital and community settings. H1N1: Eliminate potential exposures (minimize outpatient visits from clients with influenza- like symptoms but no indicated risk factors for complications, postponing elective visits until no longer contagious); engineering controls (partition triage areas or public spaces, shield personnel, use closed suctioning systems for airway suctioning of intubated clients); administrative controls (work practice and policies that prevent exposure, like vaccination or sleeve coughing); PPE. SARS: Surveillance and monitoring of healthcare workers; management of exposures and other contacts with SARS clients; PPE to control/limit spread and exposure. For community, plans need to be set for coordination between different parties involved in reporting and containment as well as treatment of infected clients. C-Difficile: Judicious use of antibiotics, contact precautions for confirmed/suspected cases, PPE, environmental sterilization and disinfection. MRSA: hand hygiene, PPE (glove, face, eyes, gown), appropriate handling/use of client care equipment and instrument/devices as well as laundry. VRE: hand hygiene, environmental cleaning (especially bathroom), PPE (gloves) when contact with bodily fluids that may contain VRE is possible, and informing HCPs of VRE status. TB: risk assessment for TB in setting; priority lab testing; administrative measures for practice and policy when dealing with TB positive clients; training and education health care workers with focus on prevention, transmission and symptoms; signage advising respiratory hygiene and cough etiquette; coordination with local or provincial health department. 3. Explain importance of hand hygiene/hand washing and review procedure for hand washing. Hand hygiene prevents transmission of infections and pathogens. Includes use of water, soap and friction; or alcohol-based hand sanitizers. Perform for 15 seconds. 4. Differentiate between regular and biohazard wastes and identify agency specific disposal procedures. Regular waste is assumed to be contaminated and potentially infectious; whereas biohazard waste is extremely harmful to biological health (usually in relation to humans) 5. Explain the first aid response to exposure to blood and body fluids and/or sharps and follow-up reporting and assessment procedures. If an individual experiences a needle stick or sharps injury or was exposed to blood or other body fluids of a patient, the following first aid care should be done immediately. 1. Thoroughly wash needle stick wounds and cuts with soap and water. 2. Flush splashes to the nose, mouth or skin with water. 3. Irrigate eyes with clean water, sterile eyewash or saline irrigating solution. 4. Immediately seek further medical evaluation/treatment such as blood test. 5. Fill out an incident report for agency and regulatory body as required. 6. Explain the learning/teaching needs of clients and family members related to isolation. Isolation may affect psychological wellbeing as body image and social relationships may be altered significantly. Inform client and family before isolation measures are taken and ensure understanding nature of conditions requiring the measures. Elicit part
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