1. Safety: safety is the primary concern when caring for clients. For all healthcare institutions, the Occupational Safety and Health Administration (OSHA) suggests following its Material Safety Data Sheets (MSDS).

   1. Fire, electrical, and radiation safety

      1. Fire safety

         1. types of fire extinguishers and their uses

         2. fire containment

         3. response to fire

            1. ARCE:

               • activate fire alarm system

               • rescue clients

               • contain fire by closing doors and windows

               • extinguish flames with fire extinguisher

         4. electrical safety

         5. radiation safety

   2. Poison control

      1. High risk groups are young children and older adults with impaired eyesight and diminished memory

      2. Goals of therapies

         1. before the body absorbs poison, remove it (e.g., vomiting, gastric lavage) or neutralize it(e.g., activated charcoal)

         2. give supportive care (manage shock, seizures, aspiration)

         3. give the correct antidote to neutralize poison

         4. speed the elimination of any absorbed poison

   3. Fall prevention

      1. Assesses client for risk factors

      2. Guidelines to prevent client falls

   4. Protect yourself from falls and injuries: body mechanics

      1. When moving objects: avoid pulling, push instead

      2. When moving clients

         1. before moving a client, arrange for help

         2. to reduce the load, lift simultaneously with your helper

         3. if there's no helper, use mechanical aids

      3. Your posture

         1. flex your knees

         2. keep back, neck, pelvis, and feet aligned

         3. widen the base of support, keeping feet apart

         4. avoid twisting your body

         5. don't lift with your back, use your arms and legs

         6. balance load and keep it centered on your trunk

   5. Use of safety devices (restraints)

   6. Disaster planning

   7. Biohazards

      1. Biologic agents harmful to an individual's health. OSHA classifies materials in the work environment according to degree of health hazard. See OSHA for guidelines on handling and disposal of hazardous materials.

   8. Security plan

2. Infection

   1. Types of infections

      1. Community acquired

      2. Hospital acquired, also called nosocomial

2. Stages of an infectious process

   1. Incubation period

   2. Prodromal period

   3. Illness period

   4. Convalescent period

3. Complications of infection

   1. Relapse: some infections may reactivate, often because they were not treated thoroughly or the client did not comply

   2. Local complications: local infections may form abscesses

   3. Systemic complications: pathogen may enter bloodstream and cause septicemia

4. Chain of transmission

   1. Causative agent (e.g. pathogen): fungus, parasite, bacterium, virus

   2. Reservoir host

   3. Portal of exit: way to get out of reservoir of host

   4. Transmission route: way to reach susceptible host

   5. Portal of entry: gain entrance

   6. Susceptible host

   7. After the pathogen enters the host, illness depends on four factors

      1. number of pathogen organisms

      2. duration of the exposure

      3. health status of host, including age, physical, mental, and emotional health

      4. genetic status of host's immune system

2. Infection Control

   2. Medical and surgical asepsis

      1. Medical asepsis

      2. Surgical asepsis

   3. Precaution types

      1. Standard (universal) precautions

         1. used for care of all clients

         2. used to prevent the spread of microorganisms

         3. synthesize the major features of

            1. universal (blood and body fluid) precautions (designed to reduce the risk of transmission of bloodborne pathogens) and

            2. body substance isolation (designed to reduce the risk of transmission of pathogens from moist body substances)

         4. apply to

            1. blood

            2. all body fluids, secretions, and excretions, except sweat, regardless of whether or not they contain visible blood

            3. nonintact skin

            4. mucous membranes

         5. designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals

   4. Personal protective equipment (PPE) is used to carry out standard precautions

      1. Gloves

      2. Masks

      3. Gowns

      4. Protective eyewear

      5. Head coverings

   5. Immunization: raises host resistance, defenses, and immunity

      1. Acquired immunity

         1. any form of immunity that is not innate

         2. obtained during life

         3. natural or artificial

            1. naturally acquired immunity is obtained by

               1. the development of antibodies resulting from an attack of infectious disease

               2. the transmission of antibodies from the mother through the placenta to the fetus or to the infant through the colostrum

            2. artificially acquired immunity is obtained by

               1. vaccination

               2. injection of an antiserum, also called an immune globulin such as a hepatitis immune globulin

         4. thought to be induced by passive or active (vaccine) means

            1. passive immunity, a form of acquired immunity, results from antibodies that are transmitted naturally through

               1. the placenta to the fetus

               2. or the colostrum to an infant OR

               3. artificially by injection of antiserum (immune globulin) for treatment of prophylaxis

            2. passive immunity is not permanent and does not last as long as active immunity

      2. Active immunity: body produces its own antibodies

      3. Passive immunity: produced by injection of serum that contains antibodies formed by another host

      4. Immunizations - for immunization tables please click on the links below

Disease reporting

Safety

• Safety is the primary concern when caring for clients.Falls are the most frequent cause of injury for elderly clients in acute care.

• Know the institution's plan for fire drills and evacuation.

• Know the emergency phone number for reporting fire.

• Know locations of all fire alarms, exits, and extinguishers.

• ARCE: Activate fire alarm, Rescue clients, Contain fire by closing doors and windows, Extinguish flames with an appropriate fire extinguisher In a fire, never use an elevator - use stairs in emergency exit Turn off all oxygen supplies in the area of the fire.

• In a fire, close all doors and windows.

• In a power failure, only certain electrical outlets access the emergency generators. Know which ones they are.

• Know your agency's policy for cleaning up a biohazardous spill.

• Safety devices are used only as a last resort. Use the least restrictive immobilizing device.

Poisons

• Never induce vomiting unless instructed to do so by a poison center or health care provider.

• If you suspect someone has taken poison, take the poisonous substance with you to the emergency room.

Infection

• Infection control with the use of standard precautions, transmission precautions and medical and surgical asepsis decreases the spread of infection.

• The major sites for nosocomial infections are urinary and respiratory tracts, blood, and wounds.

• All nosocomial infections that occur in hospitals must be tracked and recorded by risk management.

• The single most effective way to prevent infection is hand washing.

• Handwashing is the most effective method of preventing infection; friction is the most important variable.

• Standard precautions are used for contact with all body fluids except sweat.

• Standard precautions are used for all clients, and transmission precautions are used for all clients with transmittable organisms.

• Special (N95) respirator masks are necessary to care for clients under airborne precautions who have tuberculosis.

• Protective (neutropenic) isolation is used for clients with immunosuppression and low white blood counts.