The Standard of Practice for Nursing Safe Environment

Declaration

Safety is the freedom from physical and psychological injury and is usually a basic need for individuals. When health care is offered in a safe manner within a secure environment, it becomes imperative for the well-being and survival of patients. A safe environment minimizes the risks inherent in injuries and illnesses. Indeed, it helps the health professionals reduce the cost allied with health care since it prevents the extension of time required in hospitalization or treatment of the patient. The safety maintains or improves the functional status of the patient as well as their sense of well-being (Glass & Walter, 2013).

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The report by Glass and Walter (2013) was a supportive publication because it enhanced the safety of the patient by bringing it to the forefront of the Unites State’s medical error prevention. Therefore, in a bid to improve the safety of patients, many hospices devote themselves to monitoring and developing key initiatives for health care as well as offer information to the public and organizations providing health care. The institutions offering health care are now fostering a culture centered on patients. The plan is ensured through a continual focus on improving performance endeavors in an organization that provides health care.

It is enhanced through the management of risk findings as well as safety reports. The latter offers reliable and current technology, and evidence-based integrates practices into procedures. Designing an atmosphere and work environment safe for the health care providers and offering adequate education opportunities to the staff is also imperative.

The Quality and Safety Education for Nurses (QSEN)

Nurses have the overall responsibility of being integrated into activities that ensure a culture centered on a patient. They work as the inclusion of the team that takes care of the patient’s health. Indeed, an emphasis has been made on the education and training of student nurses better. The initiative would make them competent while providing care to the patients. In addition, they would promote the various practices of health care (Glass & Walter, 2013). The Quality and Safety Education for Nurses (QSEN) was initiated to overcome the challenges and drawbacks of preparing and empowering future nurses with attitude, knowledge, and skills imperative for improving the safety and quality of healthcare systems.

The projects would ensure that the nurses understood every security measure in the health care systems, where they would work after the training. Indeed, the safety competency for nurses of QSEN is often depicted as a way of reducing the providers' and patient’s risk harm via both individual performance and system effectiveness. Therefore, the nurses are supposed to incorporate critical thinking and analytical skills when engaged in job processes, as well as when assessing every patient and their surroundings for hazards that could threaten the safety of the patient.

The nurses are also supposed to intervene and plan appropriately in a bid to ensure a safe environment for the patients. When the nurses fulfill their duties, they become providers of restorative, safe, and continuing care as well as active promoters of patients’ health care. The current paper addresses the standard of practice for maintaining a calm, clean, and quiet nursing safe environment.

Literature Review

The environment for patients involves various psychological and physical factors influencing the survival and treatment of the patients. A wider perspective of the environment would cross the anticipated continuum of a setting where patients and nurses integrate or interact. For instance, patients and nurses interact in care facilities, hospitals, community centers, homes, clinics, and schools (Glass & Walter, 2013). A safe environment also protects the staff working in such environments and offers them the opportunity to work optimally.

Nonetheless, there are vulnerable groups that require assistance in achieving a safe environment, such as older adults, infants, mentally and physically disabled patients, the poor, and the illiterate patients. A setting, which is safe for everyone, involves the meeting of basic needs, pollution control, and reduced transmission of pathogens and physical hazards. The requirements include physiological needs such as nutrition, sufficient oxygen, and optimum temperatures. The aforementioned facets affect the safety of individuals. Based on the hierarchy of human needs as postulated by Maslow, the aforementioned requirements ought to be met before psychological and physical needs are considered (Glass & Walter, 2013).

Oxygen

Sufficient oxygen is needed to meet the requirement of a patient. Therefore, strict regulations are imperative to ensure that oxygen is used and stored appropriately in medical facilities. The control should be enhanced because more oxygen in the air can increase the rate of fire burning. Although it may not be true in a home setting, in a hospital surrounding, thermal burns take place (Jezierski, 1997). As a result, disposal of excessive oxygen in the air can accelerate the fire, making them burn faster and hotter. It is, therefore, incredibly significant for the health care providers to pay attention to the factors that have a probability of reducing oxygen for patients.

Additionally, a common hazard for the home environment is a heating system that does not function appropriately. A fireplace or a furnace, which is not ventilated properly, may result in carbon monoxide gas emission. Carbon monoxide gas binds with hemoglobin inherent in an individual. The process hinders the formation of ox-hemoglobin in the body. As a result, the supply of oxygen in the tissues is minimized. The low concentration of oxygen in the body tissues leads to fatigue, nausea, and dizziness. High concentration may even result in deaths if exposed for more than three minutes.

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Nutrition

Environmental knowledge and control are also important for ensuring that nutritional needs are met safely and adequately. The board of health requires restaurants and health care facilities to meet their regulations. Indeed, the commercially packaged and processed foods are subjected to the regulations of the FDA. The institution has the responsibility of making sure that the federal regulations concerning processing, manufacturing, and distribution of foodstuffs, cosmetics, and drugs are enforced. Control protects consumers from dangerous or impure substances. According to Glass and Walter (2013), despite the fact that the supply of food in the US possesses the highest safety globally, over three hundred million people are admitted to hospitals every year, while more than 5000 people pass away due to food-borne illnesses.

The most vulnerable group is pregnant women, children, and people who have compromised immune systems. Inadequately prepared foods or products that are not stored appropriately increase the chances of food poisoning and risks of infection.

Temperature

The comfort zone of an individual is about 18.3 to 23.9 degrees Celsius. Therefore, temperature extremes, notably in the summer and winter, influence the productivity, comfort, and safety of people. For instance, if one is exposed for a long period to a cold environment, he or she may suffer from frostbite or hypothermia. When the surface of the skin freezes due to exposure to extremely cold temperatures, frostbites are formed (Glass & Walter, 2013).

Moreover, hyperthermia takes place when the temperature of the body drops below 35 degrees Celsius. The groups that are particularly susceptible to the condition are old people, individuals suffering from cardiovascular conditions, patients who have taken a lot of alcohol, homeless people, as well as small children. On the other hand, the body electrolytes balance is changed by exposure to excessive heat. The situation may raise the core temperature of the body resulting in heat exhaustion or heat stroke. The people who are subject to the aforementioned conditions are the patients who are chronically ill, older individuals, and infants. Extreme heat and humid environments should thus be taken far from them.

Physical Hazard

According to Glass and Walter (2013), on average, about 33 million injuries occur annually with many of them taking place outside or inside homes. Therefore, environmental physical hazards are a threat to the safety of people. The hazards can easily result in psychological or physical injury or death. In fact, unintentional injuries have caused high numbers of deaths in the United States. Accidents that result from vehicles cause most of the fatalities followed by falls and poisoning. Disasters and fire are also additional hazards that lead to death. Thus, nurses have the responsibility of enlightening patients about various safety hazards and the appropriate ways of preventing injuries whilst ensuring that emphasis is placed on the threats that cause more problems to the patients.

Poison

Any substance that causes health impairment or life destruction when inhaled or ingested in the body can be termed as poison. If something is taken in excess within the body, it becomes toxic. Sources of a poison include medicine, drugs, liquid, and solid substances as well as vapor and gases. Poison is dangerous because it impairs key organ systems in the body (Kahn, 1999).

The health care professionals are also at the risk of being overexposed to chemicals like cleaning agents containing toxins. In particular, the toddlers at home are at the risk of accidental poisoning because they can easily ingest cleaning solutions for the house. Nurses should, therefore, enlighten patients and other people about the emergency treatments imperative when poisonous substances are ingested or when their body is contaminated with chemicals that can be absorbed via the skin.

Falls

The hazard has been one of the major problems for public health. Most deaths for older people have been caused by falls. Different factors increase the risks allied to falls, such as reduced vision, the problem in balancing, orthostatic hypotension, urine incontinence, gates, and use of sticks while walking. Other physical hazards include limited lighting, barriers barricaded along walking stairways and paths cause falls. Falls can lead to injuries like internal bleeding and fracture. The patients at the risk of injury are the ones who have tendencies of bleeding due to medical treatments and those who have osteoporosis (Glass & Walter, 2013).

Fire

According to Glass and Walter (2013), 386500 cases of home fires were reported in America in 2008. The fires had led to 13,160 injuries and 2755 deaths in the United States. Careless smoking has been one of the major causes of fire, notably when individuals smoke in their beds during the night. Cooking appliances and equipment, especially stoves and gas cookers, are also other causes of home fires (Glass & Walter, 2013). Therefore, the nurses are supposed to ensure that the patients have carbon monoxide detectors as well as smoke detectors placed strategically to alert them in the event of a fire.

Disasters

Natural disasters like hurricanes, tornadoes, and tsunamis lead to deaths and injuries when they strike. In fact, most of them leave people homeless as well as cause death to family members. According to Glass and Walter (2013), Americans are faced with different disasters every year. Another cause of the disaster is the bioterrorism attacks. The latter occurrences are accompanied by radiological, chemical, and biological outbreaks. In such cases, chemicals are used to instill fear in people. The professional health providers should, therefore, be knowledgeable about biological agents like botulism, anthrax, viral hemorrhagic fevers, tularemia, and smallpox.

Pathogens’ Transmission

According to Walker (2004), parasites and pathogens pose much threat to the safety of patients. The author defines a pathogen as a microorganism that has the capability of developing an illness in an individual. Hands transmit most of the pathogens. For example, if an individual with hepatitis A fails to wash his or her hands after a bowel movement, they pose a high risk of transferring the disease when preparing a meal. Therefore, nurses should ensure that patients adhere to medical aseptic practices.

Immunization

Immunization prevents and reduces disease transmission from one individual to the other. Attenuated or dead organisms are injected into the body to acquire active immunity. Conversely, passive immunity is attained when the antibodies produced by other animals or people are injected into the bloodstream to protect individuals against pathogens (Kahn, 1999). Additionally, most rodents and insects are pathogen carriers.

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For instance, mosquitoes are carriers of the West Nile Virus and Malaria. Mice and rats are carriers of rat-bite-fever. People who live in poverty-constrained areas sometimes get rat infections because the rodents are common in the surrounding. Thus, the nurses should be conversant with rattraps and mosquito repellant use to eliminate such risks. Moreover, they should advise people on ways to dispose of human wastes to limit the transmission of parasites and diseases (Kahn, 1999). The community needs a waste system and a satisfactory sewer to evade risks such as hepatitis and typhoid fever.

Pollution

The environment has to be termed as healthy. Pollutants are waste materials or chemicals discharged by people to the soil, water, or the air. Excessive noise is also a pollutant. Vehicles exhaust and industrial waste lead to air pollution. Cigarette smoking also causes contamination in workplaces, homes, and schools. Bioactive and radioactive waste products disposed improperly on the land mostly pollute the land. Contaminated rivers, streams, and lakes characterize water pollution (Glass & Walter, 2013). The public should use bottled water that if the water from other sources is contaminated. Finally, flooding can be a cause of damages experienced in water treatment stations.

The Factors that Influence Safety: The Knowledge Base of Nursing

Apart from acquiring knowledge on the health and home environment with the safety risks involved, it is also imperative for the nurses to familiarize themselves with the developmental levels of the patients (Walker, 2004). The features may be in terms of sensory condition, cognitive status, mobility, and lifestyle choices. The professional health practitioners are also supposed to have a knowledge base in precautions of common safety.

The Risks Experienced at the Stage of Development

The developmental stages of patients harbor threat to safety due to mobility and cognitive status, lifestyles, safety awareness, and sensory impairment. The health care practitioner should, therefore, understand how to tailor different programs based on the preferences, needs, and tastes of patients (Walker, 2004).

The Toddler or Infant Stage

Children are more prone to injuries than diseases and disabilities. For example, infants have the highest number of deaths caused by lead poisoning. Children at a tender age are exploratory and are most likely to put things in their mouths. The latter leads to increased risks of choking and poisoning. Additionally, children cause fire out of the curiosity of lighting matches. Furthermore, their limitations in physical coordination can make them fall.

The Children at the Age of Schooling

The environment expands when children get to school due to transportation routes, friends, and the activities done after school. The nurses, teachers, and parents needs to instruct school children about different measures to be adhered to while at school and whilst playing (Walker, 2004). The children should also be taught how to handle strangers. Rules for playing safely should also be availed to the kids. The use of safety equipment such as helmets among other gears of protecting the child should also be embraced.

Adolescent Stage

Children tend to develop independence and a sense of identity about their values when they reach the adolescent stage. As a result, the child starts separating emotionally from the family members; thus, peers tend to pose much influence over the child. In a bid to relieve and balance the tension allied to psychological and physical variations and peer pressure, the child is at high risk because they are likely to try new ways of life. Some of them engage in drinking alcohol, drug abuse, and smoking (Glass & Walter, 2013).

As a result, they are at high risk of causing accidents and even drowning. Indeed, when a child learns how to drive, their scope of risks increases, as well as their injury potential. Thus, more measures should be taken to protect them. Most teen’s accidents are caused by texting and eating while driving, as well as drunk driving.

Nevertheless, the parents and nurses should look for possible clues about substance abuse in the child. For instance, the parents can look for environmental signs such as magazines that are drug-oriented, liquor and beer bottles, blood spots on their clothing, and dark glasses when the child is indoors. The kid can also show psychological clues such as a change in dress code, falling grades in class, absenteeism in school, aggression, isolation, and variations in the child’s interpersonal relationship (Glass & Walter, 2013). The teenager is also prone to having sex-related risks because, at the development stage, some of the children have physical relationships with the opposite sex.

The Adult Stage

Lifestyle habits for adults tend to cause most of the threats for an individual. For instance, patients who drink alcohol excessively have a higher probability of causing an accident. Adults who engage in smoking have increased chances of getting pulmonary or cardiovascular diseases due to the nicotine attached to the circulatory system. Adults also have more stress, which may lead to accidents, headaches, and infections.

The Older Adult

Multiple medications are affected by the psychological changes that take place when people enter old age. Psychological factors and chronic or acute diseases also raise the risks for old adults, because they can easily fall or have other forms of accidents. The falls can lead to hip fractures, bruises, or even head trauma. In fact, injuries caused by falls increase with age (Glass & Walter, 2013). Older patients can easily fall into bathrooms, bedrooms, or even the kitchen. Other environmental facets like icy sidewalks, limited lighting, and broken stairs can result in accidents for old people. The inside falls for the patients mostly take place when the chairs, beds or toilets are being transferred.

Conclusion

A safe environment in the community is characterized by achievable basic needs, reduced physical hazards, minimized transmission parasites and pathogens, and enhanced and controlled sanitation. Moreover, the safe environments have the capability of ensuring reduced risks allied to injuries such as patient inherent accidents, minimized falls, equipment use, and procedure-related accidents. Therefore, the nurses should ensure that there are reduced physical hazards by offering enough lighting, making hospices secure, and decreasing clutter.

The health care practitioners should also ensure that there is a reduced transmission of pathogens via surgical and medical asepsis, food sanitation, immunization, and adequate rodents and insect control. They should also ensure appropriate human waste disposal. In addition, it is also imperative to note that every developmental stage has its own risks. For instance, the children of five years and below are subject to the many risks at home compared to any other age. The child who has reached the age of attending school is also at risk because he or she faces dangers at home and at school. Such children also experience the risk inherent in traveling to and from school.

On the other hand, adolescents are faced with the risk of automobile accidents, drug abuse, and suicide. Lifestyle habits are the major threats that affect adults because of excessive drinking, smoking, and other harmful behaviors. The older patients are also allied to psychological variations due to the aging factor. Therefore, it is imperative for the nurses to understand how they individualize the developmental stages, the environment, and lifestyle facets of the patients. Additionally, the nurses should analyze the patients continually and assess the risk allied to their behaviors, lifestyles, and other factors. Thus, individuals will be able to update their personal nursing care plans.

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Performance Improvement Concern

Deriving from the research, it is evident that there are other personal risk factors that should be put into consideration by nurses. Factors such as lifestyles, communication, or sensory impairment, lack of awareness of the patients are also a matter of concern. In fact, most people engage in lifestyle without considering the risks likely to be incurred. For instance, some people operate machines while under substance simply because they are not aware of the risk involved (Walker, 2004). Others experience fatigue and anxiety due to substance abuse. As a result, they fail to realize when they are prone to causing accidents.

On the other hand, impaired mobility poses many safety risks. Paralysis, poor coordination of the body, and other factors leads to many injuries. Medical care practitioners normally assume the aforementioned facets. Communication impairment or sensory damage is personal risk factors and should be handled with extra care. The patients who suffer from mental issues may have impaired memories and changes in orientation (Walker, 2004). The patients can easily get confused and engage in dangerous activities. Therefore, nurses have to try to understand the personal risk factors whilst handling patients.

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