Patient Safety and Professional Practice
Safety Priorities
Neurological patients are at high risk for falls, aspiration, pressure injury, and medication errors. Implement fall precautions for anyone with altered gait, weakness, or confusion. Maintain seizure precautions - padded rails, suction at bedside, and a clear environment - and never restrain a seizing patient or place objects in the mouth. Protect the airway and turn the patient to the side during a seizure.
Aspiration risk rises with dysphagia after stroke; perform a swallow screen before oral intake and keep the head of bed elevated. Monitor for pressure injury with regular repositioning, especially in immobile or unconscious patients. Use two patient identifiers and verify high-alert medications. Hand hygiene and standard precautions prevent infection, and droplet precautions are needed for suspected bacterial meningitis.
Professional Practice
Communicate using a structured handoff (situation, background, assessment, recommendation) and escalate deteriorating patients promptly. Document objective findings and trends. Advocate for the patient, respect autonomy, and follow scope of practice. Recognize that early recognition and escalation are the most protective safety behaviors.
Traps
Questions often test the priority action during a seizure - safety and airway first, not documentation. Another trap contrasts restraint (avoid) with padded environment (appropriate). Also watch for questions about who to notify first when a patient deteriorates - the rapid response team or provider per protocol, not a delay for paperwork.
Rule of Thumb
"Safety first, airway always." When in doubt in a deteriorating patient, escalate early using a structured handoff.