Safety, Emergency Response, and Infection Control
What you must know
Safety means preventing the accident before it happens: call light and personal items within reach, bed low and locked, non-skid footwear, clear pathways, wet floors marked, and frequent checks on residents who are confused or unsteady. Restraints are a last resort ordered by a provider - least restrictive type, released and repositioned at least every two hours, circulation checked, and never tied to side rails.
Emergency response: for fire, follow RACE - Rescue anyone in immediate danger, sound the Alarm, Contain the fire by closing doors, then Extinguish or Evacuate; never use elevators. For a choking resident with an effective cough, encourage coughing; for a silent, ineffective cough, call for help and start abdominal thrusts. For a seizure, protect the head, do not restrain or put anything in the mouth, time it, and turn the resident on the side afterward. Report any change in condition immediately.
Infection control: hand hygiene is the single most important step - before and after every resident contact and after removing gloves. Standard precautions apply to everyone. Donning PPE: gown, mask, goggles, then gloves. Removing: gloves first, then goggles, gown, and mask, with hand hygiene afterward. Do not share equipment between residents on isolation, and clean blood spills with gloves and the facility's approved disinfectant.
Traps
- 'The resident keeps falling out of bed, so put up the rails' is wrong - rails need an order and are not used for convenience.
- Never recap a used needle.
- Do not move a resident who has fallen and may have a head or neck injury.
Worked example
You enter a room and find a resident on the floor, unresponsive. Check for response and breathing, call loudly for help, do not move the resident, and stay with them until the nurse arrives.