Safety, Emergency Response, and Infection Control
Safety is the first question of every task
Before any task, ask: what could go wrong here, and what do I control?
Falls. Bed in the lowest position, brakes locked, call light and personal items within reach, non-skid footwear, clear pathways, good lighting, and prompt answers to call lights. Side rails used to keep a resident from getting up are a restraint - never use them for convenience.
Fire and emergencies. Know RACE (Rescue, Alarm, Contain, Extinguish/Evacuate) and PASS (Pull, Aim, Squeeze, Sweep). Keep exits clear, never use an elevator during a fire, and follow oxygen safety: no smoking, no petroleum-based products, no sparking equipment. Know your facility's codes and how to call for help.
Infection control. The chain of infection is infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Break it with hand hygiene - the single most important action - plus PPE, safe sharps handling, and cleaning. Standard precautions apply to every resident. Wash with soap and water when hands are visibly soiled or after caring for a resident with C. difficile; alcohol rub does not kill spores. Remove PPE in this order: gloves, goggles, gown, mask - then hand hygiene.
Traps the questions set
- Skipping hand hygiene because you wore gloves.
- Choosing alcohol rub for a resident with C. difficile.
- Removing the mask before the gloves.
- Treating isolation as a reason to avoid the resident; only the PPE for the specific precaution changes.
Rule of thumb
If a resident has a new symptom, a sudden change, or an injury - even with no visible mark - report it to the nurse immediately and document only what you observed.