INTRODUCTION:

To practice nursing to the fullest, we need to consider two factors. First the
normal physical structure of human body & its physiological functioning.
Second, we must realize that all patients like other people have needs. The
needs are: Basic physiological needs-- those that must be met in order to sustain
life- like need for oxygen, food, eater, rest & elimination and secondary needs
—those that must be met in order to maintain the quality of the life like-safety
need for shelter, affection, belongingness etc. Though according to Maslow
theory of hierarchy of human needs, the security & safety is in 2nd position, but
in the hospital, the patient’s safety is of prime importance. So, we will discuss
on the topic safety needs of a client.

Meaning of safe & clean of environment:

Hospital safety measures include such essential things & precaution that are
involved in ensuring the patient’s safety. Safety often, defined as freedom from
psychological & physical injury, is a basic human need that must be met.

Clean environment-

Patients environment should be neat, clean, airy & free from bad odour. A
client’s environment includes all of the many physical & psychological factors
that influence or affect the life and survival of that client. A safe environment
gives protection to the staff as well as allowing them to function at an optimal
level. A safe environment includes meeting basic needs, reducing physical
hazards, reducing the transmission of pathogens, maintaining sanitation, &
controlling pollution.

PURPOSES OF MEETING SAFETY NEEDS OF PATIENT:

1. To facilitate physical well-being.

2. To promote physical & psychological comfort.
3. To relief anxiety.
4. To protect patient from potential risk of injury.
5. To enhance resistance to infection.
CHARACTERISTIC OF HUMAN NEED: ---

1) Human needs are universal, though may be modified by cultural

influence.
2) Human needs may be altered by individual priorities.
3) Human needs may be deferred – for example a person can defer his need
for food or elimination for a period of time.
4) Human may be met in different ways a person’s need, like for self esteem
–this can be met through work activities, interpersonal relationship & so
on.
5) Human needs are aroused by stimuli that are either external or internal to
the body. For example persons have the need for food where hunger is an
internal stimulates to need for food, where as lacking food by seeing an
attractive food is an example of external stimulus.
6) Human needs are interrelated – an unmet human need result in disruption
of body activities & frequently leads to external illness –illness like
malnutrition results if a person not fulfilled his nutritional need properly.

PROVIDING SAFE & CLEAN ENVIRONMENT:

 PHYSICAL ENVIRONMENT:

Temperature:-

A person’s comfort zone is usually between 18.3 -23.8 c. Temperature

extremes which often occur during the winter & summer, affect comfort,
productivity, & safety. Exposure to severe cold for prolong periods causes
frost bite & accidental hypothermia. Older adults, the younger patient,
patient with cardiovascular conditions are at high risk for hypothermia.
Exposure to heat changes the body’s electrolyte balance & raises the core
body temperature, resulting in heat stroke or heat exhaustion. People at risk
from high environmental temperatures need to avoid extremely hot, humid
environments, or heat exhaustion will result.

Humidity:-

The relative humidity of the air affects a patient’s health & safety. Relative
humidity is the amount of water vapor in the air compared with the
maximum amount of water vapor that the air could contain at the same
temperature. Increasing the environmental humidity with the help of a home
humidifier has therapeutic benefits for patients with upper respiratory
infections. The increase in humidity helps to liquefy pulmonary secretions &
improves breathing.

Noise:-

There are various ways to decrease the problems associated with noise.
Many health agencies use posters & signs to reduce noise in hospital. Quiet
background music has been shown to have a relaxing effect for some
patients.

Ventilation:-

Ventilation is especially important when there are many persons in one

room or when one person is in a relatively small room for prolonged periods
of time. Ventilation is also important when there are

odorous or toxic substances in the air. Attention to the patient’s covering &
clothing is necessary when ventilation creates drafts, especially to older
persons who tend to be sensitive to drafts.

Light:-

Lighting, both natural & artificial, that is adequate for persons to see clearly
& without strain for the task at hand is important for both patients & health
care workers. A dim light is valuable as a comfort & a safety measure at
night in both homes & health agencies. It should be situated so that it does
not shine into the patient’s eyes. It should give sufficient lighting to the floor
around the bed so that if patient wishes to get up, he can do so with safety.
Ideally, a light at the patient’s bed should be sufficiently adjustable so that it
can serve the patient & also be used by health personnel when needed for
administering treatments.

Pests control:-

Insects & rodents are carriers of pathogens. For example some mosquitoes
are carriers of malaria. Adequate disposal of human waste also controls the
transmission of pathogens & parasites. Without a satisfactory sewer & waste
system, the population is at risk for illnesses such as typhoid fever &
hepatitis.
 REDUCTION OF PHYSICAL HAZRADS:-

Physical hazards in the environment threaten a person’s safety & result in

physical or psychological injury or death. Older adults, patients with
impaired vision & patients with impaired mobility are at greater risk of
injury due to falls.

Falls: --

In 2003 more than 1.8 million seniors age 65 yrs. & older were treated in
emergency departments for fall- related injuries. The risk of falling is
significantly higher in older clients. In addition to age, a history of previous
falls, gait disturbance, & mobility problems, postural hypotension, sensory
impairment, urinary & bladder dysfunction, & certain medical diagnostic
categories like cancer, cardiovascular, neurological, & cerebro-vascular
diseases increases the risk. One of the more common factors precipitating a
fall is a client’s attempt to get out of bed to toilet. Hip fractures are among
the most serious fall- related injuries.

Fire :-

Oxygen is a highly combustible gas & fuels fire readily. Promote safety by
using the following measures----

i) Place “no smoking” signs on the patient’s room door & over the bed.
Inform the patient, visitors, roommates, & all personnel that smoking
is not permitted in areas where oxygen is in use.
ii) Determine that all electrical equipment in the room is functioning
correctly & is properly grounded.
iii) Know the fire procedures & the location of the closest fire
extinguisher.
iv) Check the oxygen level of potable tanks before transporting to ensure
there is enough oxygen in the tank.

Accident :-

a) Client –inherent accidents ---

Client –inherent accidents are accidents (other than fall) where the client
is the primary reason for the accident. Examples of Client –inherent
accidents are self inflicted cuts, injuries & burns or injection of foreign
 substances, pinching fingers in drawers or doors. Client –inherent
accident sometime occurs as a result of seizure or convulsion.

b) Procedure - related accident---

Procedure related accidents occur during therapy. They include
medication & fluid administration errors, improper application of external
devices, & accidents related to improper performance of procedures.
Nurses are able to prevent many procedure related
accidents. For example, strictly following the procedure for administering
medications will prevent medication errors. Proper administration of
intravenous fluids prevents fluid overload or deficit.

c) Equipment – related accident ---

Equipment – related accidents result from the malfunction, disrepair, or
misuse of equipment. Accidents in hospital frequently result from using
equipment carelessly or using malfunctioning or poorly maintained
equipment. It is especially important for health practitioners to learn to
use equipment properly & to recognize signs that indicate the equipment
is not functioning correctly. For example neglecting to lock wheelchair
wheels can result in injuries to patients.

Electrical equipment : -

It has been seen that 1200 persons die annually as a result of electrical
shocks in hospital. The electrical equipment in health agencies increases the
chances of injury to both patients & health practitioners when safety
measures are ignored.

The following guidelines will help to decrease equipment –related

accidents------

i) Use equipment only for the use for which it was intended.
ii) Do not operate equipment with which you are unfamiliar.
iii) Handle equipment with care to prevent damaging it.
iv) Use three- prong electrical plugs whenever possible.
v) Do not twist or bend electrical cords. The wires inside the cord may
break.
vi) Be alerts to signs that indicate equipment is faulty, such as breaks in
electrical cords, sparks, smoke, electrical shocks, loose or missing
parts & unusual noises or odors.

SAFETY DEVICES:

Restraints:

Restraints are protective measures to limit movements. It may be either

chemical or physical. Chemical restraints are medications such as anxiolytics
& sedatives, used to control the patient’s behaviour. A physical restraint is
any manual method or a physical or mechanical device that the patient is
unable to remove. Commonly used restraints mummy restraint, elbow
restraint, extremity restraint, abdominal restraint, finger restraint, jacket
restraint etc.

1) Extremity restraint--- Restraint designed to immobilize one or all

extremities. Wrap limb restraint around wrist or ankle with soft part
toward skin & secured in place. Protect client from injury or accidental
removal of I/V line Foley’s catheter etc.
2) Mitten restraint--- Thumb less mitten device to restrain client’s hands.
Place hand in mitten, being sure to bring end all the way up over the
wrist. Prevents clients from dislodging invasive equipment, removing
dressing etc.
3) Elbow restraint --- commonly used with infants & children to prevent
elbow flexion.
4) Mummy restraint--- Maintains short-term restraint of small child or infant
for examination or treatment involving head & neck.

The use of restraints is associated with serious

complications due to immobilization, such as pressure ulcers, constipation &
incontinences. In some cases death has resulted because of restricted
breathing & circulation. There have been cases where patients have hung
themselves in a restraint while trying to get out of the bed while restrained.
As a result many health care facilities have banned the use of the jacked
(vest) restraint because of this risk. Restraints are not a solution to a problem
but rather a temporary means to maintain patient safety.
Side rails:

Side rails help to increase a client’s mobility and or stability when in bed.
Confused & disoriented patients or patients who repeatedly fall often require
the temporary use of restraints or side rails to keep them from falling out of
bed.

ROLE OF NURSING IN PROVIDING SAFE & CLEAN

ENVIRONMENT:

In the hospital the patient is the center of nursing care. The nurse, as a
member of the hospital team, assists by teaching the patient self care & by
doing for or with the patient those things the patient cannot do alone.

In the hospital, the nurse may have more than one patient to care for, &
she may need to consider hospital routines. Meals hours, physicians’ round,
& patients’ appointments for surgery, X-ray examination & laboratory
procedures must also be considered when preparing nursing work plan. The
nurse may be asked to assist temporarily with the emergencies that come up
on a busy service. In any situation we have to remember that our patient is
our first responsibility. Obviously all hospital personnel are involved in
ensuring the patient’s safety. The followings are the important role of
nursing personnel for providing safe & clean environment to the patients-----
1. PSYCHOLOGICAL SAFETY NEEDS---

Assessment
 Watch for non-verbal gesture or communications.
 Observe expression of feeling & identify any change of behavior.

Nurses role
 Remove unpleasant sights.
 Avoid loud noise which may be disturbing for the patient.
 Offensive odours should be removed.
 Proper explanation is to be given to the patient & his significant once.
2. SAFETY FOR PREVENTING CROSS INFECTION IN THE HOSPITAL

 Hand washing should be done before & after procedure.

 Patient’s room should be kept ventilated.
 Damp dusting to be done.
 Disinfectants should be used for cleaning the floor.
 Disposable gloves should be used while handling body fluids.
 Food should be served hot to the patient & it should be in cover
container.
 All waste material to be discarded properly.
 Nurses also not to give care to the client when she is having some
infections.

OTHERS ARE-

i) Keep floors dry & clean to prevent falls.

ii) Keep wards free of obstacles; promote good ward order at all times.
iii) Get adequate assistance to move & walk patients. Lift patient together
with co-worker & adequate directional signal.
iv) Do not leave medicine trays unattended, give medications properly,
ask the head nurse about any questions you may have. Discarded the
expiry drugs. Never keeps hazardous chemical in medicine cupboard.
v) Provide adequate lighting.
vi) Place the patient’s necessary items with in his or her reach, this
includes the call light.
vii) Check temperatures of different solutions before they touch patients.
Carefully observe while apply steam inhalation, hot water bottle etc.
viii) Use side rails for patients who are elderly, very young, disoriented,
confused or sedated. Lift patient together with co-worker & adequate
directional signal.
ix) Do not perform procedures that are unfamiliar to you unless you have
proper supervision.
x) Check all equipment routinely to make sure it is working properly.
xi) Make sure sterile packages have not been opened & that medications
are not expired.
xii) Check all patients frequently to make sure they are not having
difficulty.
xiii) Ensure regular spray of insecticides & pesticides.
xiv) Always be conscious of safety rules.

CONCLUSION: A safe environment is essential to promoting, maintaining,

and restoring health. A patient has the right to expect that the environment of
the hospital will provide protection from the danger of contracting another
disease that is free from nosocomial infection & protection from suffering
injury. Incorporating critical thinking skills in the application of the nursing
process, the nurse assesses the client & the environment to determine risk
factors for injury. Clusters risk factors, formulates a nursing diagnosis &
plans specific interventions, including client education, so that safety,
security & protection must be fulfilled for each individual patient.
SUBJECT : FOUNDATION OF NURSING

TOPIC : SAFETY NEEDS OF A CLIENT.

VENUE: CLASS ROOM

GROUP: B.SC (HONS) NURSING 1ST YEAR

NO. OF GROUP: 25

DATE:

TIME & DURATION: 60 MINUTES

LANGUAGE: ENGLISH

T.L. METHOD: LECTURE & DISCUSSION

A.V. Aids USED: OHP,FLIP CHART, BLACK BOARD

NAME OF STUDENT TEACHER: Purnima Mondal

NAME OF SUPERVISOR: Madam A. Mukherjee

GENERAL OBJECTIVE: After the end of the discussion the student will be able
to--

1) Gain knowledge on safety needs of client.

2) Develop positive attitude on practicing safety needs of clients.
3) Know the nurses role in providing safety needs of client.
4) Fulfill the client’s safety need during hospitalization.
TIME SPECIFIC CONTENT T.L.Activi A.V.Aids EVALUATI
OBJECTIVE ty used ON

2 Introduction:
mints. We know, that every individual
have some needs. The needs are:
Basic physiological needs-- those
that must be met in order to
Group will sustain life, and secondary needs—
be able those that must be met in order to
maintain the quality of the life. Lecture
Though according to Maslow
theory of hierarchy of human Can any
needs, the security & safety is in one say
2nd position, but in the hospital, the what is
patient’s safety is of prime the
1 importance. meaning
To state
mint.
the Announcement of the topic: of safe &
meaning of The topic for discussion is safety clean
safe & needs of a client. environm
clean Meaning of safe & clean of ent?
2
environme environment :
mints.
nt. Hospital safety measures include
such essential things & precaution Discussio
that are involved in ensuring the n
patient’s safety.
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environment should be neat, clean,
airy & free from bad odour.
Characteristic of human need:
Universal, altered, aroused by
stimuli,& also interrelated.
3 Can you
To describe PROVIDING SAFE & CLEAN tell the
mints.
the ENVIRONMENT: Lecture comforta
physical Physical environment: & Flip chart ble
environme Temperature:- A person’s comfort discussio
nt of client.
environm
zone is usually between 18.3 -23.8 n ental
c. Temperature extremes which temperat
often occur during the winter & ure?
summer, affect comfort,
productivity, & safety.
TIME SPECIFIC CONTENT T.L.Activi A.V.Aids EVALUATI
OBJECTIV ty used ON
E
2 Humidity:- The relative humidity of
mints. the air affects a patient’s health &
safety.
2 Noise:- There are various ways to
mints.
decrease the problems associated
with noise. Many health agencies
Group will uses posters & signs to reduce noise
be able in hospital. Quiet background music
3 has been shown to have a relaxing
mints. effect for some patients. Discussio
Ventilation:- Ventilation is especially n
important when there are many
persons in one room or when one
person is in a relatively small room
for prolonged periods of time.
2 Light:- Lighting, both natural & Discussio
mints.
artificial, that is adequate for n
persons to see clearly & without
strain for the task at hand is
important for both patients & health
care workers.
3 Pests control:- Insects & rodents
mints. are carriers of pathogens. So it must
be controlled.
To Physical hazards : Can you
describe Physical hazards in the environment Lecture tell some
the threaten a person’s safety & result & physical
physical in physical or psychological injury or discussio hazards
hazards in death. n in the
5
the Fire :- Oxygen is a highly hospital?
mints.
hospital . combustible gas & fuels fire readily. OHP
Promote safety during
administration.
2 Accident :- Accidents in hospital,
mints. frequently result from using
equipment carelessly or using
malfunctioning or poorly maintained
equipment.

TIME SPECIFIC CONTENT T.L.Activi A.V.Aids EVALUATI

OBJECTIV ty used ON
 E
3 Electrical equipment: . Lecture
mints. The electrical equipment in health & CHART
agencies increases the chances of Discussio
injury to both patients & health n
practitioners when safety measures
are ignored.
3
Group will SAFETY DEVICES:
mints.
be able Restraints: Restraints are either
chemical or physical. Lecture
Restraints are not a solution to a &
problem but rather a temporary Discussio Can you
To
means to maintain patient safety. n tell what
describe
the is
3 Side rails : Confused & disoriented restraints
restraints
mints. patients or patients who repeatedly ?
& side
rails. fall or try to remove medical devices
like oxygen, IV lines or dressings etc.
often require the temporary use of
10
mints.
restraints or side rails to keep them
from falling out of bed.
ROLE OF NURSING IN PROVIDING
SAFE & CLEAN ENVIRONMENT
To The nurse, as a member of the What are
describe
hospital team, assists by teaching OHP the
the nurses
role in
the patient self care & by doing for nurses
providing or with the patient those things the role in
safe & patient can’t do alone. In any providing
clean situation we have to remember that safe &
environm our patient is our first responsibility. clean
ent. Obviously all hospital personnel are environm
involved in ensuring the patient’s ent?
2 safety.
mints. SUMMARIZATION-of the topic.
CONCLUSION: A patient has the
2 right to expect that the environment
mints. of the hospital will provide
protection from the danger of
contracting another disease that is
free from nosocomial infection &
protection from suffering injury. So
safety, security must be fulfilled.
10 MCQ TEST----
mints.
 CONTENT
ON
SAFETY NEEDS
OF CLIENT

SUBMITTED TO SUBMITTED BY

MADAM A. MUKHERJEE PURNIMA MONDAL

LECTURER, W.B.G.C.O.N M.SC.NURSING STUDENT 1 ST YEAR

 LESSON PLAN
ON

SAFETY NEEDS OF CLIENTS

SUBMITTED TO SUBMITTED BY

MADAM A. MUKHERJEE PURNIMA MONDAL

1 ST YEAR

M. SC. NURSING STUDENT

BIBLIOGRAPHY:

1) Rosdahi, Caroline Bunker. (1985). Text book of basic nursing, (4th edition).
Philadelphia. J. B. Lippincott Company. 245-247.
2) Wolf, Luverne & et.al, (1983).Fundamentals of nursing, (7th edition). Philadelphia. J. B.
Lippincott Company. 280-282.
3) Potter & Perry.(2009). Fundamentals of nursing, (7th edition) Missouri,Elsevier.5,
1224-1225.

SUBJECT -- NURSING FOUNDATIONS

GROUP --- 1ST YEAR B.SC. NURSING Full Marks: 10

EVALUATION on the topic “safety needs of clients” Time: 10 mints.

 ANSWER ALL QUESTIONS

A. Encircle the right answer

1) According to Maslow’s theory of hierarchy of human needs the safety & security
need is in the
(a) First position.
(b) Second position.
(c) Third position.
(d) Fourth position.

2) A person’s comfort zone of temperature is

(a) 10.5 c—15.2 c
(b) 15.3c—18.2c
(c) 18.3c – 23.8 c
(d) 23.9 c – 28.3 c

3) Restraints are protective measures—

(a) To limit movements.
(b) To support movements.
(c) To allow movements.
(d) To increase movements.

B. Write T & F against True & False statement respectively

1) Oxygen is a highly combustible gas & fuels fire readily. ( )

2) Comfort zone of relative humidity in between 40% to 50%. ( )
3) Do not operate equipment with which you are unfamiliar. ( )
4) Neglecting to lock wheelchair wheels can result injuries to patients. ( )
5) Mummy restraint, extremity restraints are one type of chemical restraint. ( )
6) Quiet background music has relaxing effect for some patients. ( )
7) Hospital acquired infection is called Nosocomial infections. ( )