Lesson 6 Objectives: Fire & Other Safety Concerns

1. Student will be able to list fire safety guidelines and explain the appropriate emergency response in the event of a fire. Student will be able to explain the rationale for the use of side rails and potential entrapment dangers. Student will be able to identify those residents at risk of elopement and list some preventative measures that can be instituted. Student will be able to explain the safety concerns associated with smoking in a healthcare facility and measure than can be implemented to promote a safe smoking policy and environment. Student will be able to give examples of disaster situations and the role of the NA. Student will be able to explain how to protect self and others from workplace violence. Student will be able to explain the role of the NA in risk management. Lesson 6 Objectives:Fire & Other Safety Concerns

2. Fire Safety Fuel (anything that ignites) + Heat (spark/flame) + Oxygen (air) ______ = FIRE Order to Relocate Residents= Ambulatory Those needing assistance Those who are totally dependent

3. Fire Safety • To reduce Smoke Inhalation Stay Low to the ground and cover mouth with wet cloth if possible & shut all resident doors/windows. • Know facility policies • Know locations of all exits and stairways • Know locations of fire alarms, extinguishers, and fire blankets • Never Use An Elevator • Stop, Drop, & Roll to smother flames • Stay Calm, listen carefully and follow instructions

4. Fire Safety RACE-F Remove residents from danger Active the alarm Contain the fire (close doors, windows) Extinguish Fire (only if safe) Follow Facility policies regarding further actions

5. Fire Safety How to use an Extinguisher: PASS Pull the pin Aim the nozzle at the base (bottom) of fire Squeeze the handle Sweep nozzle back and forth at base of fire

6. Types of Fire Extinguishers A- Paper, Wood, Cloth B- Oil, Grease fires (kitchens) C- Electrical (maintenance areas, electrical closets) A-B-C- Universal (resident areas) ***Know facilities evacuation plan. Usually evacuations are ordered by the administrator or fire department***

7. Fire Prevention • No Smoking near Oxygen Use • Smoking in authorized areas only • Ashtrays cool before emptied • Electrical equipment turned off before unplugging • Do not use equipment with frayed cords • No aerosol sprays near open flames/cigarettes • Monitor paper accumulation • Never block exit doors

8. Side Rails & Entrapment Side Rails- considered a restraint, but can also be used to assist residents to change position or turn from side to side. Require a doctors order -Some residents prefer side rails for security (Should be care planned) -In general, if a bed is in an elevated position from the ground or the resident is in a restraint, side rails must be up, otherwise=Neglect

9. Side Rails & Entrapment Entrapment- results when resident tries to climb over side rails or a body part becomes lodged between the bed frame and/or mattress and the side rails causing serious injuries.

10. Side Rail Alternatives • Beds that can be lowered close to the floor • Side rail bolster cushions • Pressure sensitive alarms (alarm with movements) • Mats on the floor next to the bed ***Be sure to know the Facility’s Policy regarding Side Rail Alternatives

11. Elopement Elopement- resident leaving the facility without staff awareness. *Know At Risk Residents (often cognitively impaired) Exit Seeking Behaviors/Challenges: -Shaking door handles -Staying close to entrances/exits -Packing belongings frequently -Wearing coats/outerwear in the facility-Frequent statements about going home… -Pacing (walking back and forth) -Wandering (walking without purpose)

12. Elopement • At Risk Residents identified in some manner • Electronic Bracelets • Key pads at doors • Devices should never be substituted for close monitoring by staff. • Never ignore an alarm or silence it w/o knowing why it went off. • If elopement has occurred or a resident “goes missing” check the facility and surrounding property thoroughly, then follow facility policy (notify authorities, etc.)

13. Smoking • Know Facility Policies (Many no longer allow smoking on facility property) -Never allowed in bed -If smoking is allowed, they should be identified as “smoking with supervision” or “smoking without supervision” -If resident found smoking w/o permission, extinguish smoking material and notify nurse -Policies should specify location of designated smoking areas and how to store materials (often locked up in medicine room)

14. Smoking Safety Concerns • Smoking Aprons • Non-flammable ashtrays • Staff need to be strict and consistent about non-compliance • Report violations promptly • Monitor for odor of smoke in non-smoking areas, burn holes in clothing, and for visitors giving smoking materials to residents

15. Electronic Cigarettes • e-cigarettes, personal vaporizer (PV), electronic nicotine delivery system (ENDS)- electronic inhaler meant to simulate and substitute for tobacco smoking. -generally uses a heating element -some release nicotine, some a flavored vapor 2013 Benefits UNCERTAIN…Ongoing Debate…Laws vary widely concerning their use! **Know the Facility’s Policy** Still pose a Fire Risk=heating element

16. Disasters Sudden catastrophic event, many people killed and/or injured and property often destroyed -tornadoes/hurricanes -earthquakes -Blizzards -Floods -Auto/Bus/Train/Plane accidents -Riots -Explosions -Terrorist attacks/war **In-Service Training and Ongoing Drills are Required**

17. Workplace Violence -Any physical assault, threatening behavior, aggressive language occurring on facility property or off property if employee is engaged in work assignment… ***Know the facility policies*** -Risks can be anywhere, but often vary depending on place of employment. -In general avoid going to and from poorly-lit parking lots

18. Workplace Violence • What do I do if an agitated or aggressive person confronts me? -Stand far enough away -Note location of panic buttons, call bells, alarms, exits (stay close to a door) -Stay calm (soft, gentle tone of voice) -If trained in restraints and necessary, be sure to have enough help to manage the person before approaching him/her.

19. Workplace Violence What should I NOT do if I am confronted with an agitated or aggressive person? -Never approach the person alone -Never turn your back -Never back into a corner -Never argue, shout, scold, or interrupt the person -Never touch the person while agitated

20. Risk Management =Keeping all employees, residents, and visitors from getting injured All incidents, accidents, or errors must be reported to supervisory personnel even if injury did not occur, but could have. Incident Reports are always being reviewed to better the workplace environment and to prevent future errors/accidents.

21. Risk Management Filing an Incident Report: *Must be completed as soon as possible after situation occurs Must include: -Names of involved -Date and time of occurrence -Location -Detailed description of what happened -Names of any witnesses

22. Review Questions • Explain RACE-F • Describe proper use of fire extinguisher (PASS) • Describe action to be taken if clothing catches on fire. • How can the NA assist the nurse after a resident has fallen, had a seizure, or sustained a skin tear? • List 4 things the NA should NEVER do when confronted by an aggressive resident. • What types of behaviors could a resident who is an elopement risk exhibit? • Name 2 areas of the bed that could be entrapment zones.