Question

You are a home health care nurse visiting the home of an 86-year-old retired waitress to determine what alterations may need to be made to her environment. She was recently discharged from a rehabilitation facility where she received therapy after her stroke. She greets you at the door of her one-story house, proudly sharing that she has lived there for 65 years. Following her inside, you note that she exhibits minimal left-sided weakness but ambulates with a quad cane. You observe a clean but cluttered home with many pictures and memorabilia of her extensive family. Scattered throughout the home are colorful throw rugs, which she indicates help cover the stains from “accidents” of her two cats and one small dog, who seem devoted to her and follow her every move. As you visually scan her kitchen, you note her several medication bottles scattered throughout. In her bedroom, you note two electrical outlets to which are connected an alarm clock, a radio, a small television, a telephone and detached answering machine, an air conditioner, an oscillating fan, and her cell phone charger. Due to her extensive appliance use within her bedroom, you observe three extension cords crossing the room to connect to the outlets. List data pertinent to your safety assessment. Please make sure you answer in complete sentences. How might her safety be jeopardized by objects within her home? Detail potential strategies to increase her ambulation safety. How might she increase her safety in her kitchen? Outline strategies that could increase her safety in her bedroom.

1. How might her safety be jeopardized by objects within her home?
2. Detail potential strategies to increase her ambulation safety.
3. How might she increase her safety in her kitchen?
4. Outline strategies that could increase her safety in her bedroom.

Answer 1

The data pertinent safety assesment is a kind of integration and systematic analysis method .It's purpose is to make all aspects of the specification , design , operation and inspection effective and to improve safety at sea comprehensively and reasonably .This include protection of life and health , the marine environment and property .A summary of this method is avilable as follow ;-

Identification of dangerous sources ;- Its purpose is to evalute the system to identify all the possible dangers and find out the cause and consequences of the possible accidents then make a list in order of the degree of danger to further analyze major risks and put forward a corresponding control scheme.

Risk assessment and management ;- In this phase theprocedures are used to evaluate the risk of all kinds of danger and find the distribution of risk and overall level of risk , focus on the high risk area and the main factors affecting the level of risk and sort therisk in an acceptable level .

Risk restraining project ;- The effective measures are put forward to reduce risk on the basis of hazard identification and risk assessment

Cost and benefit evaluation ;- calculate the cost of each risk control measure and the benefit from reduced risk degree .

Suggestion and decision :- select the optimal risk control measure .

The potential strategies that target early and progressive mobility as the primary intervention .A formal mobility protocol was developed and approved by nursing and physician leaders to support 3 projects . The protocol is based on progressing mobility to failure , measured by what the patient can accomplish rather than each step building on gains from previous step . for example ;- if the patient can hold a lower extremity off of thebed surface , she is moved to a seated position ontheside of the bed ,If the patient can maintain balance sitting on the side of the bed , he / she is assisted to the standing position .IF the patient cab stand , she is encourged to march in place .If this can be accomplished the patient is walked with an initial goal of 50 ft and a target goal of 200 ft . To increase the human resouces needed for ambulation and get back to previous life the nurse were empowered to become the unit's mobility champion . documentation of distance walked and other out of bed activities by the nurse helps in strenthening   .

She can increase the safety measures in the kitcher by proper maintaing the medicationcation bottles in correct manner , collect them , and put in its place ,The ingredients containg jars put in lower shelf so that its easy to access ,And patient has put less efforts in reach their , All the jars and utensil which are commonly needed arrange them in the height of the patient level . As put the water source in the form of mugs or bottle at bedside for the patient .so , not to frequently come at kitchen for water .

As stroke can change many things about our life . As falling after a stroke is common - and it can be dangerous ,So , if the patient fall it cause pain and bruising or bleeding So , it is important to take some safety measures regarding this ,

We have to make sure that there's a clear , uncluttered path to any place where the patientt go - her bedroom , bathroom , and the kitchen for example put handrails and other safety devices - like a raised toilet seat or tub bench - if she need them . we have to make sure that all rugs are anchored in place with non stick tape or take them up . we can also put anti -skid mat or strips in her bathtub . She should be wear non -skid shoes aroud the house and make a point not to rush Moving slowly and carefully can helps her to avoid falls and other injuries .