Posted: January 10th, 2023
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I NEED TO RESPOND TO MY 2 CLASSMATES:
This discussion requires two replies to classmates. In your replies, compare and contrast your classmates’ initial posts with your own. Critique your classmates’ posts by suggesting an area for improvement or something new to add to the discussion.
At least one of your replies must contain a professional reference, published within the past 5 years.
WRITE 2 SEPARATE PARAGRAPHS – 1 FOR CLASSMATE 1 AND 1 FOR CLASSMATE 2.
My discussion post:
In Mrs. Smith’s home, numerous hazards risk her safety and health. These safety hazards include a dimly lit house. Research conducted by Falkenberg (2019) found that improved indoor lighting increases the quality of life for elderly adults at home. Also, lighting is an essential environmental attribute that helps improves visual, physical, and mental health and reduces the risk of falls. The extension cord plugged into an outlet across the room is a hazard that can cause tripping and falls. Also, extension cords cannot be used as permanent wiring and can present a fire hazard if overloaded or damaged. Additionally, medications stored in unlabeled containers pose a risk since Mrs. Smith can take the wrong medication or incorrect dosage, which could lead to adverse effects or drug interactions. Lastly, even though Mrs. Smith does not smoke, the presence of a smoker in the home poses a risk of fire and respiratory issues for Mrs. Smith.
To promote safety, a few nursing actions can be implemented. These actions include labeling Mrs. Smith’s medication containers with the name of the medication, dosage, and frequency of administration. In their research, Tan et al. (2021) found that ensuring the accuracy of prescription medication labels helps reduce medication errors. Improving the house’s lighting is also vital to reduce the risk of falls. It is critical to encourage Mrs. Smith’s daughter to quit smoking or to stop smoking in the home to reduce the risk of fire and respiratory issues. Also, it would be essential to involve Mrs. Smith’s daughter and other family members in the care process. This could include educating them about the safety hazards in the home and how to address them, as well as involving them in the medication management process.
Some teaching points that could be reinforced include the risks associated with smoking for the smoker and anyone exposed to passive smoking. Also, emphasize that Mrs. Smith is at great risk of falls that could lead to fatal injuries and, in severe cases, death.
Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students’ perspective. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0351-1
CLASSMATE 1 RESPONSE:
Mrs. Smith is an 85 y/o woman who lives with her small dog. She has an unlabeled medication dispenser, an extension cord running across the room, and a daughter who has been smoking inside the home. To begin The Nurse Should collect the medication bottles with the patient’s most recent medication list and “Establish order in medication lists by disambiguating prescriptions” (Kollerup, Schantz, 2018 pg.227), then assist the patient with organizing and labeling medications. The nurse should then asses the extension cord and advise the patient that dim lighting can cause visual impairment leading to falling. If there is no outlet closer to the patient chair for the extension cord then the nurse can “ Tape them down or move them out of sight,”(Sussman Ch. 24 pg. 26). Finally inform the patient that “tobacco smoke is the leading cause of preventable death worldwide. Unfortunately, the risk is not limited to smokers. It is dangerous for non‐smokers, particularly women, kids and elderly”(Zamani, Golshiri, Moqtader 2013 pg 1) and advise the patient that the ashtray, as well as any smoking, should be conducted outside the home.
Kollerup, M. G., Curtis, T., & Schantz Laursen, B. (2018). Visiting nurses’ posthospital medication management in home health care: an ethnographic study. Scandinavian Journal of Caring Sciences, 32(1), 222-232. https://doi.org/10.1111/scs.12451
SUSSMAN, H. (2022). Safety for the Elderly Population during the Holidays and throughout the Year. Exceptional Parent, 52(12), 24-26.
Zamani A, Golshiri P, Moqtader B. The study protocol of women’s education to create smoke- free home on the basis of family ties in Isfahan, Iran. Int J Prev Med 2013;4:1312-17.
CLASSMATE 2 RESPONSE POST:
The Safety hazards observed in the client’s home include dim lighting, a table side lamp, an extension cord, the daughter, the daughter’s ashtray, unlabeled medications, and the small dog. Dim lighting increases the chance of a fall risk and medication error. Mrs. Smith not using proper lighting could result in her falling over the extension cord she has plugged up across the room or possibly tripping on her small dog. Also, the cord plugged across the room to a table side lamp can increase the chances of a fire. Mrs. Smith could trip over the cord; the lamp could fall and start a fire. The patient has also been prescribed oxygen, which poses a fire hazard. The ashy tray is on the patient’s table, which could indicate that the daughter is smoking inside the home near Mrs. Smith. The unlabeled medication is dangerous. Seven unlabeled medications could result in an error. One medication could look similar to another in the eyes of Mrs. Smith, or she could not correctly see due to the dim lighting in the home, which increases her chances of taking the incorrect medication.
The actions that would promote safety for Mrs. Smith and her family would be to label and organize medication. Consider discussing a pill box the daughter could organize since she visits every Sunday. Moving the lamp or finding a closer electrical outlet that would remove the extension cord from across the room helps lower patient fall risk. Encouraging the patient to open a curtain to allow in natural lighting or speak to her daughter about purchasing an appropriate color temperature light bulb that would be more comfortable for her eyes but also enough to light the home area to decrease risks. Lastly, remove the ashtray from Mrs. Smith’s table.
Teaching points to be reinforced to the patient and family include medication, oxygen, fire and fall hazards, and safety precautions. Understanding that Mrs. Smith may be comfortable and familiar with her home environment, recognize it still presents several hazards. Discussing the actions to limit home hazards could decrease falls and other risks. Several studies have found that home modification interventions are effective at reducing the rate of falls among community-dwelling older adults (NACCO, 2021). Sharing informative information, answering any patient or family questions, and asking questions to ensure the patient and family comprehend the information could help prevent accidents. Patient safety in-home care is a multifaceted concept, which encompasses physical, mental, social, and practical dimensions. Evaluation, prevention, participation, and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital, and the insurance), self-efficacy and the ability of the caregivers (nurses). Patient safety at home will not only result in a better and safer care but will also enable the patient, their family and all the people involved (patient, family and the caregivers) to remain calm during the care (Keyvanloo Shahrestanaki et al., 2022).
Keyvanloo Shahrestanaki, S., Rafii, F., Najafi Ghezeljeh, T., Ashghali Farahani, M., & Amrollah Majdabadi Kohne, Z. (2022). Concept analysis of patient safety in home care: A hybrid model. BMJ Open Quality, 11(4). https://doi.org/10.1136/bmjoq-2022-002077
National Association of County & City Officials. (2021, February). Older adult fall prevention – NACCHO. Issue Brief: Older Adult Fall Prevention. Retrieved January 8, 2023, from https://www.naccho.org/uploads/downloadable-resources/Fall-Prevention-Issue-Brief-February-2021-Final_210212_161639.pdf
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