Got it 👍 I’ll merge your Week 5 notes into the structured rewrite I already made for Chapters 27 & 28, keeping all info, not repeating unnecessarily, and clearly calling out Professor’s Notes.

Here’s the unified and improved version:

Chapter 27 – Safety

Standards in Place

Follow hospital standards when risk situations are present.
Use military time (24-hour clock) in documentation.
Label all syringes when handling multiple medications to avoid confusion.
Name alerts: place on the board so all staff in the unit know.
Know organizational documentation standards.

Scientific Knowledge Base

Safe Environment

Check patients and belongings for weapons (e.g., guns).

Guns are not allowed.
Itemize belongings.

Family members bringing excessive items or unsafe electrical equipment can create hazards (e.g., fire, clutter).

Maslow’s Basic Needs

Hospital temperature may feel cold → use warm blankets.
Diabetic patients have reduced sensation → risk for burns.
Homeless populations are at risk for hypothermia.

Oxygen

Oxygen is a fire hazard.

Temperature

Environmental risk for vulnerable populations (e.g., homeless → hypothermia).

Physical Hazards

Motor vehicle accidents:

Older adults: vision problems.
Children: need car seats.
Seat belts for all ages.

Poison:

At home or in facilities, check products.
Educate patients not to store poisonous substances in water bottles.

Falls:

Tie shoelaces, wear slip-resistant shoes.
No walking in hospital with socks unless slip-resistant socks are provided.

Fire:

Leading cause of fire-related deaths → smoking in bed.
No smoking in hospital.

Disasters: floods, heavy rain.
Transmission of pathogens: PPE, hand hygiene.
Immunizations: prevent transmission person-to-person.

Factors Influencing Patient Safety

Developmental levels:

Infants: risk for falls (turning over).
School-age children: bikes, helmets, car seats.
Teenagers/young adults: risk-taking, peer pressure → education needed.

Mobility, sensory, cognitive status:

Elderly → shifting/moving increases fall risk.
Confused patients → may fall out of bed.
Diabetic & stroke patients → higher risk of injury.

Lifestyle: smoking, alcohol, drug use.
Knowledge of common safety precautions: seat belts, labeling substances.
Communication: language barriers require interpreter; not considered impairment.
Economic resources: underserved groups at higher risk.

Medical Errors

Wrong dosage, medication errors.
Biggest risk in hospital settings.
TJC & CMS “Speak Up” campaign:

Patients should make a list of questions.
Provides advocacy if they cannot speak for themselves.

National Quality Forum mission: addresses sentinel events.

Environmental Risks in Hospital

Patient-inherent accidents: e.g., patient climbing over bed rails instead of calling nurse.
Procedure-related accidents:

“Time out” before every procedure → confirm patient, consent, site, and procedure.

Equipment-related accidents:

Remove and label malfunctioning equipment.

Risk Management

Report issues immediately.
Use identifiers: name, date of birth.
Prevent giving two patients with the same name to one nurse.

Quality and Performance Improvement

Hospitals are paid for performance.
Focus on patient safety and improved care.

Critical Thinking

Anticipate patient needs and interpret data continuously.
Examples:

Call lights in bathrooms.
Orient patients at night; leave a light on if needed.
Assess patient before moving.

Acute and Restorative Care

Fall prevention:

If patient falls → do not lift immediately, assess first.
Use low beds and side padding for adults.

Assistive aids: crutches, walkers, wheelchairs.

Restraints

Restraints are discouraged (“bad word” in hospital).
Prefer chemical restraints or alternatives (e.g., seater) with close assessment.
Orders:

Required for physical or chemical restraint use.
Order must include criteria for release (e.g., patient is calm).
If patient worsens → need new order.
You do not need an order to remove restraints when conditions for release are met.

Side rails:

Not always considered a restraint (depends on use).
Seizures → side rails up for safety (not restraint).
Use only 2–3 rails; never all four (risk of death/falls).

Professor’s Note: Yellow box highlights → mittens not tied to bed frame are not considered restraints.
Restraint checks:

Ensure 2 fingers fit between restraint and skin.
Assess condition every hour (check circulation, extremities).

Acute Care Safety

Fire safety → know extinguisher colors.
Seizure safety → no restraint, protect patient.
Radiation (oncology unit): wear exposure badges, protective clothing (lead aprons).
Prevent workplace violence → be aware of exits.

Chapter 28 – Infection Prevention and Control

Key Principle

Hand washing = most effective prevention method.
Alcohol-based hand rubs acceptable unless visibly soiled.

PPE and Protection

Hair covers, masks, gowns, gloves → depending on patient.
Flu season → wear mask.
COVID precautions still active.
Always introduce yourself when wearing a mask.

Nature of Infection

Definitions:

Infection: invasion of susceptible host by pathogens.
Colonization: presence/growth without causing infection.
Communicable disease: transmitted person-to-person.
Symptomatic vs. Asymptomatic infection.

Professor’s Note: Next test will include many definitions → study carefully.

Modes of Transmission

Direct: patient-to-patient, patient-to-staff.
Indirect: via contaminated objects.
Droplet: influenza.
Airborne: e.g., tuberculosis, requires negative pressure rooms.
Vehicle: contaminated items/food.

Chain of Infection

MUST KNOW!!! (emphasized by professor).

Infectious Process – 4 Stages

Incubation (exposure).
Prodromal (early symptoms, malaise).
Illness stage (active symptoms).
Convalescence (recovery).

Professor’s Note: Study details in textbook.

Inflammation

Signs: pain, warmth, swelling, redness.
Inflammatory exudates.
Tissue repair.
Professor’s Note: Learn all signs of inflammation.

Defense Against Infection

Refer to Table 28.2.
Professor’s Note: Must study thoroughly.

Healthcare-Associated Infections (HAI)

Caused by unclean equipment use or poor practices.
Every patient should have their own BP cuff.
High risk:

Patients with multiple illnesses.
Elderly adults.
Poorly nourished patients.
Post-surgical patients → risk of poor wound healing.

Professor’s Note: Review types of HAI.

Factors Influencing Infection Control

Age.
Sex (different immune responses).
Nutritional status.
Stress (antibiotic overuse compromises immunity).
Disease processes.
Treatments or conditions compromising immunity.

Assessment

Review of systems, travel history.
Immunizations and vaccinations.
Nursing diagnosis examples: risk for social isolation (isolation precautions).

Nursing Process and Planning

Set SMART goals (specific, measurable, achievable, relevant, time-bound).
Team-based approach.
Goal: control or reduce extent of infection.

Implementation

Health promotion
Acute care
Asepsis:

Medical asepsis: treat all patients as infectious (standard precautions).
Surgical asepsis: prevent contamination of wounds and sterile fields.

Cleaning & Disinfection:

Use bleach, Cavi wipes, or hospital-grade products.
Clean from clean to dirty.

Sterilization: destroys all microorganisms including spores.

Patient Safety in Infection Control

Handling exudates: aseptic technique.
Cough etiquette: cover mouth with elbow; wear mask if infected.
Dirty linen: avoid soaking into uniform.
Maintain skin integrity.
Perineal care after toileting.
Indwelling catheters → risk for infection.
Wound cleaning with aseptic technique.

Special Notes

When pouring liquids → avoid splashing.
Psychological implications of isolation → Professor’s Note: review carefully.

✅ Now you have a single clean version of all your notes (Chapter 27, Chapter 28, and Week 5 content). Everything is organized, no repetition, and professor’s notes are flagged.

Do you also want me to turn this into a condensed Quizlet-style flashcard set so you can study key points faster?

Class Notes, Chapters 27 & 28 (1)