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Zorluk: Çok zorAccident, Error, and Injury Prevention

While assigned to a medical unit, a practical nurse (PN) observes an unlicensed assistive personnel (UAP) preparing to enter the room of an older adult client with disseminated herpes zoster. The client, who has no documented history of cognitive impairment, has suddenly become severely agitated and is attempting to climb over the bed rails. The UAP has donned a surgical mask and gloves, stating they intend to quickly apply bilateral wrist restraints to prevent a traumatic fall. Which action by the PN demonstrates the highest priority for comprehensive error prevention and client safety?

  1. Halt the UAP from entering, require the use of an N95 respirator and isolation gown, and collaborate to provide direct bedside supervision rather than applying physical restraints.Cevap
  2. B
    Direct the UAP to apply the restraints immediately to prevent a high-risk fall, as physical safety takes precedence over complete transmission-based precautions during a sudden emergency.
  3. C
    Advise the UAP that acute agitation is an expected physiological response to viral infections in older adults, and allow them to proceed with applying restraints using their current protective equipment.
  4. D
    Delegate the UAP to don appropriate airborne precautions, then instruct them to perform a comprehensive neurological assessment to determine the root cause of the sudden agitation.

Cevap

The practical nurse must stop the UAP, ensure the correct airborne and contact precautions (N95 respirator and gown) are worn, and use direct bedside supervision instead of physical restraints.
The correct action demonstrates a synthesis of safety protocols. It immediately prevents a transmission hazard by enforcing airborne/contact precautions (N95 and gown) for disseminated herpes zoster. Furthermore, it protects the client's rights and safety by utilizing the least restrictive alternative (direct bedside observation) rather than allowing the UAP to unlawfully apply physical restraints.

Adım Adım Çözüm

1
Analyze the infection control risk presented in the scenario.
Disseminated herpes zoster requires airborne and contact precautions. The UAP's surgical mask and gloves are insufficient; an N95 respirator and gown are required.
Preventing the spread of highly contagious airborne pathogens is a critical safety priority for the entire unit.
2
Evaluate the UAP's plan to apply physical restraints.
Applying restraints immediately is a safety violation. Restraints are a last resort and require a provider's order.
The standard of care mandates attempting the least restrictive alternative first, such as one-on-one bedside observation, to de-escalate agitation and prevent injury.
3
Assess the clinical significance of the client's sudden agitation.
Sudden agitation in an older adult with no cognitive history indicates acute delirium, a medical emergency requiring RN/provider evaluation.
Normalizing confusion leads to missed diagnoses of hypoxia, sepsis, or other life-threatening complications.
4
Synthesize findings to determine the priority action.
The PN must intervene immediately to stop the UAP, correct the PPE violation, and provide direct supervision to protect the client without using restraints.
This comprehensively addresses hazard prevention (infection control), error mitigation (avoiding illegal restraint application), and client safety (preventing a fall).

Anahtar Kavram

Comprehensive Error and Injury Prevention (Infection Control, Restraint Alternatives, and Safe Delegation)
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Konular

Accident, Error, and Injury Prevention

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