CONCEPT OF SAFETY AND RISK

MANAGEMENT

By : Ibne Amin
BSN,MSN
Khyber Medical University, Peshawar
 OBJECTIVES

By the end of presentation the learners will be able to:

 Define safety and Risk.
 Identify factors affecting safety.
 Identify environmental hazards.
 Identify hazards in hospital environment (Physical &
Microbial) which alter patient safety.

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 CONT......

 Discuss general preventive measures for patient

safety.
 Identify the preventive measures to ensure health
care workers and patient safety.
 Discuss specific safety concerns in hospital

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 DEFINITION OF SAFETY, RISK & HAZARD

 Safety may be defined as freedom from psychological and

physical injury. It is a basic human need which must be met.
(Potter & Perry, 2007)

 Risk is the probability/chance of exposure to danger, harm or

loss.
 Hazard is an agent which has the potential to cause harm.

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 RISK

Risk can be Acute, intermediate, and chronic.

Acute: leads quickly to a health crises like fall, electric

current, radiation.

Intermediate: cause a problem not too fast or too slow.

Like elevated lipid, blood pressure, obesity.

Chronic: behavioral risk like tobacco use, unhealthy diet

use and physical inactivity
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 DIFFERENT FORM OF HAZARD

Physical: Noise, slippery floors, poor lighting, fire.

Chemical: toxic properties of gases, fumes, dust and liquids.

Radiation: X-rays, gamma rays, Microview, ultraviolet rays.
Ergonomics: poor design of equipment, work station, work
flow, method , manual handling.

Psychological: work load, discrimination, ignorance,

negligence, harassment, public dealing, threat of danger.

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 CONT……..
• Biological: Infection by bacteria, viruses, fungi, insect
bite, plant, bird, and contact with infected person.

RISK MANAGEMENT
• Risk management is complex process that involves
identification, analysis, and elimination of the risk
factors.

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 FCATORS AFFECTING SAFETY

• Age and development (old or young child)

• Life styles
• Mobility status
• Sensory Perception
• Safety awareness
• Communication
• Cognitive impairment
• Environmental factor such as Health acre setting, home
and community.

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 ENVIRONMENTAL HAZARDS

Pollution Electricity Radiations

Natural Disaster Violence Accidents

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 CONT....

Extreme temperature Poison

Machinery Microorganisms
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 HAZARDS IN HOSPITAL

Electrical Hazards Radiations Equipments out of order

Mercury spill Workplace violence Accidents (Falling)

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 CONT....

Stress Non sterile techniques Body Mechanics

 Needle stick injury (HIV, Hep B, Hep C etc )

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Assessment for Environmental Hazard
or Risk
A nurse must assess the environment for any threat to the
client safety.

• Client’s immediate environment.

• Individual risk factors
• Home hazard assessment
• Medication or undergoing for any procedure.

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 General Preventive Measures for
Patient Safety
• Give orientation to the client about unit
• Ensure the provision of basic needs (oxygen, Nutrition,
Temperature)
• Place a call bell within reach of the patient and teach
how and when to use it.
• Have proper lighting in the room
• keep the bed locked and in low position

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 CONT.....

• Use infection control measures (hand washing)

• Maintain close supervision of confused patient

• Place all equipment with in easy approach
• Use restrain if required
• Provide clean and calm environment
• Explain the procedures and plans

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 CONT……

• Answer the call bell on time

• Use isolation precautions where applicable
• Provide non-slippery, well-fitting footwear.
• Keep floor surface clean and dry.
• Ensure six rights of the patient (right patient, medicine,
dose, rout, time and documentation)

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 Preventive Measures for Health Care
Professionals’ Safety
• Awareness about standard safety policies and
procedures
• Know the emergency phone numbers like
fire, & Security emergency services
• Vaccination e.g. Hepatitis B vaccine
• Use of universal precautions (Hand washing
Protective measures such as using of gloves, gown,
cap, etc)
• Do not recap the needle
• Use of danger box
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 CONT.....
• Use proper body mechanics
• Learn proper use of equipments

Needle stick injury is one of the most serious exposures

for health care personnel that may cause blood borne
diseases, such as Hepatitis or AIDS. Always plan safe
handling and disposal of needles before beginning
the procedure. (Craven & Hirnle, 2003)

In case of accident, error or injury complete an incident

report according to policy and inform the supervisor.
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 Specific Safety Concerns In Hospitals
• The nurse should be aware of how to protect his/her
client from various kinds of hazards.

Fall:
• Familiarize the client with environment.
• Teach the client how to use the call bell.
• Keep the bed in low position with brakes locked.
• Provide non-slippery footwear
• Toilet should have safety bars for weak patients

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 RESTRAINS
• Obtain consent from the attendants
• It must be in the form of belt or soft clothes
• Restrain should be temporary.
• Apply in such way not to impede blood circulation (not too
tight or too loose).
• Always tie a limb restrain with knot that will not tighten when
pulled.

Mitt Restrain
Limb Restrain
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 SIDERAILS

• Help to increase patient’s mobility when on bed

• Helps to prevent fall of unconscious patients.

• When siderails are used then bed should be

maintained at the lowest position.

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 FIRE
• Home fire mostly result from careless disposal of
cigarette, matches, faulty electric wiring.
• In hospital usually from short circuit.
• Organization should have fire alarm, extinguisher and
hydrants system in every area.
• Organization should have fire exit door
• Once the smoke is detected the nurse should follow the
mnemonics RACE for others.
• All nurses, clients and family members including children
should know the steps when they themselves catch fire
STOP, DROP and ROLL for self.

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 CONT………
RACE

• Rescue: if the area is safe to enter, take out the client

• Alarm: Pull the fire alarm to report the exact location

• Confine: Confine the fire by closing all the doors

• Extinguish: Use the fire extinguisher

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 CONT…….
• Stop: Stop where you are

• Drop: Drop to the ground and

cover your eyes and mouth with
your hands.

• Roll: Roll over and over and back

and forth until the flames are out

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 Electric Hazards
• Electricity wire should be grounded in good working
order.
• Don not place wire under the carpet or on floor.
• No loose wire or connection
• Grasp the plug not the cord while unplugging
• Keep the electric equipment/wire away from sink,
bathtub and shower.
• Keep all the electric appliance out of the reach of
children.

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 Poison
• Lock all potentially toxic agent and medicine as well

• Avoid storing toxic agent in food container.

• Do not remove container label and label the container
• Do not keep poisonous plant at home
• Poison impair the function of respiratory, CNS, GI, CVS,
and Renal failure
• Urgently need specific antidotes

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 Lighting

• Adequate light is essential to reduce the risek of fall and

to work easily
• House exterior, interior and specially staircases should
have good lighting
• Night light (dim light )

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 BATHROOMS
To minimize the risk of injuries in
toilets, should take care of:

• Place safety bar

• Place raise commode
• Don’t use slippery material in floor
(tiles)
• Use non-slip, well-fitting footwear
• Keep the surface clean and dry
• Should have good lighting

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 SECURITY SYSTEM

The most common cause of death is falling asleep while the

ignition source was burning.

• Smoke detector should be installed

• Lead should not be used in house paint
• Especially gas valve should be closed before going to bed
• Secure house from intruders

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 REFERENCES
• Christensen, B. L., & Kockrow, E. O. (2006). Foundations and Adult Health Nursing. (5th
ed.). philadelphia: Mosby.

• Craven, R. F., & Hirnle, C. J. (2003). Fundamental of Nursing Human Health and Function.
(4thed.). New York: Lippincott.

• Potter, P.A & Perry, A.G (2007). Basic Nursing: Essentials for Practice. (6th ed.) St.
Louis: Mosby.

• Roger Pressman, ÒSoftware Engineering:A PractitionerÕs ApproachÓ, McGraw-Hill, 5th

edition, ISBN: 0-07-709677-0 (Chapter 6). Retrieved from
http://www.cs.ucl.ac.uk/staff/A.Finkelstein/advmsc/15.pdf

• Faculty & staff safety hand book , The Aga Khan University

• JCIA International patient safety goals

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