Safety Standards Policy
Safety Standards Policy
Purpose
To ensure resident safety, proper body mechanics, and adherence to infection control protocols in the long-term care facility.
Policy
The following safety standards are to be followed by all staff to ensure the well-being of residents and staff, and compliance with CMS guidelines and the State Operations Manual (SOM).
General Guidelines
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Call Bells:
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Ensure call bells are within the resident’s reach whether in bed or in a bedside chair.
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Implement alternative call bell devices for residents who cannot physically operate standard call bells.
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Alarm Systems:
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Respond promptly to all alarms, including personal call bells, chair/bed alarms, stairwell alarms, and Wander guard alarms.
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Reset alarms after responding.
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Body Mechanics:
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Use proper body mechanics when lifting residents or heavy objects.
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Transfer Status:
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Document the resident’s transfer status on the resident care card and follow it.
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Mechanical Lifts:
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Use two staff members to assist with transfers using a mechanical lift or sit-stand lift.
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One staff member controls the lift, while the other guides the resident.
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Ensure the lift legs are fully opened during the transfer, or as per the manufacturer’s guidelines.
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Review the resident’s care plan for the number of staff required and any specific instructions.
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Gait Belts:
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CNAs must use gait belts to transfer residents requiring physical assistance to avoid injury.
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Wheelchair Transport:
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Ensure the resident’s lower limbs are on leg rests or that they can hold their legs up.
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Ensure upper limbs are placed inside the chair.
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Check for tubing placement before transport.
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Lock wheelchair brakes when left at the resident’s bedside.
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Footwear:
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Encourage residents to wear safe footwear when out of bed.
Tubing Care
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Oxygen, Feeding, Foley, or Supra Pubic Catheter Tubing:
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Ensure tubing is not on the floor, kinked, pulled taut, or positioned under the resident.
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Ensure tubing is not dislodged and is patent.
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Maintain gravity flow for all urinary catheters.
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Tube Feeding:
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Keep the head of the bed (HOB) elevated to >30 degrees at all times, except when providing care.
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Contact the nurse if the resident needs to be at <30 degrees for care.
Fire Hazards
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Oxygen Use:
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Avoid fire hazards such as lit matches, cigarettes, and electrical appliances near residents requiring oxygen.
Bathroom Safety
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Supervision:
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Do not leave residents with poor safety awareness or without trunk control unattended in the bathroom.
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Reinforce the need to call for assistance when ready to get off the toilet.
Elevator Safety
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Operation:
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Use the DOOR OPEN button to hold the elevator door open.
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Allow residents to exit the elevator first.
Personal Care Products
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Storage:
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Do not leave personal care products on linen carts, nursing stations, hallway railings, or in bath core areas.
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Store resident personal care products in bedside stands.
Shower Safety
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Supervision:
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Do not leave a resident unattended in a shower chair.
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Use safety belts at all times during transportation and showering.
Clutter and Cleanliness
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Resident Areas:
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Ensure resident bedrooms and bathrooms are clutter-free.
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Return items to their appropriate places.
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Ensure gym mats are up and off the floor when the resident is not in bed.
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Spills:
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Wipe up spills immediately or place a wet floor sign and contact the Resident Support Services department.
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Food Items:
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Cover food items in resident rooms.
Meal Service
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Meal Tickets:
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Check meal tickets to ensure the correct resident receives the correct meal with appropriate adaptive equipment.
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Do not leave hot food to cool in front of confused residents.
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Fluid Thickeners:
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Ensure fluids are properly thickened according to directions.
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Aspiration Precautions:
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Follow individualized aspiration precautions with proper positioning and supervision.
Emergency Preparedness
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Response:
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Respond immediately to emergency preparedness codes: Dr. Hunt, Dr. Rambo, Code One, Code Blue.
Equipment Safety
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Electrical Equipment:
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Check the integrity of electrical cords before use.
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Report urgent equipment issues to Physical Plant via phone immediately.
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Document non-urgent issues in the Maintenance books on each nursing floor or at the receptionist desk.
Incident Reporting
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Accidents:
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Report accidents involving employees, family members, or visitors to the Nursing Supervisor.
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Complete an accident form prior to leaving the facility.
Infection Control Safety
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Hand Hygiene:
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Wash hands per policy, including between residents, even when gloves have been worn.
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Personal Protective Equipment (PPE):
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Wear PPE as indicated by isolation protocols.
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Do not wear PPE in hallways.
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Remove gloves before leaving the resident’s room. One glove may be worn if transporting dirty linen or trash.
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Bedpans/Urinals:
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Do not place on over-bed tables unless part of the resident’s plan of care. Use a towel or draw sheet if necessary.
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Linen Handling:
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Follow policy for handling linen, ensuring only the amount needed is brought into the room.
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Consider linen dropped on the floor or removed from the room as contaminated.
Safety Rules and Reporting
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Report Problems:
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Report any problems, concerns, or additional safety precautions or recommendations to your supervisor.
Safety is everyone’s business. Let’s all try to work together to make the facility a safe environment for staff and residents alike.
References:
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Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities.
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State Operations Manual (SOM), CMS.
