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 

• Call Bells: 

• Ensure call bells are within the resident’s reach whether in bed or in a bedside chair. 

• Implement alternative call bell devices for residents who cannot physically operate standard call bells. 

• Alarm Systems: 

• Respond promptly to all alarms, including personal call bells, chair/bed alarms, stairwell alarms, and Wander guard alarms. 

• Reset alarms after responding. 

• Body Mechanics: 

• Use proper body mechanics when lifting residents or heavy objects. 

• Transfer Status: 

• Document the resident’s transfer status on the resident care card and follow it. 

• Mechanical Lifts: 

• Use two staff members to assist with transfers using a mechanical lift or sit-stand lift. 

• One staff member controls the lift, while the other guides the resident. 

• Ensure the lift legs are fully opened during the transfer, or as per the manufacturer’s guidelines. 

• Review the resident’s care plan for the number of staff required and any specific instructions. 

• Gait Belts: 

• CNAs must use gait belts to transfer residents requiring physical assistance to avoid injury. 

• Wheelchair Transport: 

• Ensure the resident’s lower limbs are on leg rests or that they can hold their legs up. 

• Ensure upper limbs are placed inside the chair. 

• Check for tubing placement before transport. 

• Lock wheelchair brakes when left at the resident’s bedside. 

• Footwear: 

• Encourage residents to wear safe footwear when out of bed. 

Tubing Care 

• Oxygen, Feeding, Foley, or Supra Pubic Catheter Tubing: 

• Ensure tubing is not on the floor, kinked, pulled taut, or positioned under the resident. 

• Ensure tubing is not dislodged and is patent. 

• Maintain gravity flow for all urinary catheters. 

• Tube Feeding: 

• Keep the head of the bed (HOB) elevated to >30 degrees at all times, except when providing care. 

• Contact the nurse if the resident needs to be at <30 degrees for care. 

Fire Hazards 

• Oxygen Use: 

• Avoid fire hazards such as lit matches, cigarettes, and electrical appliances near residents requiring oxygen. 

Bathroom Safety 

• Supervision: 

• Do not leave residents with poor safety awareness or without trunk control unattended in the bathroom. 

• Reinforce the need to call for assistance when ready to get off the toilet. 

Elevator Safety 

• Operation: 

• Use the DOOR OPEN button to hold the elevator door open. 

• Allow residents to exit the elevator first. 

Personal Care Products 

• Storage: 

• Do not leave personal care products on linen carts, nursing stations, hallway railings, or in bath core areas. 

• Store resident personal care products in bedside stands. 

Shower Safety 

• Supervision: 

• Do not leave a resident unattended in a shower chair. 

• Use safety belts at all times during transportation and showering. 

Clutter and Cleanliness 

• Resident Areas: 

• Ensure resident bedrooms and bathrooms are clutter-free. 

• Return items to their appropriate places. 

• Ensure gym mats are up and off the floor when the resident is not in bed. 

• Spills: 

• Wipe up spills immediately or place a wet floor sign and contact the Resident Support Services department. 

• Food Items: 

• Cover food items in resident rooms. 

Meal Service 

• Meal Tickets: 

• Check meal tickets to ensure the correct resident receives the correct meal with appropriate adaptive equipment. 

• Do not leave hot food to cool in front of confused residents. 

• Fluid Thickeners: 

• Ensure fluids are properly thickened according to directions. 

• Aspiration Precautions: 

• Follow individualized aspiration precautions with proper positioning and supervision. 

Emergency Preparedness 

• Response: 

• Respond immediately to emergency preparedness codes: Dr. Hunt, Dr. Rambo, Code One, Code Blue. 

Equipment Safety 

• Electrical Equipment: 

• Check the integrity of electrical cords before use. 

• Report urgent equipment issues to Physical Plant via phone immediately. 

• Document non-urgent issues in the Maintenance books on each nursing floor or at the receptionist desk. 

Incident Reporting 

• Accidents: 

• Report accidents involving employees, family members, or visitors to the Nursing Supervisor. 

• Complete an accident form prior to leaving the facility. 

Infection Control Safety 

• Hand Hygiene: 

• Wash hands per policy, including between residents, even when gloves have been worn. 

• Personal Protective Equipment (PPE): 

• Wear PPE as indicated by isolation protocols. 

• Do not wear PPE in hallways. 

• Remove gloves before leaving the resident’s room. One glove may be worn if transporting dirty linen or trash. 

• Bedpans/Urinals: 

• Do not place on over-bed tables unless part of the resident’s plan of care. Use a towel or draw sheet if necessary. 

• Linen Handling: 

• Follow policy for handling linen, ensuring only the amount needed is brought into the room. 

• Consider linen dropped on the floor or removed from the room as contaminated. 

Safety Rules and Reporting 

• Report Problems: 

• 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: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.