Safety & Infection Control

Learn how to study the Safety & Infection Control section of NCLEX NextGen like a nurse.  For more information on topic or for questions visit my website NurseFirstNp.org

Transcript

Hey guys

And welcome to N-Deep with NCLEX NextGen Podcast

I am Dr. Nanette Spencer. I am a doctorally Prepared Family Nurse Practitioner, Nursing Tutor, and founder of NurseFirstNp an online nursing tutoring service designed to empower nursing students with the confidence and competence to pass nursing school and NCLEX. I am dedicated to teaching nursing students how to think like a nurse so they can understand nursing content not just memorize it. 
 If your looking for a nursing tutor who doesn’t just teach you what to know but also teaches you how to think like a nurse to pass nursing test in the comfort of your home, or while doing whatever it is that keeps you on the go. You are in the right place. Make sure you subscribe and leave a review. Also, feel free to leave me a message on my website NurseFirstNP.org of any content you would like me to discuss on a future podcast… I am here to serve you guys. 

Hey guys its Dr. Spencer from NurseFirstNP.  You are listening to N-Deep with NCLEX NextGen weekly videos to guide you on what to and how to study to pass NCLEX NextGen on your first attempt. 

In this weeks video, I am going to be talking about…Safety and Infection Control…which is a big chunk of the material you will see on NCLEX Next-Gen. And the Safety and Infection Control section specifically accounts for about 13% of NCLEX test question. This section test questions are geared towards nursing interventions and patient education on ways to protect patients and healthcare personnel from health and environmental hazards. When studying for NCLEX guys remember to strategize by studying the most heavily tested upon material. 

Remember, NCLEX tests your understanding of the information not just your ability to memorize facts. And in order to pass NCLEX you need to be able to think like a nurse…

 So we are going to go over the most tested upon topics under the Safety and Infection Control Section. 

 When studying to improve your test scores in this topic you should focus you studies how to prevent accidents/error/injury to the patients and to yourself ( the future nurse).  

 And when studying this section, make sure you are correlating prevention interventions/education to your patient’s age as well as prioritizing those prevention interventions/education that addresses your patients airway, breathing, and circulation concerns. 

 For example, 

 When it comes to newborns and infants you want to think about what teaching information you would give to the parents when it comes to infant safety…Think Airway, Breathing, Circulation! 

 A good way to remember is to think about what physiological changes you can expect to see in an newborn or infant as well as developmental milestones such as Feud/Erikson.

 For example, since newborns aren’t born with the ability to roll over, they are at increased risk for what? Things like SIDS.

And what would you teach the parents to do to prevent SIDS.

 Think what other precautions needed to be taken because of their lack of ability to roll over (major risk for airways)…

 Since they aren’t able to roll over they are also at a higher risk for drowning In the tub as well as suffocation.

 So what would you teach parents when it comes to infants taking a bath or placing stuff animals in the cribs with them… 

Other physiological factors you want to think about…is what type of precautions would you tell parents due their infants skin not being fully developed and them not being able to regulate their body temperatures… This place infants at risk for what? burns or frostbite. Where do they lose they most heat…Is it their head or their feet or both.

So with that being said…. You know  that infants are in what phase as it relates to Erikson and Feud?

What teaching precautions would you teach to parents accordingly….

 So thinking about what development phase babies are in as it relates to Feud…You know babies love putting things in their mouth. So think about what patient teaching would you tell parents to help prevent choking, poisoning and suffocation.

 Remember this guys…Infants and the geriatric population is at highest risk for falls in the hospital. So, when taking NCLEX you want to narrow your answer choices down to the very young or the very old. 

 Moving along…

 As you guys know toddlers love to place things in their mouth as well…So the same precautions applies, even more so now, do to them having more mobility. So as toddlers have more mobility think about specific things you would teach parents to make sure toddlers don’t get hurt. 

Remember airway, breathing, and circulation. 

Think of different techniques in ways to lock up medications or poisonous things such as bleach. What would you tell the parents to do if child does get in to contact with medications or cleaning supplies. 

 Who do they call? 

 This is big danger to infant safety….

How do you transport toddlers? Do you transport them the same way you transport an infant. Think about at what age or height do you change them from a rear facing car seat to a front face car seat. vs rear facing car seat or booster seat. 

Babies and Toddlers are so cute people just want to take them. 

 So you need to teach about what??? Stranger danger.

 As children get older injury prevention is still a safety concern. 

As it relates to school -aged children you want to mainly think about safety because based off of development.  

Children are able to roll over, run, and be way more physically active. They love to use their imagination and think they are spiderman and such. 

 So you want to make sure they have necessary protective gear when riding bikes or etc. Think about Traffic safety- looking both ways before crossing the street, water safety and wearing a life jacket, fire safety, and stranger danger (trafficking)

Remember the purpose of this podcast is to get you thinking like a nurse to pass NCLEX. Because giving you the information doesn’t make you understand the why!!!

When it comes to adolescents, think about what’s going on physiologically (puberty) and developmentally ( as it relates to thinking process). 

 Since you know that, you know that you want to teach them about sex education as well as mental health. And if those things aren’t adequately addressed, what can it lead to… Mental health concerns such as anorexia nervosa, anxiety etc.  

Due to people living longer with chronic medical conditions you can expect questions as it relates to injury prevention and the older population. When studying about this population and injury prevention make sure you think about factors that make this generation more prone to falls, side effects of medications, and elder abuse. What do you do or who do you contact if you expect your patient is suffering from elder abuse? What are the signs?

 So if you are studying the older population and injury prevention make sure your thinking about what teaching would you tell these patients based off vision, hearing, and sensory deficits.

 A big one guys…Make sure you know the leading cause of unintentional deaths as it relates to  each age group.

 So switching from patient teaching to nursing interventions as it relates to patient safety…Same applies guys think about those conditions/medications/procedures that pose the most risk to Airway, Breathing, and Circulation.

 What would you do if your patient is actively having a seizure and what preventive measures would you carry out if your patient has a past history of seizures?

 Think about what complications can occur during seizures

What medication would you give to your patient if you start to notice they are having a seizure..  Would you give it through an IV or by mouth??? Why??

 How do you properly administer the medications according to the medication rights?

 What are some ways to prevent medication error such as ensuring there is proper lightening or having a second nurse verify the medication dosage etc. 

 What type of medications requires sign off from another nurse??

Think about narcotics, blood, IV nutrition??

 How do to safely administer narcotics? 

What assessment findings would you monitor for when giving narcotics. 

When it comes to medications make sure your thinking about those medications that require a therapeutic range before administering and why? 

What are the signs of medication toxicity? For instance, think about what you would see if your patient has a digoxin overdose. 

How do you know if a patient is allergic to a medication, what do you do or what would you give them?

 Okay guys switching gears…So we discussed what to do if your patient is having an active seizure right…well there are other emergencies you guys need to be familiar with for NCLEX.

 Think about what would you do in emergency situations in the hospital such as a hurricane or hospital fire or a patient coming in with a firearm.

 Who would you triage first? 

An older patient, a young patient, a patient who is able to walk or a patient is not able to walk. What would you assess for when triaging?

Would you look to triage patients who have breathing issues first or bleeding issues? 

Just a few tips… When triaging patients and thinking of ABCs …You want to first think about those patients with diseases that may have issues with clearing and opening their airway, those with signs of respiratory distress (remember what would you see that would alert you this patient may be in respiratory distress such as – looking at their quality of breathing is it labored? , or those with circulation issues like signs of external bleeding. You know to think about key assessment findings that would indicate hemorrhaging such as pulse rate, blood pressure or level of consciousness.

Interventions to address safety precautions include safety when it comes to hospital equipment.

Think about what you would do if  you notice a broken wire? What would you do? 

You know to Label it, and remove it, but where do you place it, and who do you report it to. 

 Think about what you would do if you noticed that the IV pump isn’t working in the hospital?? 

 Remember all non-working equipment should be labeled clearly and put in a separate area to be reviewed by the equipment department. 

 Soo big one guys…

 What would you tell your patient to do if a fire breaks out at home? 

 What if your patient is on oxygen and a fire breaks out at home or in the hospital?

Think about the acryonyms RACE and PASS…

 When it comes to patient safety and nursing safety interventions…

 Think about how would you move/position patients with comorbidities such pressure ulcers or those who have recently undergone hip surgery. What patient factors would make you think about grabbing assistive devices, using a trochanter rolls, or an extra set of hands.

 Think about how would you teach patients to use crutches, or a walker. How long or often can they be on crutches…What complications can arise from using crutches for a long period in time? 

 What would you do if your patient started being a danger to themselves and you had to place them in restraints. Who would you have to call to get the order. Does and when does that provider have to come and assess the patient. How often does the order have to be  renewed. What would you assess for every 15 minutes or every 4 hours. Which patient would you most likely give chemical restraints too. What medications are given as chemical restraints. 

 How do you document the order for restraints. 

Little side note guys… Looking back on when I was in nursing school and studying for NCLEX. I knew I knew the information but I didn’t feel as confident taking the test because although I knew the information when it was put in a question format..My mind sometimes would draw a blank or I would constantly doubt myself. So I am getting you in the habit of getting familiar with questions so you will know how to think when its time to take the test….

 I know we are always taught patient-centered care and everything is always about the patient…but Nurses matter too…. You guys always want to protect yourself from harm at all times.

 So be mindful of body mechanics when your trying to help patients. 

 So what if your patient that requires restraints fell out the bed and has to be placed back in to the bed in [1]order for the restraints to be placed on…

 Think about how would you move them? 

 How do you safely move the patient from the floor to the bed?? Do you bend using your knees or back to pick up the patient.?

When your getting ready to help your bedridden patient change positions in the bed helping Would you raise the level of bed first before moving the patient? 

What patient factors would indicate that patient is not safe to be moved based on patient assessment?

For instance, those patients that may be in a lot of pain or BMI of greater than 30 (which may indicate the patient is too large for you to move by yourself).

 As stated before nurses matter… so  

So you and your team have successfully transferred that patient that needed to be in restraints back to the bed. Your CNA panicks and says you guys should have put on a gown because that patient has community acquired pneumonia. 

 You inform her there is a difference between an infectious agent and one that’s not. For instance the bacteria that causes the flu is infectious but no pneumonia. 

 You remember the infectious cycle and no that you would just use standard precautions for everyone but you may need to add additional PPE if that patient with Pneumonia had an immunocompromised disorder like low WBCs or an autoimmune disease. Just to protect them because you guys have a couple of patients on the floor in isolation. 

 Make sure you guys remember all of the transmission precautions and the difference between how you put on PPE and take off PPE as it relates to each precaution. 

 Also make sure you know when you would use sterile technique verses transmission precautions or clean techniques (standard precautions). 

 For instance, cleaning a patients wound would bee standard technique but if you expect splashing of blood you may add googles or a gown. 

 in addition to protecting yourself from infectious diseases…

 How do you handle infection materials such as bloody linen or dressings?

Do you place it in the same container as the other trash? 

What do you do with old IV needles?

When do you have the sharps container changed. Do you do it?  Do you place them in the trash if the sharps container is full?

What happens if you accidently stick yourself with the bloody needle. Who do call?  What testing must the patient undergo? Do you get tested as well?  

What if the patient test results come back positive for HIV. What do you do? Where do you go to get tested and who do you notify? 

 Do you document it as an incident report. Who keeps check on incident reports? When should you file an incident report. 

 So lets dig a bit deeper in incident reporting..

 So what happens if your CNA calls you into the room because your patient fell. Do you document the patient fell even when you did not see the fall?

 No-  You should just document the findings of the event in the patient’s chart. And who ever found the patient should file an incident report. 

 So what if you accidently gave the your patient the wrong medication… Where do you document your error in an incident report and/or in the client’s medical record. Do you document everything in the chart or just the facts. 

 These are the type of questions you guys need to be asking yourselves as your studying for NCLEX Next-Gen. Asking yourselves these types of questions ensures you actually understanding the information, so you can better apply it when taking NCLEX Next-Gen. 

 As mentioned before guys this podcast is geared towards teaching you how to think like a nurse in order to pass NCLEX NextGen on the first attempt. Similar to you guys, I knew I knew the information but the way the test questions asked the question, I would always doubt myself. So this podcast is to help you get familiar with the type of questions you should be asking yourself as you study for NCLEX. 

Thank you guys so much for listening this podcast, I pray that this serve as a guide to help you become more confident and competent in taking NCLEX. Please guys reach out to me on Instagram- nursing tutor or on my website Nursefirstnp.org if you need any additional clarification on topics presented in this podcast- questions can range from how to learn the medications better, or if you just need tips on how to study for NCLEX whether its your first time or third time.  or if you would like the  cheatsheet showing you not only how to study this section but what to study in this section. Remember, I am here to serve you guys.   Good luck and best wishes..

 Remember, guys you don’t need to know everything to pass NCLEX NextGen just the most important things. So study with Strategy!! See you next week.