Elderly residents are at greatest risk for accidents due to factors like confusion, dementia, and changes in body systems from aging. Falls are a major safety concern in long-term care facilities and can be caused by hazards, medications, vision issues, and more. Hip fractures from falls can lead to serious complications like blood clots, pain, and even death. Proper prevention includes keeping areas clutter-free, ensuring call lights are accessible, and more. Residents also face risks like burns, choking, and poisoning that staff must be aware of and take precautions for. Oxygen safety, restraint use, body mechanics, and fire safety are also important concepts for staff to understand to keep residents safe.

1. Safety and Body
Mechanics
Chapter 6

2. Risk for accidents
 Who’s at greatest risk?
◦ Elderly residents
 Confusion
 Dementia
 Changes in body systems due to the aging
process
◦ Hearing
◦ Vision
◦ Sensory – decreased sense of touch (sensation),
circulatory impairment
 Medications, drowsiness

3. Prevention is the key
 Watch for safety hazards
 Report unsafe conditions to supervisor
 Falls
◦ Majority of incidents that occur in a LTC facility
◦ Caused by trip hazards, effects of meds, vision
impairment, needing to go to the bathroom,
call lights not answered promptly, confusion,
loss of ability to get up safely,
◦ Fractures – bones fragile in elderly

4. Hip fractures
 Most common fracture
 Can lead to death or serious impairment
 Why? Complications.
◦ Blood clots
◦ Pain
◦ Does not walk again, lack of participation in PT
◦ Pneumonia – how does this happen?

5. More prevention of falls
 Keep all areas free of clutter, cords
Rugs with non-skid backing
 Have residents wear shoes
 Have call light within reach and answer
right away
 Clean up spills right away
 Lock WC & beds before helping to get up
 Return bed to lowest position

6. Burns & Scalds
 Residents with decreased sensation are at
greatest risk.
 Always check water temperature
 Pour hot drinks away from resident

7. Resident ID
 Extremely important!
 Different forms of ID in different facilities
◦ Bracelet
◦ Picture
◦ Asking person what his/her name is
◦ Asking another CNA who knows resident
 When feeding, identify patient before
setting food down in front of him or her,
look at name card.

8. Choking
 Who is at risk?
◦ Babies who put things in their mouth
◦ Residents with swallowing impairment
◦ Residents who are unconscious
◦ Allergic reaction – tongue swelling
 Always have resident sitting as straight up as
possible
 Special diets, thickened liquid

9. Other safety concerns
 Poisoning – confused residents, cleaning agents, hoarders of food
◦ Investigate any odors
◦ Keep cleaning agents out of reach
 Abrasions/Bruises
◦ Be careful how you move residents…older people bruise easily, have fragile
skin
 Put any sharp objects away after use and be careful when using.
 Report injuries immediately!
 Promote safety at all times.

10. Oxygen
 Some residents need to use oxygen in LTC
to help them breathe.
 Prescribed by MD.
 NA does not stop, adjust, or give oxygen
in LTC. May be different in acute care
 Fire hazard. Makes other things burn.
 Safety precautions around O2
 NO SMOKING!!!!

11. Oxygen Safety
 Remove fire hazards from room or put
away
◦ Electric razors, matches, flammable liquids
(hair spray, etc.)
◦ Make sure signs are in place “No smoking” and
“Oxygen in use”
◦ Never mix smoking and oxygen together.
◦ Do not burn candles, light matches or use
lighters around oxygen.
◦ Do learn how to turn oxygen off in case of fire.

12. Material Safety Data Sheet
 MSDS – Details about how to safely clean
up hazardous spills

 All chemicals used in a facility have to
have one of these.
 Learn where it’s located in case you need
it
 Eyewash station:
◦ Know where it is and how to get to it.

13. Restraints
 Definition:
◦ A physical or chemical way to restrict voluntary
movement or behavior.
 Only used when absolutely necessary
 Examples:
◦ Side rails on a bed
◦ Special chairs – geri-chairs pg 83 & 85
◦ Medications
 Needs a doctor’s order and you must be
trained to use, if applicable

14. Restraint problems and prevention
 Sometimes restraints are necessary
◦ 4 point, psych units, one-to one CNA
 Problems:
◦ Can cause pressure sores
◦ Must check every 15 minutes: circulation
◦ Very regulated due to past abuse

15. Restraint Alternatives
Studies show that people respond better to
alternatives when pulling at tubes,
wandering, or other undesirable
behavior…
 Some alternatives
◦ Distract or redirect interest
◦ Decrease stimulation
◦ One to one CNA
◦ Alarms

16. Body Mechanics
 Prevents injury
 Maintain good alignment
 Posture – holding oneself up
 Have base of support – feet approx 12
inches apart – shoulder width
 Bend your knees
 Keep object close to your body
 No twisting..face the object of person you
are moving
 Pivot

17. Good habits for injury prevention
 Adjust bed height to what’s comfortable
 Bend knees to lower self, no waist
bending
 Use both arms and hand to lift, push, or
pull
 Avoid bending and reaching
 Pivot instead of twisting from waist
 Plan procedure with resident…”1, 2, 3”
 GET HELP!!! We all need this sometimes…

18. Fire
 Recognize hazards
 Fire plan – Know facility policy.
 Fire drills, most facilities have these
 PASS – Pull the pin, Aim at base of fire,
Squeeze handle, Sweep back and forth
 RACE – Remove residents, Activate 911,
Contain fire (close doors), Extinguish or
fire dept will