1. NATCEP Day Eight
General Safety Practices and
Procedures

2. Objectives
• Identify safety concerns in LTCFs
• Identify safety precautions that help to prevent
residents from falls
– SKILL: Walking an Unsteady Resident
• Identify safety precautions the STNA should know to
help prevent resident falls from beds, chairs and
wheelchairs
• Identify precautions the STNA should take to
prevent residents from being burnedIdentify the
safety precautions the STNA should take to help
prevent the resident from choking

3. Objectives
• Demonstrate the steps of the abdominal thrust
procedure (Heimlich maneuver)
– SKILL: Abdominal Thrust on Conscious Victim
• Identify measures the STNA should take to prevent
ingestion of harmful substances
• Identify measures the STNA should take if a resident
ingests a harmful substance
• Identify measures to protect resident from
elopement and other potential harm

4. Why Safety Precautions?
• Mental Confusion
– Alzheimer’s
• A neurological illness that affects older adults, is the
result of abnormal changes in brain tissue. Can only
be diagnosed by autopsy
– Dementia
• The loss of cognitive function that interferes with
routine personal, social, and occupational activities
• Impaired Mobility
• Diminished Senses

5. • Encourage residents to wear shoes or
slippers with non-skid soles.
• Avoid long gowns or robes that may
trip the resident.
• Encourage the use of hand rails.
• Ensure residents have non-skid tips on
canes, walkers and chair legs.
Preventing Falls

6. • Check with charge nurse before
applying skin lotions, bath oils or
powders.
– Make resident’s skin, equipment and
floors (such as tubs) slippery
• Use assistive devices for residents
with limited mobility.
– shower chairs
– raised toilet seats
– grab bars
Preventing Falls

7. • Keep traffic areas clear of objects and
furniture.
• Observe resident frequently.
• Instruct resident to call for assistance
using the signaling device.
• Answer call lights promptly.
Preventing Falls

8. • Encourage resident to wear clean,
appropriate eyewear.
• Always follow plan of care for resident-
specific needs.
• Always follow manufacturer’s
instructions & facility policies for use
of all equipment.
Preventing Falls

9. • Lock wheels on bed or wheelchair when
transferring.
• Transport resident in a bed, geriatric chair or
wheelchair carefully.
– Slowly approach corners with resident facing
front (forward)
• Use gait (transfer) belt if appropriate.
• Place a mattress on the floor per care plan &
facility policy.
• Use caution with tubing.
Preventing Falls
from Beds, Chairs or Wheelchairs

10. Preventing Burns
• Assist the resident when giving a hot
liquid to drink.
• Check water temperature before
placing under the shower or in a tub.
• Never leave the resident unattended in
shower/tub.

11. Preventing Burns
• Supervise residents when they smoke.
• Enforce restricted smoking areas for
residents, visitors and staff.
• Monitor carefully any equipment that
produces heat when in use.
– May have decreased sensation
– May not feel skin is being burned
• Be aware of potential hazards
– Chemical agents
• Secure hazardous materials in locked cabinets

12. Preventing Choking
• Make sure the resident has received
the accurate and appropriate diet.
• Check with the nurse before changing
the diet or offering other foods.
• Assure that food is cut or chopped in
small enough pieces for the resident to
swallow.
• Feed the resident slowly, alternating
food and liquids.

13. Preventing Choking
• Allow time to chew and swallow.
• Check care plan:
– Swallowing or restorative dining program?
– If on a swallowing program
• know program
• be trained on the technique required
– i.e. modified diet
• Stop feeding immediately if any
problems arise; notify the nurse.

14. How To Recognize Choking

15. Managing Choking

16. Preventing Poisoning
• Never leave harmful or potentially
harmful substances at the bedside or
in unlocked areas.
• Remove Styrofoam and plastic wrap
from the trays of confused residents.
• Monitor the use and placement of
household plants- many are
poisonous.

17. Suspect Poisoning?
• Identify the ingested substance, if
possible.
• Notify the charge nurse immediately.

18. Elopement
• Defined as
– Wandering from a supervised environment
• Always know where the resident is!
• Know facility policies and procedures.
• Report immediately when a resident is
missing

19. Stairwells
• Keep doors to stairwells closed at all
times.
• Know facility policy on stairwell use.
– Know when stairwells are to be utilized
– Follow facility policy regarding helping
residents down the stairs
– Use a two-person chair-lift to carry
resident down the stairs if indicated

20. Two-Person Carries
• Four-Handed Seat
– Carrying conscious & alert victims
moderate distances.
– Victim must be able to
• stand unsupported
• hold themselves upright during transport.

21. Two-Person Carries
• Four-Handed Seat
– Position hands as indicted.
– Lower seat and allow victim to sit.
– Lower seat using legs, not back.
– When victim is in place, stand using legs,
keeping back straight.

22. Two-Person Carries

23. Two-Person Carries
• Two-Handed Seat
– Carrying victim longer distances.
– This technique can support an
unconscious victim.

24. Two-Person Carries
• Two-Handed Seat
– Pick up victim by having both rescuers
squat down on either side of victim.
– Reach under victim's shoulders & under
their knees.
– Grasp other rescuer's wrists.
– From squat, with good lifting technique,
stand.
– Walk in direction that victim is facing.
– Position hands as indicted.

25. Two-Person Carries

26. Use of Alarms
• Facility-wide alarms
– Fire
– Tornado
• Personal Protective alarms
• When you hear - ACT!