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Home Safety

It is the responsibility of our agency to provide care, treatment and services in an environment that poses no risk of an immediate threat to your health or safety; however, all patients need to take special precautions to ensure a safe living environment. Most accidents in the home can be prevented by eliminating hazards. This list will help you find potential hazards in your home. Take note of each statement that you need to work on to make your home a safer place. Please speak with your nurse / therapist or call the agency at any time if you have any concerns or questions about patient safety.

Preventing falls:
At least half of all falls happen at home. Each year, thousands of older Americans experience fall that result in serious injuries, disabilities, and even death. Falls are often due to hazards that are easily overlooked but easy to fix. Use the following Self Assessment. Check all of the risk factors below that apply to you and your home. The more factors checked, the higher you risk for falling:
  • History of Falling- 2 or more falls in the last 6 months
  • Vision Loss- changes in ability to detect and discriminate objects; decline in depth perception; decreased ability to recover from a sudden exposure to bright light or glare.
  • Hearing Loss- may not be as quickly aware of a potentially hazardous situation.
  • Foot Pain/Shoe Problems- foot pain; decreased sensation/feeling; skin breakdown; ill-fitting or badly worn footwear.
  • Medications- taking four or more medications; single or multiple medications that may cause drowsiness, dizziness, or low blood pressure.
  • Balance or Gait Problems- decline in balance; decline in speed of walking; weakness of lower extremities.
  • High or Low Blood Pressure- that causes unsteadiness.
  • Hazards Inside your Home- tripping and slipping hazards; poor lighting; bathroom safety; spills; stairs; reaching; pets that get under foot.
  • Hazards Outside you Home- uneven walkways; poor lighting; gravel or debris on sidewalks; no handrails; pets that get under foot; hazardous materials (snow, ice, water, oil) that need periodic removal and clean up.
Review each of the following safety tips and not the ones you need to work on:
  • Keep emergency numbers in large print near each phone.
  • Put a phone near the floor in case you fall and can't get up
  • Wear shoes that five good support and have thin, non-slip soles. Avoid wearing slippers and athletic shoes with deep treads.
  • Remove things you can trip over (such as papers, books, clothes, and shoes) from stairs and places where you walk
  • Keep outside walks and steps clear of snow and ice in the winter.
  • Remove small throw rugs or use double-sided tapekeep them from slipping.
  • Ask someone to move any furniture so your path around the house is clear.
  • Clean up spills immediately
  • Be aware of where your pets are at all times
  • Do not walk over or around cords or wires i.e. cords from lamps, extension cords, or telephone cords. Coil or tape cords and wires next to the wall so you can't trip over them. Have an electrician add more outlets if needed.
  • Keep items used often within easy reach (about waist high) in cabinets.
  • Use a stead step stool with hand bar. Never use a chair as a step stool.
  • Improve the lighting in your home. Replace bulbs as needed. Lamp shades or frosted bulbs can reduce glare.
  • Make sure stairways, halls, entrances, and outside steps are well lit. Have light switch at the top and bottom of the stairs.
  • Place a lamp, flashlight, and extra batteries within easy reach of your bed.
  • Place night lights in bathrooms, halls, and passageways, so you can see where you're walking at night.
  • Make sure the carpet is firmly attached to every step. If not, remove the carpet and attach non-slip rubber treads on the stairs. Paint a contrasting color on the top front edge of all steps so you can see the stairs better.
  • Fix loose handrails or put in new ones. Make sure handrails are on both sides of the stairs and are as long as the stairs. Fix loose or uneven steps.
  • Install grab bars next to your toilet and in the tub or shower.
  • Use non-slip mats in the bathtub and on shower floors.
  • Use an elevated toilet seat and/or shower floors
  • Exercise regularly. Exercise makes you stronger and improves your balance and coordination. Talk to your doctor about what exercise is right for you.
  • Have your nurse, doctor or pharmacist look at all the medicines you take, even over-the-counter medicines. Some medicines can make you sleepy or dizzy.
  • Have your vision checked at least once a year by an eye doctor. Poor vision can increase risk of falling.
  • Get up slowly after you sit or lie down.
  • Use a cane or assistive device for extra stability, if needed.
  • Consider wearing an alarm device that will bring help in case you fall and can't get up.
Disposal of Controlled Drugs:
  • When a patient no longer requires the controlled drug, the nurse shall inform the family of the need to destroy the remaining medication.
  • The hospice will discuss and review its policy and procedure with the patients and their caregivers at the time of admission. Caregivers will be instructed in safe disposal of controlled drugs following federal prescription disposal guidelines in the event drugs are disposed of while hospice nurse is not in the home:
    • First option is to return medications back to the pharmacy and the hospice will assist in the process.
    • Take the medications out of their original container and mix the medication with an undesirable substance, such as cat litter or coffee grounds.
    • For any unused IV controlled drugs, take the bag and tubing and dispose of under the observance of a licensed professional i.e. Registered Nurse (RN)
    • Before throwing out a drug container, remove any personal identification information or refill information so as to prevent the illegal re-ordering of the medication or privacy violation.
    • Never flush medication down the sink or toilet.
  • Documentation for the controlled drugs;
    • Name of Drug
    • Amount disposed
    • Name of the Pharmacist
    • Name of the RN
    • Date and Time
  • Documentation reflecting the name and amount of the drug, method of disposal, and witnesses shall become part of the medical record.
  • Should the patient/family refuse to return to pharmacy or destroy the drug(s), the nurse shall document this refusal in the clinical record and notify the physician and the Clinical Nurse Manager.
Hazardous Items and Poisons:
  • Know how to contact your poison control team.
  • Carefully store hazardous items in their original containers.
  • Do not mix products that contain chlorine or bleach with other chemicals.
  • Purchase insecticides for immediate need only and store excess properly.
  • Keep hazardous items, cleaners and chemicals out of reach of children and confused or impaired adults.
  • Dispose of hazardous items and poisons only as directed.
Oxygen Safety:
  • Use oxygen only as directed.
  • Oxygen creates a high risk for fire because it causes an acceleration of flame in the presence of flammable substance and open flames.
  • Do not smoke around oxygen. Post "No Smoking" signs in the home.
  • Store oxygen cylinders away from heat and direct sunlight. Do not allow oxygen to freeze or overheat.
  • Keep oil/petroleum products (such as Vaseline(R), oily lotions, face creams or hair dressings), grease and flammable material away from your oxygen system. Avoid using aerosols (such as room deodorizers) near oxygen.
  • Dust the oxygen cylinder with a cotton cloth and avoid draping or covering the system with any material.
  • Keep open flames (such as gas stoves and candles) at least 10 feet away from the oxygen source.
  • Have electrical equipment properly grounded and avoid operating electrical appliances such as razors and hairdryers while using oxygen. Keep any electrical equipment that may spark at least 10 feet from the oxygen system.
  • Use 100% cotton bed linens and clothing to prevent sparks and static electricity.
  • Place oxygen cylinders in appropriate stand to prevent tipping, or secured to the wall or placed on their side on the floor. Store in a well-ventilated area and not under outside porches or decks or in the trunk of a car.
  • Have a backup portable oxygen cylinder in case of a power or oxygen concentrator failure.
  • Alert property management of oxygen use when living in a multi-dwelling residence.
Fire Safety / Burn Precautions:
  • Post a fire department number on every telephone.All family members and caregivers should be familiar with emergency 911 procedures.
  • Notify the fire department if a disabled person is in the home.
  • Do not smoke in bed or where oxygen is being used. Never leave burning cigarettes unattended. Do not empty smoldering ashes in a trash can. Keep ashtrays away from upholstered furniture and curtains.
  • Install smoke alarms on every floor of your home, including the basement. Place smoke alarms near rooms where people sleep. Test smoke alarms every month to make sure they are working properly.
  • Install new smoke alarm batteries twice a year or when you change your clocks in the spring and fall.
  • Fire extinguishers should be checked frequently for stability.
  • Make a family fire escape plan and practice it every six months. Plan at least two different escape routes from each room for each family member. If your exit is through a ground floor window, make sure it opens easily.
  • If you live in an apartment building, know where the exit stairs are located. Do not use an elevator during a fire emergency.
  • Designate a safe place in front of the house or apartment building for family members to meet after escaping a fire.
  • If your fire escape is cutoff, remain calm, close the door and seal the cracks to hold back smoke. Signal for help at the window.
  • Evacuate a bedbound patient to a safe area by placing him or her on a sturdy blanket and pulling or dragging the patient out of the home.
  • Remember, life safety is first, but if there fire is contained and small, you may be able to use your fire extinguisher until the fire department arrives.
  • Have your heating system checked and cleaned regularly by someone qualified to do maintenance.
  • Wood-burning stoves should be properly installed. The chimney should be inspected and cleaned by a professional chimney sweep and trash should not be burned in the stove because it could overheat. Gasoline or other flammable liquids should never be used to start wood stove fires.
  • Keep portable electric or kerosene heaters out of high-traffic areas. Operate them on the floor at least three feet from upholstered furniture, drapes, bedding, and other combustible materials, and turn them off when family members leave the house or go to sleep. Use kerosene heaters only in well-ventilated rooms. Store kerosene outside in a tight sealed, labeled container.
  • Make sure electrical appliances and cords are clean, in good condition and not exposed to liquids.
  • Electrical outlets should be grounded and outlets with several plugs should not be used.
  • Keep storage are above the stove free or flammable/combustible items.
  • Wear short or tight sleeves while cooking; don't reach over stove burner.
  • Do not leave the stove unattended when cooking ,especially when the burner is turned to a high setting.
  • Turn pan handles away from burners and the edge of the stove.
  • Avoid cooking on high heat with oils and fat.
  • Puncture plastic wrap before heating foods in the microwave.
  • Never place hot liquids/solids at the edge of counter.
  • Place layered protection between skin and heating pad.
  • Keep electrical appliances away from the bathtub or shower area.
  • Never leave patient alone in the shower/tub
  • Set water heater thermostat below 120°F to prevent accidental scalding.
  • Store flammable liquids in properly labeled, tightly closed, non-glass containers. Store away from heaters, furnaces, water heaters, ranges, and other gas appliances. Make sure the garage is adequately ventilated.
Medication Safety:
  • Do not take medications that are prescribed for someone else.
  • Create a complete list of current medications (including prescription and over-the-counter medications, herbal remedies and vitamins), and keep this list with you at all times in the event of emergency situations. Review the list for discrepancies and make changes immediately as they occur. Show the list to your doctor or pharmacist to keep from combining drugs inappropriately.
  • Know the name of each of your medicines, why you take it, how to take it, potential side effects and what foods or other things to avoid while taking it.
  • Report medication allergies or side effects to your health care provider.
  • Take medications exactly as instructed. If the medication looks different than you expected, ask your health care provider or pharmacist about it.
  • Drug names can look alike or sound alike. To avoid errors, check with your health care provider if you have questions.
  • Do not use alcohol when you are taking medicine.
  • Do not stop or change medicine without your doctor's approval, even if you are feeling better. If you miss a does, do not double the next dose later.
  • Use a chart or container system (washed eggs carton or med-planner) to help you remember what kind, how much and when to take medicine.
  • Take your medicine with a light on so you can read the label.
  • Read medicine labels (including warnings) carefully and keep medicines in their original containers.
  • Store medications safely in a cool, dry place according to instructions on the label of the medication.
  • Keep medicines away from children and confused adults.
  • Federal disposal guidelines for medications: Follow any specific disposal instructions on the prescription drug labeling or patient information insert. Do not flush medications down the sink or toilet. We participate in the community pharmaceutical take-back program; therefore, take your unused drugs to them for proper disposal. In addition, we have an agreement with the pharmacy to return unused drugs to them. If not possible to return to pharmacy, then remove drugs from their original containers and mark out any identifying information on the original containers. Mix the drugs with an undesirable substance like coffee grounds or kitty litter. Place the mixture in a sealable bag, empty can or other container and place it and the empty, original containers in the trash.
Medical Equipment Safety:
  • Keep manufacturer's instructions with or near specialized medical equipment. Perform routine and preventive maintenance according to the instructions.
  • Keep phone numbers available in the home to obtain service in case of equipment problems or equipment failure.
  • Have backup equipment available, if indicated.
  • Provide adequate electrical power for medical equipment such as ventilators, oxygen concentrators and other equipment.
  • Test equipment alarms periodically to make sure that you can hear them.
  • Have equipment batteries checked regularly by a qualified service person.
  • Have bedside rails properly installed and use only when necessary. Do not use bed rails as a substitute for a physical protective restraint.
  • If bed rails are split, remove or leave the foot-end down so the patient is not trapped between the rails.
  • The mattress must fit the bed. Add stuffers in gaps between the rail and mattress or between the head and foot board and mattress to reduce gaps.
  • Register with your local utility company if you have electrically powered equipment such as oxygen or ventilator.
"We'll walk with you along the way..."