Foundations of Health, Safety, and Nursing Practice: Structured Study Notes

Health and Wellness Concepts

What is Health?

Health is defined as a state of complete physical, mental, and social well-being, not merely the absence of disease. Well-being encompasses subjective happiness, purpose, and life satisfaction.

• Health: A holistic state including physical, mental, and social aspects.

• Well-being: Involves subjective measures such as happiness and life satisfaction.

Disease vs. Illness

Understanding the distinction between disease and illness is crucial in health psychology and nursing.

• Disease: Objective biological problem identified by a health professional.

• Illness: Subjective experience of feeling unwell (how the patient perceives it).

Approaches to Health

Multiple approaches are used to understand and promote health.

• Medical Approach: Focuses on curing disease through treatment.

• Behavioural Approach: Emphasizes lifestyle choices (exercise, diet, smoking).

• Socioenvironmental Approach: Considers social, economic, and environmental factors (e.g., poverty, housing, access).

Disease Prevention

Disease prevention strategies are categorized by the stage of intervention.

• Primary: Prevent disease before it occurs (e.g., vaccines, education).

• Secondary: Early detection (e.g., screening).

• Tertiary: Managing disease to prevent complications or disability (rehabilitation).

Social Determinants of Health (SDOH)

SDOH are non-medical factors influencing health outcomes.

• Include income, education, employment, social support, housing, gender, culture, and health services.

Safety in Practice

Patient Safety

Patient safety involves minimizing risks and preventing harm in healthcare settings.

• Risks: Falls, medication errors, malfunctioning equipment, infections.

• Safety factors: Patient age, developmental stage, environment, cognition, sensory status.

Nursing Process & Infection Prevention

The Nursing Process

The nursing process is a systematic method for delivering patient care.

• Assessment: Collect and validate data.

• Diagnosis: Identify actual or potential health problems.

• Planning: Set SMART goals and outcomes.

• Implementation: Carry out interventions (direct/indirect).

• Evaluation: Determine effectiveness; modify as needed.

Chain of Infection

Understanding the chain of infection helps prevent the spread of disease.

• 1. Infectious Agent

• 2. Reservoir

• 3. Portal of Exit

• 4. Mode of Transmission

• 5. Portal of Entry

• 6. Susceptible Host

Breaking the chain: Hand hygiene, PPE, disinfection, patient isolation.

Common Healthcare-Associated Infections (HAIs)

• VRE: Contact transmission (intestinal bacteria resistant to vancomycin).

• MRSA: Resistant staph; spread via contact.

• C. Diff: Spore-forming, causes diarrhea after antibiotic use — requires soap and water, not alcohol rub.

Body Mechanics, Positioning & Mobility

Principles of Body Mechanics

Proper body mechanics prevent injury and promote safe patient handling.

• Maintain alignment and center of gravity.

• Use large muscle groups.

• Face direction of movement to reduce twisting.

• Push or roll rather than lift when possible.

Positioning

• Supine: Flat on back; watch for pressure points.

• Prone: On abdomen; relieves back pressure.

• Lateral (Side-lying): Reduces pressure on spine/buttocks.

• Sims (Semiprone): Between lateral and prone; used for enemas.

• Fowler's (SemiHigh): Head elevated (comfort, ventilation).

Range of Motion (ROM)

• Active ROM: Patient moves independently.

• Passive ROM: Nurse assists.

• Joint Movements: Flexion, extension, rotation, abduction, adduction, circumduction.

Ambulation & Transfers

• Use gait belts and assistive devices (canes, walkers, crutches).

Falls, Seizures, and Restraints

Falls Prevention

Falls are a major safety concern, especially in older adults and those with mobility issues.

• Common causes: Age, mobility, medication, sensory loss, confusion.

• Assessment Tools:

  • Morse Fall Scale: 6 items, score >51 = high risk.

  • Hendrich II Model: Considers confusion, depression, elimination, dizziness, meds, mobility.

• Prevention: Call bell within reach, bed low, lighting, footwear, purposeful rounding.

Seizure Precautions

• Before: Padded rails, suction and airway equipment ready.

• During: Do NOT restrain or put anything in mouth; clear area; stay with patient.

• After: Recovery position, reorient, comfort, quiet environment.

Restraints

• Types:

  • Physical: Mitts, belts.

  • Chemical: Sedatives.

  • Environmental: Locked units.

• Least-Restraint Policy: Use alternatives first (distraction, reorientation, family involvement).

• Legal/Ethical: Doctor's order required within 1 hour; reassess every 2–4 hours depending on age.

• Risks: Pressure injuries, incontinence, asphyxiation, emotional distress.

Hygiene and Personal Care

Purpose of Hygiene Care

• Promotes comfort, cleanliness, self-image, circulation, and skin integrity.

Bathing Techniques

• Complete Bed Bath: Nurse assists entirely.

• Partial Bath: Nurse cleans areas patient can't reach.

• Self-help Bath: Patient does most with some help.

• Back Rub: Promotes relaxation and circulation.

Perineal Care

• Always cleanse front to back.

• Female: Labia majora → minora → meatus.

• Male: Clean tip in circular motion, retract foreskin if uncircumcised.

• Catheterized patients: Clean around catheter and perineum.

Oral Care

• Conscious: Upright position.

• Unconscious: Side-lying to prevent aspiration; never put fingers in mouth.

• Dentures: Handle gently, store in labeled container with water.

Hair, Nail, Ear, Eye Care

• Hair: Maintain hygiene and assess for scalp issues.

• Nails: Don't trim unless allowed; inspect for circulation.

• Eyes: Wipe inner to outer canthus with no soap.

• Ears: Clean external ear only; no objects inside.

Older Adult Considerations

• Additional info: Older adults may require modified hygiene techniques due to skin fragility, mobility limitations, and cognitive changes.