Risk for Injury

 

Risk for Injury

Vulnerable for injury as a result of environmental conditions interacting with the individual’s adaptive and defensive resources, which may compromise health.

Instead of being viewed as a major public health problem, injuries have been recognized as inevitable accidents that happen in our daily life. However, a considerable epidemiological and medical study has shown that injuries, unlike accidents do not occur by chance. Like any disease, the risk of injury follows a predictable pattern, thus making them preventable.

Implementation of favorable injury prevention program is an important part of nursing care in any healthcare setting and needs a multifaceted approach. Nurses also have a significant role in educating patients, families, and caregivers about the prevention of falls beyond the care continuum.

Risk Factors

Here are some factors that may be related to Risk for Injury:

External

• Biological (e.g., immunization level of community, microorganism)
• Chemical (e.g., pollutants, poisons, drugs, pharmaceutical agents, alcohol, caffeine, nicotine, preservatives, cosmetics, and dyes)
• Mode of transport or transportation
• Nutrients (e.g., vitamins, food types)
• People or provider (e.g., nosocomial agents, staffing patterns, cognitive, affective and psychomotor factors)
• Physical (e.g., design, structure, and arrangement of community, building, and/or equipment)

Internal

• Abnormal blood profile (e.g., leukocytosis/leukopenia)
• Altered clotting factors
• Biochemical, regulatory function (e.g., sensory dysfunction, integrative dysfunction, effector dysfunction, tissue hypoxia)
• Decreased hemoglobin
• Developmental age (physiological, psychosocial)
• Immune-autoimmune dysfunction
• Malnutrition
• Physical (e.g., broken skin, altered mobility)
• Psychological (affective orientation)
• Sickle cell
• Thalassemia
• Thrombocytopenia

Goals and Outcomes

The individual relates fewer or no injuries, as evidenced by the following indicators:

• Patient remains free of injuries.
• Patient explains methods to prevent injury.
• Patient identifies factors that increase risk for injury.
• Patient relates intent to practice selected prevention measures.
• Patient increases daily activity, if feasible.

Nursing Assessment

A detailed assessment that identifies the individual’s risk factors for injury. This will assist with clinical decision-making by indicating which interventions should be included in the care plan.

Assessment	Rationales
Assess general status of the patient.	This is to determine the patient’s condition that may cause injury.
Assess mood coping abilities, personality style that may result in carelessnes.	Mood coping abilities and style of personality aid to determine the patient’s level of cooperation.
Recognize racial/ethnic diversity at the onset of care.	Discovering race/ethnicity issues will enhance communication, establish rapport, and promote treatment outcomes.
Evaluate the importance of cultural beliefs, norms, and values on the patient’s perceptions of risk for injury.	What the patient considers risky behavior may be based on cultural perceptions.
Determine whether exposure to community violence is contributing to risk for injury.	Exposure to community violence has been associated with increases in aggressive behavior and depression.
Check on home environment for threats to safety: clutter, improper storage of chemicals, slippery floors, scatter rugs, unstable stairs and stairwells, blocked entries, dim lighting, extension cords across pathways, hazardous electrical or gas connections, unsafe heating devices, inappropriate oxygen placement, high beds without rails, extremely hot water, pets, and pet excrement.	Patients experiencing impaired mobility, impaired visual acuity, and neurological dysfunction, including dementia and other cognitive functional deficits, are at risk for injury from common hazards.

 

Nursing Interventions

The following are the therapeutic nursing interventions for Risk for Injury:

Interventions	Rationales
Thoroughly conform patient to surroundings. Put call light within reach and teach how to call for assistance; respond to call light immediately.	The patient must get used to the layout of the environment to avoid accidents. Items that are too far from the patient may cause hazard.
Avoid use of restraints. Obtain a physician’s order if restraints are needed.	If patients are restrained, they can sustain injuries, including strangulation, asphyxiation, or head injury from leading with their heads to get out of the bed.
In place of restraints, utilize the following: Alarm systems with ankle or wrist bracelets Bed or wheelchair alarms Increased observation of patient Locked doors to unit Bed with wheels removed to keep bed low (NOTE: may not be acceptable with fire regulations)	These are alternatives to restraints that can be helpful for preventing falls and injuries.