HSR-320 Goodwin College – You are a home health care nurse visiting the home of an 86-year-old retired waitress to determine what alterations may need to be made to her environment

QUESTION

You are a home health care nurse visiting the home of an 86-year-old retired waitress to determine what alterations may need to be made to her environment. She was recently discharged from a rehabilitation facility where she received therapy after her stroke. She greets you at the door of her one-story house, proudly sharing that she has lived there for 65 years. Following her inside, you note that she exhibits minimal left-sided weakness but ambulates with a quad cane. You observe a clean but cluttered home with many pictures and memorabilia of her extensive family. Scattered throughout the home are colorful throw rugs, which she indicates help cover the stains from “accidents” of her two cats and one small dog, who seem devoted to her and follow her every move. As you visually scan her kitchen, you note her several medication bottles scattered throughout. In her bedroom, you note two electrical outlets to which are connected an alarm clock, a radio, a small television, a telephone and detached answering machine, an air conditioner, an oscillating fan, and her cell phone charger. Due to her extensive appliance use within her bedroom, you observe three extension cords crossing the room to connect to the outlets.

1. List data pertinent to your safety assessment.
2. How might her safety be jeopardized by objects within her home?
3. Detail potential strategies to increase her ambulation safety.
4. How might she increase her safety in her kitchen?
5. Outline strategies that could increase her safety in her bedroom.

ANSWER

 Enhancing Safety for an Elderly Stroke Survivor: Assessing Home Environment

Introduction

As a home health care nurse, ensuring the safety of patients in their living environment is crucial. This essay examines the case of an 86-year-old retired waitress who recently suffered a stroke and returned home after rehabilitation. We will discuss the data pertinent to the safety assessment, identify potential safety risks within her home, and outline strategies to enhance her safety in ambulation, the kitchen, and the bedroom.

Data Pertinent to Safety Assessment

To conduct a comprehensive safety assessment, the following data is pertinent to consider:

Physical Condition: The patient exhibits minimal left-sided weakness and uses a quad cane for ambulation.

 Home Environment: The home is clean but cluttered, with numerous pictures and memorabilia. Colorful throw rugs are scattered throughout the house. The patient owns two cats and one small dog.

 Medication Management: Several medication bottles are found scattered throughout the kitchen (Toney-Butler, 2022).

Electrical Setup: The bedroom contains multiple electrical appliances connected to outlets, with extension cords running across the room.

Safety Risks within the Home

The following objects and conditions within the patient’s home pose potential safety risks:

Throw Rugs: The presence of colorful throw rugs increases the risk of falls, especially given the patient’s ambulation challenges and the potential for tripping.

Medication Scattered Throughout: Dispersed medication bottles in the kitchen pose the risk of medication errors or accidental ingestion (Gershon, 2008).

Electrical Setup and Extension Cords: The excessive use of electrical appliances and extension cords in the bedroom increases the risk of tripping, electrical hazards, and potential fire hazards.

Strategies to Increase Ambulation Safety

To enhance ambulation safety for the patient, the following strategies can be implemented:

 Clear Pathways: Remove or secure the colorful throw rugs to provide clear and unobstructed pathways, reducing the risk of tripping and falls (Morris & O’Riordan, 2017).

 Assistive Devices: Encourage the consistent use of the quad cane to provide stability and support during ambulation.

Home Modifications: Consider installing grab bars or handrails in critical areas, such as the bathroom, to provide additional support and stability.

Strategies to Increase Kitchen Safety

To improve kitchen safety, the following strategies can be employed:

Medication Organization: Implement a medication management system to ensure proper storage and organization of medications, minimizing the risk of errors or accidental ingestion (Preventing Falls at Home: Room by Room, n.d.-b).

Clear Countertops: Encourage the patient to declutter the kitchen countertops to reduce the risk of objects falling and causing injury

Labeling and Identification: Label medication bottles clearly and place them in a designated area to facilitate easy access and prevent confusion.

Strategies to Increase Bedroom Safety

To enhance safety in the bedroom, the following strategies can be considered:

Electrical Management: Relocate or reorganize electrical appliances to reduce the need for extension cords and prevent tripping hazards (Preventing Falls at Home: Room by Room, n.d.-b).

 Outlet Safety: Ensure that outlets are not overloaded and recommend using surge protectors with built-in circuit breakers to prevent electrical hazards.

Cord Management: Secure and organize cords to minimize the risk of tripping and potential falls.

Conclusion

Assessing the home environment of an elderly stroke survivor is crucial for ensuring their safety. In this case, identifying potential risks and implementing targeted strategies can significantly enhance the patient’s safety. By addressing concerns related to ambulation, kitchen safety, and bedroom hazards, healthcare professionals can promote a safe living environment and support the patient’s overall well-being.

References

Gershon, R. R. (2008, August 1). Home Health Care Patients and Safety Hazards in the Home: Preliminary Findings. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 1: Assessment) – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK43619/

Morris, R., & O’Riordan, S. (2017). Prevention of falls in hospital. Clinical Medicine, 17(4), 360–362. https://doi.org/10.7861/clinmedicine.17-4-360

Preventing Falls at Home: Room by Room. (n.d.-b). National Institute on Aging. https://www.nia.nih.gov/health/preventing-falls-home-room-room

Toney-Butler, T. J. (2022, August 29). Nursing Admission Assessment and Examination. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK493211/

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