Susceptible to bodily harm due to trauma, electrical discharges, changes in pressure, and / or radiation

• Cluttered environment
• Confusion
• Exposure to toxic chemicals
• Inaccurate follow-through of safety protocol
• Inadequate caregiver knowledge of safety precautions
• Inadequate knowledge of modifiable factors
• Inadequate knowledge of safety precautions
• Inadequate safety equipment
• Inadequate safety protocol
• Inadequate safety rails
• Inattentive to environmental safety
• Inattentive to safety devices during sports activities
• Malnutrition
• Physical barrier
• Psychomotor agitation
• Unsafe mode of transport

• Abnormal blood profile
• Altered mental status
• Altered psychomotor performance
• Biochemical dysfunction
• Decreased level of consciousness
• Effector dysfunction
• Hypoxia
• Medical devices
• Pharmaceutical preparations
• Sensation disorders
• Sensory integration dysfunction

• Age
• Gender
• Physical head-to-toe examination
• Patient's health status, including presence of acute or chronic illness and changes or deterioration in mental or physical functioning
• Developmental status, including cognitive abilities (language and reasoning), sensory perception, response to stimuli (pain, touch, and warmth), level of independence, and motor skills
• Health history, including accidents, falls, and exposure to environmental hazards
• Environmental factors, including household layout, electrical wiring, lighting, utilities, fire precautions, presence of toxic or noxious substances, medications, special safety needs, and childproofing
• Mental status, including mood, affect, thought processes, thought content, orientation, judgment, and ability to perform activities of daily living
• Knowledge level, including understanding of household safety precautions and automobile safety
• Participation in recreational activities, such as swimming, diving, motorcycling, bicycling, and contact sports
• Family status, including caregiver relationship to patient; time and resources available for caregiving; willingness and ability to meet patient's physical, social, and psychological needs; feelings of frustration; and history of abuse of any family member

• Patient will remain free from physical injury.
• Patient and family will follow safety precautions in and out of home.
• Patient and family members will develop strategy to maintain safety.

Suggested NOC Outcomes

• Assist patient and family to identify situations and hazards that can cause accidents to increase patient's awareness of potential dangers.
• Assess and document any motor, mental, or sensory deficits to identify specific safety needs.
• Assess patient for evidence of physical or mental abuse or neglect. Observe for bruises or abrasions, body odor, or a dirty, unkempt appearance to ensure safety and well-being.
• Question patient privately about findings to encourage trust and promote open communication.
• Encourage patient to make repairs and remove potential safety hazards from environment to decrease possibility of injury.
• Encourage adults to discuss safety rules with children. For example:
  • Don't play with matches.
  • Use electrical equipment carefully.
  • Know location of fire escape route.
  • Don't speak to strangers.
  • Dial 911 in an emergency.
  Teaching by parents fosters household safety.
• Improve environmental safety, as needed:
  • Orient patient to environment.
  • Assess patient's ability to use call bell, side rails, and bed positioning controls.
  • Keep bed at lowest level, and conduct close night watch. These measures will help patient cope with unfamiliar surroundings.
  • Teach patient and family about need for safe illumination.
  • Advise patient to wear sunglasses to reduce glare.
  • Advise using contrasting colors in household furnishings. These measures will enhance visual discrimination.
  • Test heating pads and bath water before using; assess extremities daily for injury to assist patient with decreased tactile sensitivity.
  • For patient with hearing loss, encourage use of hearing aid to minimize deficit.
  • Teach patient with unstable gait correct use of adaptive devices to decrease potential for injury.
• Promote electrical safety. Apply electrical outlet covers to all unused outlets. Inspect all electrical appliances brought from home and have them approved by a safety officer before use. Don't place liquids, jellies, or creams on electrical appliances. Finally, test all electrical equipment before using on a patient. Electrical appliances pose potential hazards for patient and staff members.
• Provide additional patient teaching as needed. Possible topics may include household, automobile, and pedestrian safety. Refer patient to appropriate resources (police, fire, and home health care agency) for more information. Health education can help patient take steps to prevent injury.
• Instruct the child and family members in standard safety practices, including
  • wiping up spills immediately.
  • providing nonslip surfaces in hallways, on stairs, and in bathtubs and shower stalls.
  • draining all water from bathtubs immediately after a bath.
  • placing toxic substances in locked cabinets or out of reach of the child. Teaching promotes household safety.
• Immediately report malfunctioning equipment to appropriate personnel for replacement or repair to help prevent accidents.
• Refer patient to appropriate community resources for more information about identifying and removing safety hazards. This enables patient and family to alter environment to achieve optimal safety level.

Suggested NIC Interventions

• Patient remains free from physical injury.
• Patient and family identify and eliminate safety hazards in their surroundings.
• Patient and family members demonstrate prevention and safety precautions.
• Children describe safety measures they have learned.
• Patient and family point out evidence of childproofing measures in home.
• Patient increases self-care activities within limits posed by sensorimotor limitations.

• Patient's statements about situations that cause accidents and injuries
• Patient's lack of awareness of, or disregard for, safety hazards
• Assessment of home environment
• Observation of physical findings
• Patient's and family members' knowledge of safety practices
• Patient's cognitive deficits that inhibit learning or attention to safety hazards
• Interventions to help patient recognize and eliminate safety hazards
• Patient's or family's response to nursing interventions
• Evaluations for expected outcomes

• Ambutas, S. (2017). Continuous quality improvement. Fall reduction and injury prevention toolkit: Implementation on two medical-surgical units. MEDSURG Nursing, 26(3), 175-197.
• Kahriman, I. L., & Karadeniz, H. (2018). Effects of a safety-awareness-promoting program targeting mothers of children aged 0-6 years to prevent pediatric injuries in the home environment: Implications for nurses. Journal of Trauma Nursing, 25(5), 327-335. doi:10.1097/JTN.0000000000000384
• Marshall, M., Cruickshank, L., Shand, J., Perry, S., Anderson, J., Parker, D., & de Silva, D. (2017). Assessing the safety culture of care homes: A multimethod evaluation of the adaptation, face validity and feasibility of the Manchester Patient Safety Framework. BMJ Quality & Safety, 26(9), 751-759. doi:10.1136/bmjqs-2016-006028
• Ruiz-Millo, O., Climente-Martí, M., & Navarro-Sanz, J. R. (2018). Patient and health professional satisfaction with an interdisciplinary patient safety program. International Journal of Clinical Pharmacy, 40(3), 635-641. doi:10.1007/s11096-018-0627-7