Maintaining a safe environment

Abstract

INTRODUCTION Managing our own safety is thought to be a basic survival skill, which all individuals possess. We are not aware of managing our physiological homeostasis (for example, ensuring that our body cells are supplied with sufficient oxygen to produce the energy they need to function), and spend years learning to calculate and avoid risk from the external environment, The ability to control safety, including physiological homeostasis, and using physical ability and intellectual ability to manage risk, depends on a person’s stage in their lifespan development, their physical and mental wellbeing, their cognitive ability and the ability to control environmental factors such as housing, traffic, pollutants and even conflict. Throughout the world there are many differences in the types of hazards and risks that people are exposed to and just as many differences in the way that people manage their own safety. The inclusion of this AL in the Roper et al (1996, 2000) model is to draw your attention to the importance of being able to recognise the threats that exist to human survival and wellbeing and identify the impact that this may have upon any individual at any given time in their lives. In order to develop the knowledge that you need to apply it to your nursing practice, you will also need to read about the underlying physiology (how the body functions), pathophysiology (the disease process), psychology (thoughts, feelings and behaviours) and nursing practice in more depth. Several health psychology and psychology for nursing texts are referred to throughout this chapter, but physiology, pathophysiology and nursing practice are underpinned by core texts (Brooker & Nicol, 2011; Waugh & Grant, 2014). By understanding the processes involved in maintaining a safe internal and external environment for the person, you will learn to assess risk and plan care to maintain the safety of your patients. The model helps us to develop our understanding by focusing upon three key areas: • the human body's ability to protect itself and the biological mechanisms that it employs to carry this out • the ability that individuals have to make choices and take action to keep safe and free from danger • the identification and understanding of the dangers and hazards that exist in the surrounding environment (including the health care environment) and how they pose a threat to individual safety and wellbeing. These three areas will be discussed throughout this chapter within the framework of the model and will help to develop an understanding of the AL and enable nursing interventions to be as individualised and effective as possible. Often concern for our own health and safety only becomes heightened when we become ill, have an accident or hear about a tragedy or event that has had terrible human consequences. However, patient safety is essential for high quality health care, and a requirement in the United Kingdom Code for Nurses, Midwives and Health Visitors (Nursing and Midwifery Council, 2015) is to make the care and safety of people our main concern. Therefore, in nursing, we need to be able to assess and prevent risk, whether it arises from the person’s own health needs, or from the care we give and the way in which we give it. By using the framework of the Roper et al (1996, 2000) model in the following way we can begin to examine and identify how complex and varied health and safety issues really are and also identify the interrelatedness that exists between the other ALs. This chapter will therefore focus on the following: 1 The model of living • maintaining a safe environment in health and illness across the lifespan • dependence and independence in the activity of maintaining a safe environment • factors influencing the activity of maintaining a safe environment. 2 The model for nursing • the nursing care of individuals with health problems that affect their ability to undertake the activity of maintaining a safe environment • understanding of the hazards in the health care setting and how to promote patient safety effectivel