At risk for injury as a result of environmental conditions interacting
with the individual’s adaptive and defensive resources
• Biological: Community immu-
• Abnormal blood proﬁle:
nization level; microorganisms
Altered clotting factors;
• Chemical: Cosmetics; drugs,
decreased hemoglobin; leuko-
pharmaceutical agents; dyes;
alcohol, nicotine, preservatives;
cytosis/leucopenia; sickle cell;
• Biochemical dysfunction
• Human: Nosocomial agents;
• Immune or autoimmune
stafﬁng patterns; cognitive,
affective, psychomotor factors
• Developmental age: physiologi-
• Nutritional: Food types,
cal and/or psychosocial
• Tissue hypoxia
• Physical: Design, structure, and
arrangement of community,
building, and/or equipment
• Mode of transport
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Risk management
The patient will
• Acknowledge presence of environmental hazards in their everyday
• Take safety precautions in and out of home.
• Instruct children in safety habits.
• Childproof house to ensure safety of young children and
cognitively impaired adults.
SUGGESTED NOC OUTCOMES
Immune Status; Risk Control; Safety Behavior: Home Physical Envi-
ronment; Safety Behavior: Personal; Safety Status: Falls Occurrence;
Safety Status: Physical Injury
INTERVENTIONS AND RATIONALES
Determine: Help patient identify situations and hazards that can
cause accidents to increase patient’s awareness of potential dangers.
Perform: Arrange environment of patient with dementia to minimize
risk of injury:
– Place furniture against walls.
– Avoid use of throw rugs.
Maintain lighting so that patient can ﬁnd her way around room
and to bathroom. Poor lighting is a major cause of falls.
Prevent iatrogenic harm to hospitalized patient by following the
2007 National Patient Safety goals. This resource provides compre-
hensive measures designed to prevent harm.
Follow agency policy regarding the use of restraints—they are
generally used as a last resort after other measures have failed.
Agency policies will provide clear direction to use restraints safely.
Inform: Encourage adult patient to discuss safety rules with children
to foster household safety. For example:
– Don’t play with matches.
– Use electrical equipment carefully.
– Know location of the ﬁre escape route.
– Don’t speak to strangers.
– Dial 911 in an emergency.
Attend: Encourage patient to make repairs and remove potential
safety hazards from environment to decrease possibility of injury.
Manage: 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
SUGGESTED NIC INTERVENTIONS
Environmental Management: Safety; Fall Prevention; Health Educa-
tion; Parent Education: Adolescent; Parent Education: Childrearing
Family; Risk Identiﬁcation; Surveillance: Safety
Bright, L. (2005, January). Strategies to improve the patient safety outcome
indicator: Preventing or reducing falls. Home Healthcare Nurse, 23(1),
Yuan, J. R., & Kelly, J. (2006, February). Falls prevention, or “I think I can, I
think I can”: An ensemble approach to falls management. Home Healthcare
Nurse, 24(2), 103–111.