Fundamentals - Principles, part 14: Sharps Injuries, Body Mechanics, and Brachytherapy

by Meris Shuwarger July 19, 2021

Full Transcript

Hi. I'm Meris and in this video, we're going to be talking about sharps injuries, proper body mechanics, and caring for patients undergoing internal radiation sometimes called brachytherapy.

I'm going to be following along using our Nursing Fundamentals flashcards. These are available on our website LevelUpRN.com. If you already have them and you want to follow along with me, I'm starting on card number 39. So let's get started.

Okay, so first up we're talking about sharps injuries. Now, these are very important to understand how to prevent as well as how to care for them.

So first and foremost most things in the hospital that could hurt you have some kind of a safety function. So if you are starting an IV or giving a medication that has a needle you very likely are using some kind of a system that has a safety feature. So be sure to use that safety feature. Deploy it immediately after you are done with the needle.

Also, we don't recap needles whenever possible. In the NCLEX world you're never recapping a needle.

And if for some reason you did need to recap it you would use the scoop or swoop method where the cap is going to be laying on the table and using one hand you're going to try and scoop up the cap onto the needle and then once it's already on the needle then you would cap it.

That's only if it is completely unavoidable. We also dispose of everything immediately in the sharps container. And when it is full we report that so that can be replaced. Very important.

Now, what do I do if I get a sharps injury? So the first thing I'm going to do, I'm immediately going to rinse my hand or wherever I was injured, using either water or normal saline.

And then, I'm going to go immediately to a charge nurse or nurse manager, whoever is directly above me in that moment, and report the injury, even if you don't think it's a big deal, even if there was no patient blood on it or anything.

You're reporting it no matter what because there are serious complications that can come from sharps injuries, and you need to make sure that you undergo post-exposure prophylaxis.

This might mean blood work. It might mean medications. There's a lot of things that can be done to see if you have any sort of complications from your injury and if you need any treatment.

So always, always, always report it to whoever is your immediate supervisor after it happens.

Okay. So moving on, we're going to be talking about proper body mechanics.

It's very important to understand proper body mechanics because this is how to protect you, yourself, as a care provider. So one of the things we want to do is make sure that our feet are shoulder-width apart. That gives us a nice, wide base of support. We never want a narrow base.

If we ever have to lift anything, we're going to do that using our legs by squatting, and not our backs by bending over. We always want to make sure to raise the bed to an appropriate height when we provide care.

You only have one back so protect it because, yes, maybe one time bending over to do something for your patient is not going to hurt your back forever, but if you're doing it all the time, you're really going to hurt your back.

So make sure that you raise the bed up to your waist level when you're providing care so that you are not bending over.

Any time you need to ambulate a patient or anything like that, make sure you have an appropriate number of care providers to help you.

And then also, we pivot slightly when we are moving a patient, but we never want to twist at the spine. A little bit of a pivot is okay, but anything where we are actively twisting and our base of support is not moving, that's not going to be in our best interest.

Okay. So moving on now to card number 41. I'm going to tell you right now, this card is covered in red text because this is very important for your nursing exams and the NCLEX.

This is a concept that I personally struggled with a lot. It took a lot of review because there's a lot of stuff to know about it, so if you find that this concept is tricky for you, definitely keep practicing.

So internal radiation, sometimes called brachytherapy, is going to be when a patient is given a sealed radioactive device that is placed inside their body in some capacity in order to provide short-term but targeted radiation therapy.

Very important things to know because this is going to be really dangerous. Right? This is dangerous because it's radioactive.

So the patient should be kept in a private room with the door closed meaning that we are not giving a semiprivate room, they don't have a roommate, and that door is kept shut at all times.

We're going to cluster our care so that we can get lots of things done at once so we're not going in and out of the room multiple times because we want to limit our care time to 30 minutes total if we can in that room.

Obviously, that's not always going to be possible but that's kind of the standard we're hoping for.

When you go into a patient's room you as the care provider should wear a dosimeter badge.

A dosimeter badge is going to tell you how much radiation you have been exposed to. So I don't need my patient to wear it because we already know they're being exposed to the radiation.

But I need to know in case I'm being exposed to unsafe levels of radiation.

The other thing is that I should be wearing a lead apron at all times. And if you've ever worn one you know that it completely covers me in the front but it does not cover my back all of the way.

So I want to make sure that I am facing the patient at all times not turning my back to them because then my back could be being irradiated when I am looking away from them.

When it comes to visit visitors. Visitors must be six feet away from the patient at all times, and they should limit their visits to less than 30 minutes.

No children under the age of 18 should be going in, and nobody pregnant, care providers or visitors, should be going in.

We do not send pregnant people into the patient's room if they are having brachytherapy.

And then one more super important thing to know, if that radiation implant should become dislodged and now it is out of the patient, on the floor, something like that, I'm going to want to use long-handled tongs to pick it up and place it in a lead container, meaning the lead container should be in the room already, and then I call the provider.

The first thing I need to do is provide for the patient's safety and my safety by making sure that that implant goes in a lead-lined container so that it is not irradiating everybody around.

Okay. So that is it for sharps injuries, body mechanics, and brachytherapy. I hope that review was helpful. This is all very important information.

So if you like this video, please give it a like. And if it's there's something that helped you remember one of these concepts, I would love to hear it in the comments below. It would make my day.

In my next video, we're going to be talking about the nursing process, the interdisciplinary team, SBAR communication, and continuity of care.

We're going to be transitioning from the principles section of the deck to the practice and skills section of the deck. So you don't want to miss it, I promise you. Make sure you subscribe to the channel to be the first to know. Thanks so much, and happy studying!


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