Ch 27 Patient Safety and Quality Flashcards
A basic review of key concepts from Nursing Fundamentals by Potter for Nursing 105 @ Schoolcraft College. Some answers are lengthy and really only require familiarization. This is not meant to be exhaustive.
Identify the Joint Commission 2021 National Patient Safety Goals
*Identify Patients Safely
*Improve Staff Communication
*Use Medicines Safely
*Use alarms safely
*Prevent Infection
*Identify patient safety risks
*Prevent mistakes in surgery
Maslow’s Hierarchy of Needs that influence a person’s safety most are:
Oxygen, Nutrition, Temperature
Name the five most common environmental hazards that lead to injury in America:
1) MVAs
2) Poison
3) Falls
4) Fire
5) Disaster
Define pathogen:
A microorganism that can cause disease
Define Immunization:
The act of making a person or animal resistant to a particular infectious disease or pathogen, typically by vaccination.
Define Pollutant:
A harmful chemical discharged into the soil, water, or air
In addition to being knowledgable about the environment, nurses must be aware of the patient’s:
1) Developmental level
2) Cognitive, mobility, sensory status
3) Lifestyle choices
4) Knowledge of common safety precautions
5) Limited economic resources
6) Workplace culture
Four major categories for violations of patient safety in the health care environment are :
1) Procedure related events
2) Equipment related events
3) Patient-Inherent Events
4) Falls
5) Chemical exposure (sometimes considered a procedure related event)
ADPIE
What are five things the nurse needs to assess when addressing patient safety?
1) Their perception of safety
2) Lifestyle
3) Medication History
4) History of Falls
5) Home Maintenance and Safety
ADPIE
What are six diagnoses that apply to patients whose safety is threatened?
1) Risk for Injury
2) Impaired cognition- confusion
3) Risk for poisoning
4) Lack of Knowledge
5) Risk for Fall
6) Impaired mobility
ADPIE
What are strategies for interventions that lead to safe nursing care?
CRED
a. Communicate observations of hazards to patients, families and the health care team
b.Reduce reliance on memory
c.Employ technology and standardized practices that support safety and quality
d.Demonstrate effective use of strategies to reduce the risk of harm to self or others
ADPIE
What are considerations a nurse needs to take when planning for patient safety?
1) Involve the patient
2) Make outcomes measurable and realistic
3) Focus on outcomes related to the safety risk diagnosis.
Nursing interventions aimed at eliminating environmental threats include:
1) Think of Maslow- Oxygen, Nutrition, Temperature
2) Modify the home to reduce fall risks
3) Take precautions against MVAs,Poison,Falls,Fire,Disaster
JCO wants a fall risk assessment performed when?
Upon admission and regularly until discharge
What is a physical restraint?
Any method, device, material or equipment that immobilizes or restricts movement of a patient’s arm, leg, head or body
What is a chemical restraint?
Medications that are not standard for the patient’s condition, but are given to modify their behavior.
Restraint use must meet one of these four objectives:
1) Reduce risk of patient injury from falls.
2) Prevent interruption of therapy
3) Prevent a confused or combative patient from removing life support equipment
4) Reduce risk of harm to others by patient
Thinking about how to respond to a fire, what does the mnemonic RACE stand for?
Rescue
Alarm
Contain
Extinguish
What are seizure precautions?
Stay- record time
Safe- Protect from sharp things, falls, etc
Side - If conscious, place on side to prevent aspiration
JCO requires that hospitals have an emergency management plan that addresses what:
a) Possible emergencies and their impacts
b) Maintenance of adequate supplies
c) A formal plan to restore services and resume normal operations
What is the temperature comfort zone of patients?
65-75 ℉
What is the comfortable humidity zone for patients?
60-70 %
What are common hazards for the infant/toddler/preschool population?
*poisoning & choking, fire, falls, lead poisoning , safe sleep
*Suffocation is #1 in infants
Drowning in toddlers
What are common hazards for the school aged population?
*school environment, bike & sport injuries, explore environment, risk for violence
- MVAs are leading cause of death by injury
What are common hazards for the adolescent population?
Leading cause of death from injury?
*risk taking behaviors, MVA
*MVAs are leading cause of death by injury
What are common hazards for the adult population?
lifestyle habits
*poisoning, MVAs, & falls are leading causes of death, in that order
What are common hazards for the older adult population?
physiologic changes associated with aging, multiple meds, psychological & cognitive changes, acute & chronic disease, sensory changes, falls
*Falls are the leading cause of death by injury
T or F : Always use the least restrictive restraint necessary.
True
Alternatives to the use of restraints include :
Frequent observations for needs like toileting
Place near nurses’ station
Ask Family to act as sitters
Re-orientation
Use of stimuli, i.e. TV
Camoflage iv lines, etc
Use protective devices like hip pads, helmets,
Remove bothersome treatments like foleys ASAP
How do you use a fire extinguisher?
PASS
Pull pin
Aim the snozzle
Squeeze the handle
Sweep from side to side
What are the three leading causes of death from injuries?
MVAs
Poisonings
Falls
What are risk factors for falls in order of importance?
Risk factors for falls in order of evidence strength include a history of falls, impairment in balance, reduced muscle strength, visual problems, polypharmacy (defined as taking over four medications) or psychoactive drugs, gait difficulty, depression, orthostasis or dizziness, functional limits, age over 80 years, female sex, incontinence, cognitive difficulties, arthritis, diabetes, and pain.
