Ch 37. Patient Saftey

Question 1

6 Domains of quality of care

Answer 1

1) Accessibility right to care receive at right time/setting nd by right person
2) Effectiveness, -care recived the expected benifit
3) Efficiency – care is waste free (time/supplies)
4) Patient safety- harm avoid
5) Patient-centred care – respectful and repponsive to patients wants/vlaues
6) Equitability – care received regardless of gener/socioec status, etc.

Question 2

Factors influencing safety -5

Answer 2

1) Patient and provider factors – characteristics of the individual (age, culture)
2) Task factors –characteristics of tasks that HCW has to perform (workload, having to give meds to patients in a short time when there’s a time constraint)
3) Technology factors – how advance is the tech (types, availability)
4) Environmental factors – features of work environment (lighting, layouts)
5) Organizational factors – company/hospitals organization/structure/policies

Question 3

Risks in health care settings: Staff

Answer 3

Environmental risk: Workplace Hazardous Materials Information System (WHMIS)
Infection prevention and control
Violence

Question 4

Risks in health care settings: Patient

Answer 4

Falls (up to 90% of reported incidents)
Procedure-related accidents  medication errors
Equipment-related accidents  lift break, wheelchair breaks (use manual procedures, but don’t take shortcuts with lifting)

Question 5

Safety Nursing Process: Assessment

Answer 5

Health history
Patient’s home environment
Health care environment
Risk for falls
Risk for medical errors – nurses respocibility to ensure they don’t occur
Patient expectations

Question 6

Developmental interventions 
Infants, toddlers, and preschoolers - ?
School-aged children – ?
Adolescents – ?
Adults – ?
Older persons – ?

Answer 6

Infants, toddlers, and preschoolers - poison
School-aged children – stranger danger, bike safety
Adolescents – learn make safe choices, suicide
Adults – lifestyle factors, stress, PPD, substance abuse
Older persons – fall risk, disease process, sensory issues

Question 7

Environmental interventions

Answer 7

Fire prevention
Basic needs: carbon monoxide detectors, food handling, adequate lighting, and security measures
Physical hazards
Transmission of pathogens

Question 8

Fall prevention Strategies

Answer 8

Stairs
Install treads with uniform depth. Uniform texture or plain coloured surfaces. Proper lighting. Adequate headroom so patient does not have to dock. Remove protruding objects from walls. Maintain outdoor walkways in good condition.

Handrails
smooth slip resistant handrail. Secure handrail firmly. Install grab rails in bathtubs and toilets. Install elevated toilet seat

Floors
shoes and slippers with non skid surface. Secure carpeting mats and tiles. Bathmats or strips on shower stall floors. Secure electric cords against baseboards. Good illumination

Facility Orientation
Disoriented patients placed near nurse station. Supervised confused patients. Show patient how to use call light. Bedside tables close to patients. Remove clutter. Leave one side railed up.

Transport
Lock beds and wheelchairs when transferring patient. Placed side rails up when transporting by stretcher