Chapter 27 Patient Safety Flashcards

1
Q

Define safety:

A

often defined as freedom from psychological and physical injury, is a basic need

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2
Q

Safety in Health Care Organizations:

A
Performance Improvement
Risk management and safety reports
Current reliable technology
Evidence-based practice
Safe work environment
Adequate staff education
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3
Q

QSEN

A

Quality and Safety Education for Nurses

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4
Q

Future Nurses need what to promote safety?

A

knowledge, skills, and attitudes

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5
Q

What is essential for QSEN?

A

continuous improvement

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6
Q

QSEN minimizes risks of harm to

A

-patients and providers by:
system effectiveness
individual performance

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7
Q

In patient safety, critical thinking is a

A

on going process

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8
Q

Standards of critical thinking have been developed by

A

ANA and TJC

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9
Q

Use of what is important when planning care that promotes safety?

A

Nursing process

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10
Q

Safety in Health Care Settings:

A
  1. reduce incidence of illness and injury
  2. prevents extended length of treatment/stay
  3. improve or maintain functional status
  4. increases patient’s senses of well-being
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11
Q

A Safe Environment includes meeting patient’s

A

physical and psychosocial needs

patient’s and health care provider’s well being

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12
Q

The environment applies to

A

all places where patients receive care

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13
Q

The environment reduces

A

risk of injury and transmission of pathogens

and maintains sanitation and reduces pollution

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14
Q

Basic Human Needs

A

Oxygen
Nutrition
Temperature

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15
Q

Oxygen:

A

Low concentration: hypoxia
High concentration
Carbon monoxide

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16
Q

Nutrition:

A

Proper Storage
Proper refrigeration: FDA
Preparation area
5,000 deaths per year

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17
Q

FDA

A

Food and Drug Administration

  • regulations for food producers
  • US most safest of foods but still deaths
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18
Q

Temperature:

A

Normal: 65 and 75 F comfort zone
Hyperthermia
Hypothermia: core temp is 35 C (95 F)
Frostbite

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19
Q

Physical Hazards

A
Motor vehicle accidents
Poison
Falls
Fire
Disasters: natural or man-made
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20
Q

Poison

A

any substance that impairs health or destroys life when ingested, inhaled, or absorbed by the body

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21
Q

Transmission of Pathogens:

A

pathogens and parasites passed by through contact

most common is by hands

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22
Q

pathogen:

A

any microorganism capable of producing an illness

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23
Q

Immunization:

A

reduces and some cases prevents the transmission of disease from person to person

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24
Q

Pollution has

A

pollutants

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25
Q

Pollutants

A

harmful chemical or waste material discharged into the water, soil, or air

26
Q

Risks at Developing Stages:

A
Children less than 5 years old: poisoning - don't know labels 
School Age Child: head injuries
Adolescent: substance abuse
Adult: usually due to lifestyle habits 
Older Patient
27
Q

Individual Risk Factors:

A

Lifestyle
Impaired Mobility
Sensory or Communication Impairment
Lack of Safety Awareness

28
Q

The Joint Commission Patient Safety Goals for Hospitals:

A
  1. Identify patients correctly
  2. Improve staff communication
  3. Use medicines safely
  4. Reduce the risk of health care– associated infections
  5. Check patient medicines
  6. Identify patient safety risks
29
Q

NQF

A

National Quality Forum: procedure to report an event

improves quality of care by building consensus, endorsing national standards, promoting goals

30
Q

NQF also lists serious re-portable events (SREs):

A

Surgical events
Product or device events
Patient protection events: wrong person discharged
Care management events:disability with medication reaction
Environmental events: o2, burns, restraints, electric shock
Criminal events: diagnosing breast cancer when healthy for money

31
Q

CMS list of “Never Events”

A

The Centers for Medicare and Medicaid Services

  • “never events” should never occur
  • denies hospitals higher payments resulting from by a never event
32
Q

Risks in Health Care Agencies:

A

Falls
Patient-inherent accidents: self-harm
Procedure-related accidents: caused by providers
Equipment-related: malfunction, misuse

33
Q

Other risks in agencies:

A
Chemical use (Material Safety Data Sheets MSDS)
Medical Errors
34
Q

Medical errors include:

A

infection

bed sores failure to diagnose and treat in time

35
Q

Assessment:

A

Through the patient’s eyes
Patient’s home environment
Nursing History

36
Q

Assessment questions:

A

activity and exercise
medication history
history of falls
home maintenance and safety

37
Q

health care environment:

A

risks in immediate environment
risks for falls
risk for medication errors
disaster preparedness: disease, not epidemic

38
Q

Diagnosis:

A
risks for falls
impaired home maintenance
risk for injury 
deficient knowledge
risk for poisoning 
risk suffocation
risk for trauma
39
Q

Planning:

A

Goals and outcomes
setting priorities
teamwork and collaboration

40
Q

Goals and outcomes:

A

prevent and minimize safety threats
measurable and realistic
may include active patient participation

41
Q

Setting priorities:

A

plan based on developmental stage, level of health, lifestyle, and cultural needs

42
Q

Teamwork and collaboration:

A

with coworkers, patient, family

43
Q

Implementation: QSEN

A

demonstrates effective use of technology and strategies to reduce risk of harm of others, strategies to reduce reliance on memory

44
Q

Implementation: Health promotion

A

individualization of implementation:

  • developmental stage
  • life style
  • environment: basic needs
  • general preventive measures
45
Q

General preventive measures:

A

lighting
changing the environment
organization

46
Q

Acute care safety:

A
Fall risk prevention: canes, walkers
Restraints are last resort 
Restraint alternatives
Seizures
Poisoning
Electrical hazards
Radiation
Disasters
47
Q

Restraint:

A

any manual method, physical, or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely

48
Q

Alternatives to restraints:

A
Explain all procedures
Use trained sitters
Music
Put near nurses station
Simple calm statements
Use time-out techniques
Appropriate visual or audio stimuli 
remove cues that promote leaving
promote relaxation techniques
institute exercise schedules
attend frequent to toileting, food, liquid
camouflage intravenous lines with clothing
ensure effective pain management
reassess physical status and review lab findings
49
Q

Hospitals must have an

A

emergency management plan

50
Q

Seizure:

A

hyper-excitation and disorderly discharge of neurons in the brain leading to a sudden, violent, involuntary series of muscle contractions that is episodic

51
Q

Aura:

A

bright light, smell, or taste during a seizure

52
Q

Status epilepticus:

A

prolonged or repeated seizures

53
Q

Seizure precautions:

A

encompass all nursing interventions to protect patient form traumatic injury

54
Q

RACE:

A

Rescue patients
Activate alarm
Confine fire
Extinguish

55
Q

PASS:

A

Pull
Aim
Squeeze
Sweep

56
Q

A newly admitted patient was found wandering the hallways for the past two nights. The most appropriate nursing interventions to prevent a fall for this patient would include:

A

use an electronic bed monitoring device

57
Q

Evaluation:

A

Through the patient’s eyes

Patient outcomes

58
Q

Evaluation: through the patient’s eyes:

A

are the patient’s expectations met?

are the family’s met?

59
Q

Evaluation: patient outcomes:

A

monitor care by the health care team
measure outcomes for each diagnosis
continually assess needs for additional support

60
Q

A nurse floats to a busy surgical unit and administers a wrong medication to a patient. This error can be classified as:

A

A procedure related accident

61
Q

expected outcomes:

A

a safe physical environment
a patient whose expectations have been met
a patient who is knowledgeable about safety factors and precautions
a patient free of injury