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Organizational Influences > Culture Of Safety/patient Safety > Flashcards

Culture Of Safety/patient Safety Flashcards

1
Q

What is culture of safety?

A

Focuses on the care that was delivered

Communication about errors/near misses and actual harm without discipline

How care will be changed to avoid reoccurrence

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2
Q

How does the AORN advocate for both patient and worker safety?

A

Evidence based practice guidelines

Associations mission statement, position statements and took kits

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3
Q

What does the AORN provide to help achieve workplace safety?

A

Provide a standardized foundation to help deliver safe patient care

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4
Q

What are the US regulatory organizations at a state level?

A

Public health departments
Insurance commissioners
Licensing boards

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5
Q

What are US accreditation agencies?

A

The joint commission
Accreditation association for ambulatory health care
Accreditation commission for health care
DNV GL

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6
Q

What are US professional organizations?

A

AORN

Ambulatory surgery centre association

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7
Q

What does WHO focus on?

A

Safety
Checklists
Communication tools

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8
Q

What is the 3 step universal protocol for site marking and who came up with it?

A

The joint commission

  1. Verification
  2. Site marking
  3. Time out
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9
Q

Verifying patient?

A

2 identifiers

Name
DOB
Hospital number

Involve patients and/or family when possible

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10
Q

What are some key components to site marking?

A 
2 identifiers 
Identifying right site 
-include patient when able
Done by surgeon before procedure 
Must be visible after prep and draping
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11
Q

The institute of medicine (IOM) published report:
To Err is human..
what did that report identify?

A

To prevent errors safer system must be identified

When error occurs system needs to be examined

Standardization of process can improve safety

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12
Q

Human factors effects on patient safety?

A

Skill based
- has knowledge for action and attention was diverted

Knowledge based

  • errors in perception, judgement or interpretation
  • further training may fix

Situational factors
- lack of attention and situational factors play time in error

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13
Q

What are some elements that promote culture of safety in Perioperative setting?

A 
Correct cleaning/care of instruments 
Effective communication 
Fall prevention 
Fire safety 
Infection prevention 
Patient centred 
Patient handling/movement 
Safe sharps 
Appropriate staffing 
Teamwork
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14
Q

Unrestricted zones?

A

Public hallways/waiting areas

No dress code

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15
Q

Semi-restricted zone?

A

Surgical attire is required

  • scrubs
  • hair covering
  • clean shoes

Secured by public access without approval

Ex. Hallway leading to OR, supply rooms

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16
Q

Restricted zone?

A

OR’s

Dress code, PPE

  • scrubs
  • hair covering
  • clean shoes
  • surgical mask and eye wear
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17
Q

What is HVAC?

A

Heating
Ventilation
Air conditioning

18
Q

What is the temp of an OR?

A

20-24 degrees C

Or

68-76 degrees F

19
Q

What is the humidity range in an OR?

A

20-60%

20
Q

How many air exchanges happen in an OR?

A

A minimum of 20 air exchanges per hour with a minimum of 4 outdoor exchanges per hour

21
Q

True or false.

OR’s are negative pressure rooms?

A

False

OR’s have positive pressure rooms that moves from restricted to unrestricted areas

22
Q

Transferring patient to OR safety?

A

Cover patients hair
Keep away from sterile equipment
Ensure bed locked

If patient able to transfer self safely let them otherwise ensure enough people/equipment use to safely move

23
Q

Max weight 2 hands can lift?

A

22.2lbs

24
Q

Most weight 1 hand can lift?

A

11.1 lbs

25
Q

What is the Briefing period?

A

Done before procedure
Patient awake
Involves all team members

26
Q

What are some things covered in briefing period?

A 
Patient Verification
Consent 
Procedure
Site marked
Allergies 
Medications - pre op abx
Anesthetic equipment ready 
Monitors ready 
Patient imagining and bloodwork done 
Warming 
VTE prophylaxis
27
Q

Time out?

A 
Pause right before start of procedure 
Patient asleep 
Final assessment 
- right patient
- correct site
- correct position 
- correct procedure
28
Q

How long do you give antibiotics prior to procedure?

A

30min prior to cutting

29
Q

4 stages of surgical checklist?

A

Pre procedure check in
Briefing
Time out
Debriefing

30
Q

What is covered in debriefing?

A 
Procedure
Unexpected events 
Total blood loss
Wound class 
Counts 
Specimens collected 
Anesthesia review 
- how much used
31
Q

3 most common types of distractions that affect patient safety?

A

Distractions
Interruptions
Noise

32
Q

Where are fires most common on patient?

A

Above xiohoid process

Head, neck or upper chest

33
Q

Where can fires occur in OR?

A

On or in patient

  • surgical drapes, patients skin or body cavity
34
Q

Fire triangle?

A

Ignition source
Ex. Lasers

Oxidizer
Ex. O2, nitrous oxide

Fuel
Ex. Alcohol prep, drapes

35
Q

What time of emergency carts are there?

A

Code cart
Difficult airway
Malignant hyperthermia
LAST

36
Q

What is LAST?

A

Local anesthetic systemic toxicity

Needs 20% lipid emulsion

37
Q

What is malignant hyperthermia?

A

Biochemical chain reaction triggered by anesthesia

Treated with dantrolene sodium

38
Q

What are social determinants of health?

A

Economic and social conditions that influence individual and group differences in health status

Health factors found in ones living and working conditions

39
Q

What are some social determinants of health?

A

Where they work
Where they are born
Where they grow up
Where they they live

Affect..
Education
Employment opportunities
Living conditions 
Access to health care
40
Q

What are some S&S of malignant hyperthermia?

A 
Severe muscle rigidity or spasms
Rapid, shallow breathing
Rapid heart rate
Abnormal heart rhythm
High body temperature.
Excessive sweating
Patchy, irregular skin color (mottled skin)
41
Q

What are S&S of LAST?

A 
agitation/confusion
dizziness/drowsiness
auditory changes/tinnitus
perioral numbness
metallic taste
dysarthria

Untreated: seizures, respiratory arrest and coma

Organizational Influences (1 decks)

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