Final Flashcards
what areas can harm effect
physical, emotional, social, spiritual
Harmful incident
results in harm to a patient
Near miss
a safety incident that did not reach the patient and therefore no harm resulted
No harm incident
A patient safety incident that reached the patient but did no cause harm
A system grounded on safety does what?
Recognizes risks and acts on them
Adverse event
unexpected and undesired effect during the process of providing care
Contributing factor
the reasons, situations, factors or latent conditions that cause an adverse event
Critical incident
A serious incident resulting in the loss of life or a body part
Disclosure
A caregivers well-defined communication process to inform the patient and their families of a safety issue
Incident
An event, process, or outcome that creates a risk for patients
Patient safety
A practice designed to promote positive patient outcomes by reducing and intercepting harmful acts
Root cause analysis
A systematic process of investigating a critical incident to determine the multiple, underlying, and casual factors
Risk
probability of danger, loss, or life-threatening injury within healthcare
Risk management
an organizational strategy designed to reduce and prevent adverse events or moderate the actual financial losses following undesired outcomes
System failure
describes the entirety of health care process, operation, or structure that causes the patient or health care workers injury or undesired outcome
Swiss cheese model
(James reason), Holes are the holes in the safeguard, Harmful events can pass through each layer of the system. It takes multiple failures to lead to a patients harm. A fault, breakdown, or dysfunction
Domino theory
(WH Heinrich), Safety events take form in falling dominos. Each time it passes through a system a domino falls causing the next to fall and the domino begins and is not stopped.
Iceberg model
(Mr Smith), Above the water are the easy things to see for example wrong sling to emergency stop not working, Just under water line is things that are uncovered with deeper investigation that are indirect like no policy, poor mechanical lift, the deeper it goes is the the root analysis like unit short staffed, budget cut
Quality improvement
A range of strategies and techniques that are designed to improve patient safety and quality across systems
4 approaches to quality improvement
- Scientific approach and evidence based
- Emphasis on system not individual people
- A team work
- Continuous
Root cause analysis Process
Gather info, initial understanding, additional information, literature review, timeline and final understanding, determine contributing factors and root causes, formulate casual statements, develop actions
Disclosure
-How incident was handled, future plans to minimize the event of occurring again, regret the event occurred
Canadian Interprofessional health collaborative framework competencies
Role clarification, team functioning, patient/family/community centred care, collaborative leadership, and inter interprofessional conflict resolution
Role clarification
Knowing your own role and the role of others, communicate roles, knowledge and skills, access others skills
Patient/Client/family/community-centred care
-supports participants/ families, educate them, listen to all parties
Team functioning
understand team development, develop a set of principles , participate in a respectful manner, establish and maintain relationship
collaborative leadership
work with others to enable effective outcomes and team process, collaborative practice, work together for quality improvement
Interprofessional communication
Listening to others, ensure common understanding, develop a trusting relationship
Interprofessional conflict
recognize conflict and work to address, safe diverse environment, many different views should be heard.
ISBARR
Identification, situation, background, assessment, recommend/request, repeat back
Identification
name, who you are and why you are calling
Background
Admitted with (only what applies)
Situation
Current condition (what it is, why it is, how to serve) why you need them
Assessment
What the problem is (changes and stability)
Recommend/Request
What should be done?
Repeat back
To conform
Team work communication principles
ISBARR, Creating a healthy work environment, Barrier to professional communication, transforming the workplace environment
Creating a healthy work environment
civility is at the heart of this, CREST, (respect, engagement, support),
Barriers to professional communication
Incivilty is the most common barrier. Related to lateral violence, horizontal violence, relational aggression, and bullying
Transforming a work environment
effective and respectful communication is one approach to establishing civility
Communication styles
Nonconfrontal, cooperative and assertive strategies
Nonconfrontal
1.Placating: avoid conflict
2. Distracting: Attempt to avoid by being disruptive
3. Computing: Emotionally detaching from conflict. Being unapproachable.
4. Withdrawing: Responding in a negative way. “whatever” or sarcastic
Cooperative and assertive strategies
- controls emotions
- Self aware
3.others oriented - Focus on the issue not personality
- Use I language
- Focus on shared interest
- monitor your nonverbal behaviour
- Brainstorm for possible solution
- Apologize
- Present yourself as equal rather then superior
- seek collaboration
What is inter professional Collaboration
everyone sharing one interest working together as a team to come up with the best patient outcomes
Patient Safety
The reduction and mitigation of unsafe acts within healthcare, best practice to lead better patient outcomes
Patient Incident
Event or circumstance that can or will result in harm
Evidence-informed practice
Professional Practice should be based on the best available research evidence applied conjunction with client preferences, context, available resources, and practitioner expertise
Steps in EIP
- reflection
- framing the question
- searching for the literature
- Critical appraisal of the research literature
- Synthesis of findings from the divergent literature
- adaption of findings to practice
- Implementation of practice change
- Evaluation
- reflection
reflect on what topic you will choose. It is important to use proper terms and thin of things as a whole
2.framing the question
Think about all the different aspects that come into play. What are the different ways you can phrase it.
PICO
P: Client, population, participants
I: Intervention
C: Comparison
O: Outcome
The 6S Pyramid
-System, summaries, synopses of synthesis, synthesis, synopses of studies, studies
systems
client records and guidelines for care, give patient info. Found on the web.
Summaries
Text based and related to a specific disease or condition.
Synopses
brief report on the study, key method and results.
Synthesis
Systemic reviews that could be found on a particular focused question
Studies
THE GREATEST RANGE OF INFORMATION IS FOUND, related to particular focused questions
- Critical Appraisal of research literature
-Even peer-reviewed can have questionable methods
-Trusted source with a medical journal
-The process of deciding whether a journal is reliable or not
- Synthesis of findings from divergent literature
Systemic reviews:
-recent date
-review recent research
-High-quality information
Primary Studies:
-looking up the primary studies that were applied
- Adaption of finding to practice
“can I use this research with my clients?” look at participants in the study.
- Implement of practice change
What is the message?
To whom is the audience?
By whom is the messenger?
How transfer method?
With what expected impact evaluation?
-accepting change in practice
- Evaluation
evaluate any changes in client outcome
How do Nurses use evidence in practice
They use trusted sources to advance patient outcomes. They introduce, change, see impact and outcome and adjust from there
Steps in conducting research
- define question
- Conduct literature review
- Develop methods, info, and consent letters
- Get ethics approval
- Collect data
- Analyze data
- Write report
- Disseminate report
Regarding cultural safety what are nurses obligations
-Do not discriminate
-Respect unique history and interests
-do not engage in any form of lying, torture or punishment
-Aware of social positioning and attitude
Ethnicity
encompasses many different aspects such as race, organ, ancestry, identifying language, nationality, religion
What is a problem occurrence with ethnicity
people often assume what PEOPLE EAT, how their family functions, how death is ritualized, but it is more complex
what are 3 approaches to culture in healthcare
Cultural sensitivity, cultural competence, and cultural safety
aspects of Cultural sensitivity
-Diversity between groups
-People often disagree with assigned classification
-Many people do not do cultural practices
-not falsely assuming things
-Some cultural groups may find categorizing offensive
-Focuses on tightening emphasis on individuals, often in isolation of and over looking the broader context if peoples lives
-sensitivity and tolerability
definition of cultural safety
Being aware that cultural differences and similarities between people exist without assigning them a value – positive or negative, better or worse, right or wrong.
Cultural Competence
-understanding different cultures beliefs, values, and practices. Competence in learning about yourself, biases, and knowledge
Cultural safety
Dynamic and ever changing. Actively addressing inequitable power dynamics. Counteracts injustice. Refers to how a group is treated. Social, economic, influence on health. Individual discrimination. “Demeaned, disempowered, diminished” Reflection is essential
Health
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
Wellness
Evolving process of becoming aware and making choices toward fulfilling sense of individual life accomplishments. Physical and mental
wellbeing
presence of the highest quality of life
disease
the physiological deviation from normal that therefore objective or measurable
Illness
the subjective experience of living with a disease or condition and its accompany symptoms
Domains of wellness
Emotional, intellectual, occupational, physical, sexual, spiritual, environmental, social,
Emotional wellness
Understanding feelings and controlling them when necessary. Ex if someone is being rude to you and you get upset you are able to contain yourself
Intellectual wellness
the attaining of knowledge and the realization of creative potential are priority, and the ability to use critical thinking. Ex. in a pressure situation you can use your knowledge to make a good decision
Occupational wellness
-specifically to the value that individuals place on work whether paid or volunteer
-being satisfied through serving others
-Feeling satisfaction from giving your patient a dressing change
Sexual wellness
an approach to sexuality founded in accurate knowledge, personal awareness, and self acceptance such as ones behaviour, values, and emotions
-Central aspect of being human through out life that encompasses sex, gender, and identity
ex. accepting that you are a female
Spiritual wellness
holistic view of an individual, the person as a mingling of mind body and spirit
-I am a Christian and I choose to live my life like one
Environmental
use and need of nature resources, connected to the social determinants of health, health has to do with the environment.
Ex. if you have unhealthy living conditions then your health will have an effect
Social wellness
-concerns the relationship of the individual to others or the environment
Aspects: respect, cooperation, support and communication skills
ex. I have no friends because I can’t communicate in a healthy way
Acute illness vs Chronic
Acute illnesses generally develop suddenly and last a short time, often only a few days or weeks. Chronic conditions develop slowly and may worsen over an extended period of time—months to years.
describe the effects of illness on the roles and functions of individuals and families
3 factors they can effect
1) A family member who is ill
2) The seriousness and length of illness
3) Culture and social customs the family follows
-role changes
-task demand and time
-increased stress
-responsibility
-finances
-Loneliness
-change in social customs
describe how self-concept relates to health and illness
self-perceptions, appearance values, and beliefs that influence behaviour and are referred to when using the word I or me. It is Influences because illness can have a big impact on many of these contributors and effect your life in a Jurassic way
Self knowledge
inside into ones abilities, nature, and limitations
Self expectation
what one expects of oneself may be realistic or unrealistic
Social Self
how a persona perceives society
social Evaluation
The appraisal of oneself in relationship to others, events, or situations
Maslows heiarchy of needs
Physiological, safety, belongingness and love, esteem, Self actualization
Physiological needs
Food, warmth, water, rest what we need to survive
Safety needs
what we need to stay safe
Beloning and love needs
Intimate relationships and friends
Esteem needs
Prestige and feeling of accomplishment
Self actualization
Achieving your full potential including creative activities
Models of wellness
Clinical model, Role performance model, Adaptive model, Eudaimonistic model, AGEN-HOST-ENVIRONEMENT, illness-wellness,
Clinical model
Newest interpretation of health, views people physiological, identifies absence of illness and injury. Focusing on the relief of pain and symptoms.
Role performance model
People who can fulfill their roles are healthy even if they have clinical illness
Adaptive model
health is a creative process, disease is a failure in adaption. extreme good health is flexible adaption to the environment and interaction with the max advantage. Stability through growth and change.
Eudaemonistic model
Comprehensive view of health. health is the actualization or realization of a persons potential. Actualization (complete development). Ilness prevents this. Goal directed behaviour, self care, satisfying relationships
Agent-host-environemnet model
risk factors. Promote and maintain health.
1. agent: any envornemntal factor or stressor
2. host: A person or people who may or may not be at risk of requiring a disease
3. Environmental: Includes all factors external to the host that may or may not cause them to develop a disease
Critical thinking
assess, analyze, and process. Guided my client situation and needs, becomes easier with practice. actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action
Reflection
taking the bigger picture and understanding all of its consequences, thinking deeply about something
Reflexion
the fact of someone being able to examine their own feelings, reactions, and motives (= reasons for acting) and how these influence what they do or think in a situation: Thinking back how can I do better.
describe the historical context and evolution of health care in Canada
head evolved to the comprehensive, accessible, and universal health services. Even before confederation in 1867 C Indians struggled to build a health care that was cosial, economic, and technological. Post confederation there has ben a process of outlining jurisdiction and delivery
Canada Health Act (1984)
protect, promote, and restore physical and mental wellbeing and to facilitate reasonable access to health services Gave access to universal coverage to all Canadians.
differentiate the five pillars of the Canada Health Act
Public administration, Comprehension, Universality, portability, accessibility.
Public administration
each province has Canadas health care system, not-for-profit. Each province is accountable to respect this.
Comprehensive
must cover al services provided by hospitals. Services must be equal to all. Insurance plans available. Equal opportunity for everyone
Universality
Residents must register with their respective government following you are eligible to receive free healthcare
Portability
when moving from province to province they will receive healthcare
Accessibility
Protects all people of Canada from extra charge for health career from discrimincation. Reasonable access.
Provincal/territorial roles
the provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents
Federal Roles
The federal government is responsible for: setting and administering national standards for the health care system through the Canada Health Act.
Healthcare reform
A general term that refers to discussion about change to and creation of healthy policy
Publicly funded health challenges
lack of health promotion and disease prevention, lack of continuity among providers and institutions, health sustain access, and quality of work.
Primary healthcare
services that play a part in health. Including health promotion, illness, and injury prevention and treatment of illness
Secondary healthcare
specialized referals
Tertiary health care
specialized supports and resource, Specialized intensive care unit, advanced services.
Population health
The improving of social determinants of health from the perspective of a nation.
Health promotion
Enabling people to increase control over and to improve their health. Action takes place where people live, work, play, and love
5 principles of primary healthcare
-accessibility
-active public participation
-health promotion and chronic -disease prevention and management -the use of appropriate technology and innovation
-intersectoral cooperation and collaboration.
Steps to root cause analysis
Define the problem.
Collect data.
Identify causal factors.
Identify root cause(s).
Implement solutions
