M 8 Safety Flashcards
Clinical judgement
Based on critical thinking and nursing knowledge
Applied to clinical situations
Clinical judgment is acquired best through
Experience
When to use Clinical Judgement
Challenging med dosage
When to admin med
Assess pt med status
Assess pt suicide risk
Effective communication
Clinical judgement positives
Safety
Quality
Client centeredness
Positive outcomes
EBP
Clinical judgement negatives
Death/sentinel event
Unsafe environment
Bad pt outcomes
Breakdown in judgement
Nursing process
Assessment
Diagnosis
Planning
Implementation
Evaluation
Examples of sentinel events
Wrong side surgery
Med errors
Criminal sentinel events
Why sentinel events happen
Inadequate comms
Incorrect assessment
Inadequate leadership/training
Do you have to report sentinel to the joint commission
NO, but are encouraged too
A major sentinel event categories is
Wrong site surgery
Removal of unaffected limb, organ or body part,
Preventing wrong site surgery
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Med error sentinel event causes
Order confusion
Drug name similarity
Narrow therapeutic index
Patient response
Nurse fatigue
Most common med to have issues with
Insulins
Anticoagulants
Opioids
Criminal sentinel event examples
Impersonation
Abduction
Rape/assault
Prevention strategies for sentinel events
Checklists
No interruption zones like a med room
Safety checks
Education
Ethical delema
Choosing between TWO undesirable outcomes
Why do nurses face ethical delemas
Need to do the best good for all
PT
DR
Organization
At thesame time
Utilitarianism decision making
Greatest good for most people
Rights based decision making
Individuals have inherent rights
Duty based decision making
Duty to do a task or refrain from one
Intuitionist based decision making
Goals are weight on case-by-case bases
Autonomy
self determination
Beneficence
Doing good
Nonmaleficence
Not doing bad
Paternalism
An individual assumes all decision making for another person
Utility
Good of many outweighs individual needs
Justice
Right to fair treatment
Veracity
Truth
Fidelity
Keep promise
Confidentiality
Keep info private
How to solve an ethical dilemma
Utilize structure problem solving
Adequate data collection
Examine alternatives
How can leaders promote ethical decisions
Separate legal from ethical
Have an ethics committee
Use review boards
Foster ethical work environment
Who participates in quality improvement
Everyone
Core of quality improvement
PT and Staff safety
QI goals are set by
via
WHO, TJC
Benchmarks - new approaches, or best practices
QI is an _ process
Ongoing
As we progress through career QI goals
Change
from individual as a nurse
to group as a nurse leader
FOCUS PDCA
Find process
Organize team
Clarify knowledge
Understand variables
Select plan
Plan
Do
Check
Act
TJC current QI goals
Acute MI
Children’s asthma
Psych services
Immz
Stroke
DVT
