Midterm 1 Flashcards
What are the 6 elements in the chain of infection? what does it mean to break the chain?
1.) Transmission
2.) Portal or entry
3.) Host susceptibitly
4.) Infectious agent
5.) Reservoir
6.) Portal of exit
Breaking the chain refers to the methods and techniques we as health care providers use in order to stop or “break” the chain of infection Ex.) hand washing, keeping areas clean
Principles of hand hygiene, use of barrier, techniques and routine environmental cleaning are examples of?
Medical asepsis or the “clean technique”
When are tear 1 isolation requirements put in place?
The transmission-based precautions are for those who are known or suspected to be infected or colonized with infected agents, including certain epidemiologically important pathogens, which require additional control measures to effectively prevent transmission
-Use with ALL patients
When are tear two isolations precautions put into place?
Includes precautions designed for care o patients who are known or suspected to be infected, or colonized, with microorganisms transmitted by contact, droplet, or airborne route or by contact with contaminated surfaces
-Use with specific types of patients (airborne, droplet or contact precations)
What is Infection Control?
Practices that control or prevent transmission of infection help create an environment that protects patients and health care workers.
What are the factors for the the potential growth of microorganisms to cause disease depend on?
1.) A sufficient number of microorganisms
2.) Virulence, or the ability to produce disease
3.) The ability to enter and survive in the host
4.) The susceptibility of the host
Exogenous Infection Vs Endogenous infection?
Exogenous Infection: Is an infection that arises from microorganisms that are external to the individual that do not exist as normal flora. Ex.) salmonella
Endogenous infection: This can occur when some of the patient’s flora become altered, and overgrowth occurs. Ex.) Yeast infection
Normal flora Vs body system defences Vs inflammation?
Normal flora: are microorganisms that do not typically cause disease when residing in their usual area of the body but instead participate in maintaining health and may assist in fighting infections and inflammation and maintaining homeostasis.
Body system defences: These are the specific defences that each area of the body has and uses to help protect us (skin, mouth, eye, vagina, urinary tract, respiratory tract and gestational tract)
-A number of the body organs have unique defences against infection
Inflammation: Is the body’s cellular response to injury or infection
-It is a protective vascular reaction that delivers fluid, blood products, and nutrients to interstitial tissues in an area of injury
What is quality of care defined as? What are the 6 domains? How do they contribute to patient safety?
-The degree to which health care services for individuals and populations increase the likelihood of desired health outcomes are consistent with current professional knowledge
1.)Accessibility- Available to everyone, right care received at the right time, place in the right setting and by the health care provider
2.) Effectiveness- Care received reaches the expected benefits and is based on the best scientific evidence
3.)Efficiency- Care received is waste free, including the waste of supplies, equipment, time, ideas and information
4.)Patient safety: Care received where harm is avoided
5.)Patient center care: Care received that is respectful and responsive to individual patient preferences, needs, cultural traditions and values
6.) Equitable: Care received regardless of gender, age, ethnicity, geographic location and socioeconomic status
What is a patient safety incident? (adverse event) What are the three different kinds? Why do we avoid calling them accidents? Whats contributes to them?
An event or circumstance that could have resulted, or did result in unnecessary harm to a patient
1.) Harmful incident: an incident that resulted in patient harm
2.) Near miss: An incident that did not reach the patient (no harm resulted)
3.) No harm incident: An incident that reached the patient but no discernible harm resulted
-An accident is no longer used as it refers to an unforeseeable or unpreventable event occurring, because of this they are referd to as incidents.
System flaws, communication errors, protocols can contribute to poor quality care
What 5 factors the influence safety? What influences people’s ability to protect themselves?
1.) Patient and health care provider factors – personal characteristics of each individual, personal wellness, age, weight, intelligence, language,etc
2.) Task factors – workload, time pressure, staffing levels, the tasks themselves as well as their characteristics
3.) Technology factors – what kind is used, how effective is it, does it breakdown
3.) Environmental factors – consider the physical work environment, lighting, physical space and layout
4.) Organizational factors – structural, cultural and policy-related characteristics of the institution, are the structural, cultural, and policy related characteristics of the institution.
Peoples ability to protect themselves is influenced by age, lifetyle, health status, sensory perception, emotional state, enviroment, anbilitly to communicate
Patient safety?
The reduction and mitigation of unsafe acts within the health care system, through the use of best practices shown to lead to optimal patient outcomes.
Refers to the processes of analyzing incidents and identifying the causes, it intales that we actually have to find the root cause of what the error was and what caused it
What is the pivotal post-incident question?
Why did the safeguards fail rather then who caused the incident
What is the Reasons swiss cheese model?
It is not a blame, shame, name approach. The SYSTEM needs to be analyzed.
It is developed by reason, each slice of cheese represents a barrier put in place to try and make the health care system safer. Each safeguard inherently contains a number of weaknesses, which are represented by hole in the cheese. The holes in the cheese are continuously moving around and often a subsequent barrier is able to stop a hazard from reaching the patient but when a hole lines up in certain combinations, hazards have the opportunity to sneak through safeguards that have been put in place and find their way to the patient. The holes at the end of the system, which come into contact with the patient are termed “active failures” and generally involve those directly involved in patient care
What is the iceberg conceptual model?
ROOT CAUSE ANALYSIS
Looks for contributing factors rather than direct cause to prevent additional adverse events in the future
Looks at the root causes, indirect causes and the near miss causes
What is a “RCA” and “FEMA”?
1.) Root cause analysis, used to find out what underlying features of a situation contributed to a patient safety event, it is used to seek, identify and understand all contributing causes in order to redeign the system to make it safer in the future
2.) Failure mode and effect analysis, is used to identify problems with processes and products before they occur, they take on an engineering approach and usually take place in the early developmental phase of a product with the aim of imaginatively identifying potential failures and their effects. It is used to analyze every aspect of a systems design.
How do we build a culture of safety? What does a culture of patient safety include?
1.) Reporting culture-need for trust
2.)Informed culture-awareness of potential safety issues
3.)Flexible culture and learning culture- Teamwork, shared power, lifelong learning
4.) Work in teams for patient safety
5.)Communicate effectively for patient safety
6.)Manage safety risk
7.) Optimize human and environmental factors (work-life balance)
-The goal is to provide services that are safe
-People take action when it is needed, and safety culture comes from ALL directions… it is the job of everyone who works there..All staff must draw the change
-Messaging about safety must be consist and sustained
What are the risks for staff and patients in healthcare settings?
Staff
1.) Environmental Risks: Chemicals (WHIMIS), hazards
2.) Infection prevention and control: Protecting the care provider
3.) Violence: From patients/families directed at nurses
-It is up to the worker to proceed themselves
Patient Safety: Specific risks to a patients safety within the health care environment which include falls, procedure related incidents and equipment related incidents
1.)Falls: Account for up to 90% of reported safety incidents
2.) Procedure-related accidents: They occur during therapy, Medication errors, improper application of devices, improper execution of skills
3.) Equipment-related accidents: Malfunctions
How are nurses able to prevent procedure-related incidents and equipment related incidents?
By adhering to organizational policy and procedures and standards of nursing practice we can avoid procedure related incidents
We can avoid equipment-related incidents by not operating monitoring or therapy equipment without adequate instruction
What are the leading causes of injuries for infants and Children? Adolescents? Adults? and Older persons?
Infants and Children:
-Unintentional injuries are the leading cause of children aged 1-14years. The nature of the injuries sustained is related to normal growth and development
*The incident of posining is highest in late infancy and toddlerhood because of children’s increased level of oral activity and growing ability to explore the environment.
-Childhood injury are also reflective of adults perceptions of the causes of accidents and their ability to prevent them.
Adolescents:
The struggle for identity may cause a teenager to experience shyness, fear, and anxiety with, resulting dysfunction at home or school. These feeling may lead to substance abuse, sports, higher risk of suicide, MVA
Adults:
Lifestyle habits (smoking, drinking)
Older Persons:
-The physiological changes that occur during the again process increase a patient’s risk for injury. Chnages in vision, hearing, mobility, reflexes, circulation and the ability to make quick judgements predisopse older persons to fall
Why and how are nursing errors reported in health care?
We fill out incidents reports (RLS) Reporting system for harmful events
We want to have a clear transparent policy to keep the population safe
It lets the adverse event team know about the events and allows us to learn from the incident and put new safeguards in place so it doesn’t happen again
What must we do if an adverse event occurs?
1.) Discole the incident
Disclosure process must include:
-How the incident was handled
-Future plans to minimize the event from occurring again
-Regret that the event occurred
-We document the factual events of occurance
-Incident reporting is based on the factual events so we can get to the root of what happened, Objective data only…keep subjective out
2.) Anticipate the patient/families reaction
3.) Plan for support if needed
- It is usually the managers job but nurses must use the same approach
What is the nurse’s and student nurses’ role in patient safety?
-Assist the client to meet basic needs
-Reduce physical hazards
-Reduce equipment-related and procedural harm
-Reduce transmission of pathogens
-Maintain sanitation
-Control pollution
-Develop relationships with family
-Maintain continuity of care for patients and families
-Act ethically at all times
-Avoid blaming when an error occurs
What is the purpose of the assesment in the nursing process? What do we want to do during this stage? What will the nurse collect during this stage? What should it include?
1.) Assesing is the systematic collection, organization, validation, and documentation of data
2.) The goal is to gather sufficient information that results in a comprehensive understanding of the patient’s situation.
3.) The nurse will:
-Collect Data
-Organize Data
-Validate Data
-Document Data
-Include the client’s strengths, perceived needs, health problems, related experiences, health practices, values, culture, social network, and lifestyle preferences
