Patient Safety & Quality Flashcards
Medical errors
Wrong medication administered, infections, falls
What have hospitals done to lower the number of medical errors?
Steph education, formulation of clinical practice guidelines, development of policies and procedures
Who is responsible for the patient?
Everyone has a team effort
Centers for Medicare and Medicaid services (CMS)
Are the pair/reimburse her to the hospital and want to ensure patient is not injured
The joint commission (TJC)
They are not government, they are independent private group, that a credit to private agencies and try to improve the patient safety/quality of care in the community
Office of the inspector general (OIG)
Regulatory and licensing agency for long-term care/Day Care
Culture of safety
Acknowledgment
Blame – free environment
Collaboration
Commitment
Culture of safety-Acknowledgment
Is knowing day-to-day providing medication to patient is a high-risk(patience could have a negative reaction to new medication, provide it to them)
Culture of safety – blame – free environment
You will not get in trouble, when errors occur it is not anyone’s fault, but would like to know what the issue was to prevent occurrence in the future
Culture of safety – collaboration
Working together as a team effort
Culture of safety – commitment
Making a commitment to your staffing, community to practice safely and provide precautions (barcode, scanning)
Environmental safety
•Basic needs: meeting, patients basic needs such as nutrition, living circumstances, do they have heat/AC
•Common environmental hazards: residential fires, floods, tornadoes, wildfires
•Transition of pathogens, bioterrorism, immunizations
Pollution: what is in our water? What is in our air?
What is developmental level?
As nurses we have to provide age/appropriate education
For adolescence: they are at most risk for suicide
For adult: they have issues with the lifestyle habits
For older adult: they suffer with risk for falls, cognitive, and polypharmacy
What are the six risks in healthcare agencies?
1.Procedure – related.
2. Equipment – related.
3. Chemical exposure.
4. Falls.
5. Medical errors.
6. Workplace safety
Procedure – related risk in healthcare
This is often caused by a healthcare provider
Example: the healthcare provider does some thing against policy meaning they possibly did it incorrectly
Equipment related risks in healthcare
It could be malfunctioning equipment or missed used equipment
Example: if a certain item is not up-to-date with his annual check up
Chemical exposure related risks in healthcare
This could be items such as cleaning products, chemo medication, as they can be strong
Falls are risks in healthcare
As falls can result in injury/death
Medical errors are risks in healthcare
This can also be a part of procedure – related risks, this is failing to administer medication, incorrect medication administered, medication administered through wrong route
Workplace safety related risks in healthcare
This could be regarding what kind of environment is around you, is there a threat in the building, or a staff member could be a threat
There are two types of risk factors
Intrinsic(patient related) & extrinsic (environment or process related)
What is intrinsic (patient related) mean
This is predisposing factors that a patient has (physical conditions)
What does extrinsic (environment or process related )mean?
This refers to communications, which in this case would be staff members
An example: the nurse did not communicate with oncoming nurse that patient was a fall risk
How do we provide safety and quality in acute and restorative care
By providing the patients with
Fall screenings
More frequent rounding’s (once every hour)
Bedside handoff
Maintaining bed at lowest position
What are the two types of restraints?
Chemical and physical restraints
What are physical restraints?
They limit the patient’s mobility, they are temporary to ensure patient does not get harmed
-You must have a physicians order. The order is only good for 24 hours.
-The patient’s family must be notified immediately
What are the 2 types of physical restraints?
-Non-violent: handcuffs that must be checked every two hours(checking skin, color, temperature)
- Violent restraints: must be checked every 15 minutes
When requesting these restraints, it is necessary for the provider to come look at the patient within an hour
Chemical restraint
Chemical restraint is medication that is provided to the patient in order to calm them or sedate them
R. A. C. E. (Fire)
Reassure and remove, activate, the alarm, confine the fire, extinguish the fire
P. A. S. S.
Paul, I am low, squeeze, handle, sweet side to side
Electrical hazards
Must ensure that all electrical items are up-to-date on their annual check ups
What does the phrase timeout mean before a procedure?
It is win the doctors and nurses all stop and ask the patient questions ensuring they have the correct patient and ensuring the correct procedure is being completed
For a patient safety what must be done when changing their medication through an IV?
A patient must be monitored using a pulse ox monitor
Sentinel event
*Is not related to natural course of the patients illness or underlying condition
A centile event is a patient safety event that reaches a patient and result in
-Death
-Permanent harm(regardless of the severity of harm)
-Severe harm(regardless of duration of harm)
