Quality & Patient Safety - Restraints And Safety For Everyone

Question 1

Safety is the responsibility of…

Answer 1

Everyone

Question 2

Patient

Answer 2

Rights and responsibilities

Question 3

System/organizational

Answer 3

Ex: ottawa hospital quality and safety department

Question 4

Individual

Answer 4

Scope of practice, CNO code of conduct, CNO standards and guidelines

Question 5

Strategies to decrease adverse event incidents

Answer 5

Education, leadership, protocols and guidelines, patient awareness, reporting adverse events and near misses, technology, inter professional communication and teamwork

Question 6

Restraints, what is it?

Answer 6

Measure used to restrict movement or control the behaviour of a client. Can be physical, chemical and environmental

Question 7

Policy/law as you understand it in ontario?

Answer 7

Bill 85 - patient restraints minimization Act, 2001 least restraint/last resort

Question 8

Restraints use risks

Answer 8

Increased injury, skin breakdown, confusion, agitation, loss of dignity, loss of will to live, loss if bone mass and muscle atrophy, incontinence and constipation, loss of appetite and dehydration

Question 9

When can restraints be used?

Answer 9

Protection - ex: when clients may cause serious harm to themselves or others
Maintaining treatment - ex: to prevent removal of a breathing tube
Enhance freedom or enjoyment of life - ex: locked unit or garden in LTC facility

Question 10

Alternatives use of restraints

Answer 10

Falls, sliding & unsteadiness - medication review, lower bed, routine positioning, clutter free room, mattress on floor

Cognitive impairment, acute confusion & wandering - alarm devices, soothing music, relaxation techniques

Pulling out invasive tubes, aggression & agitation - gentle touch, soothing music, redirection with simple ands

Question 11

Nursing responsibilities

Answer 11

1. Assess behaviour and use alternatives, Ensure consent is obtained, Collaborate, Individualized plan of care, least restrictive restraint, consult agency policy, evaluation, reassess and reevaluate, document

Question 12

Client abuse

Answer 12

Misuse of power, betrayal of trust, respect or intimacy in the therapeutic relationship (physical, verbal, neglect, financial, sexual, emotional)

Question 13

Safety: expected outcomes

Answer 13

• A client who is free of injury
• client who is knowledgeable about safety factors and precautions
• a safe physical and emotional environment

Question 14

Inter professional/ integrated client / patient care

Answer 14

Collaboration among health team, respect, understanding of roles, supportive of each others roles -> results in… positive impact upon health care, debunking stereotypes

Question 15

Key elements of inter professional collaborative client care

Answer 15

Cooperation, assertiveness, autonomy, trust & respect, communication, responsibility, coordination

Question 16

Inter professional collaborative client care - benefits

Answer 16

Better patient outcomes, better transitions, improved patient safety, provider/team member satisfaction

Question 17

Inter professional collaborative client care - challenges

Answer 17

Fear of losing turf, power challenge, doing someone else’s job, changing culture in institutions “this is the way we do it”

Question 18

Inter professional collaborative client care - risks

Answer 18

If not integrated effectively, can lead to adverse healthcare outcomes: poor communication impacting patient safety & negative health outcomes, burnout and stress, decreased job satisfaction