Risk Management & Emergency Management and Disaster Planning Flashcards
What’s a hospital acquired infection?
An infection that you get while in the hospital. Precautions are taken to minimize these infections.
What are the risks for medication administration?
- verbal orders
- high patient loads
- multiple distractions
- transcription errors
What is a sentinel event?
Any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not resulting to the natural course of the patient’s illness
What is root-cause analysis?
A problem solving method which is used to pinpoint the exact cause of a problem or event
What happens when you remove the cause from a specific problem?
It removes the undesirable effect from occurring
What is alarm fatigue?
Ignoring the machines beeping or alarming
How much more likely are IV medications to harm patients?
Twice more likely
What are some risk management strategies for falls?
- beds in low position
- call bell in reach
- identification of high risk patients
- improve proximity to nurses station
What can cause pressure ulcers?
- age
- medications
- immobility issues
What are some risk management strategies for pressure ulcers?
- assessment and documentation of skin upon arrival to the facility
- assessment and documentation of skin every shift
- turning and repositioning patients every 2 hours
- staff education
- nutrition and hydration
- moisture barriers
What is an emergency?
An event that requires a rapid and and skilled response to protect the health, safety, and wellness of individuals and to limit damage to property and the environment
What is a disaster?
An outcome of a natural hazard or event or the result of human action or error, whether malicious or unintentional, that seriously disrupts the functioning of a community or society
What are the two main approaches for disaster planning?
- Agent-Specific Approach
2. All-Hazards Approach
What is the agent-specific approach?
Planning for threats in a specific geographic area
What is the all-hazards approach?
A comprehensive strategy in which both natural and human-induced hazards are considered possibilities (fire, transportation mass casualties)
Is an all-hazards approach to emergency management used all across Canada?
Yes
What is a hazard?
Anything that has the potential to cause harm or loss, threaten the delivery of critical care services, cause social or economic disruption, property or environmental damage
What are 3 examples of hazards?
- substances
- human activities
- physical events
What is emergency preparedness?
Having plans of action, supplies, and resources in place to respond in a timely manner inevitable emergency events
What does EMO stand for?
Emergency Management Organization
Does every province have an emergency management organization in place?
Yes
What is an emergency management organization responsible for?
Developing, coordinating, training, and responding organizations in their jurisdiction
What is an emergency management organization composed of?
Government and non-government organizations
What scale of emergencies would the emergency management organization respond to?
Large scale
What government is more likely to respond to disasters?
Federal government
Who is responsible for addressing and responding to emergencies in First Nation’s communities?
The First Nation’s Government
What are the 3 phases of disaster management?
- Pre-Incident
- Incident
- Post-Incident
What is pre-incident?
Activities designed to plan, prevent, and mitigate emergencies or disasters
What is the incident phase?
All activities involved in the response and management of the emergency or disaster
What is post-incident?
Recovery and rehabilitation of the incident along with an evaluation of the response
What phase is mitigation involved in?
Pre-incident
What is mitigation?
- assessment of potential risks
- identify and implement advance long term strategies to reduce risks
- ex; research into influenza variation and vaccine development, identification of flood areas and limits to community development
What phase is preparedness involved in?
Pre-Incident
What is preparedness?
- a proactive activity that occurs pre-incident
- pre-planning; agencies have assigned duties within the emergency plan
What phase is the response involved in?
Incident
What is involved in the response phase?
- emergency operations and services respond to emergency and disaster situations
- nursing is most viable in this phase of disaster
- nurses may be required to work in a variety of different places during this phase such as emergency aid shelters, homes, mass immunization sites, shelters, mortuaries, or makeshift clinics
What phase is the recovery and rehabilitation involved in?
What is involved in the recovery and rehabilitation phase?
- staff, an organization, or a community regains the ability to function after a disaster
- care and coordination of nursing care services
- case management
- identification and implementation of casualty referrals (social services, physio therapy, counselling?
What does EOP stand for?
Emergency Operations Plans
What does EOP do?
Describes how emergencies will be handled (identified, initiated, managed and terminated)
What are the two types of emergency operations plans?
- internal disasters
2. external disasters
What are internal disasters?
Situations that threaten or disrupt the daily or routine services of a health care facility (outbreaks or power outage)
What are external disasters?
Originate outside the healthcare facility (mass causality accident)
What are the contents of the healthcare emergency operations plans?
- activation of emergency status
- communication plan
- plan for the coordination of client care
- staffing plan
- equipment and supply plan
- security plan
- documentation and data management strategy
- deactivation and recovery processes
- post incident debriefing plans
- educational plans
- testing of emergency plans (fire drill)
What is the Canadian IMS based on?
The ICS (Incident Command System)
What is the Canadian IMS?
It is an integrated and flexible framework that identifies disaster response roles
What is the goal of the Canadian IMS?
Ensure effective communication, command structure, and control during disaster responses
What are some roles in the Canadian IMS?
- public information officer
- safety officer
- liaison officer
- medical-technical officer
What is IMS referred to in the hospital?
Hospital Incident Command System
What does the hospital incident command system do?
Enables quick action, provides access to needed resources, and ensures continuation of essential services through all phases of disaster
What does triage allow for?
- human survival
- equitable distribution of patients to appropriate services and facilities within the healthcare service
- rapid assessment and sorting casualties into priority order
- patients are tagged and then sent to the most appropriate medical facilities
What does the CTAS stand for?
Canadian Triage and Acuity Scale
Where is the Canadian Triage and Acuity Scale used?
Emergency departments
How many levels are there in the Canadian Triage and Acuity Scale?
5 levels
What does “immediate/red” triage mean?
- unstable patients who require immediate transport
- poses an immediate threat to life or limb
- respiratory distress, chest pain with diaphoresis, active hemorrhage, unstable vital signs
- respirations >30/min; perfusion - capillary refill >2 seconds, decreased LOC
What does “delayed/yellow” triage mean?
- non life-threatening, transport can be delayed
- pneumonia, displaced fractures, dislocations, lacerations without major hemorrhage
- respirations <30/min, perfusion <3 seconds, neuro; follows simple commands
What does “minor/green” triage mean?
- walking wounded, minor injuries
- sprains, strains, colds, simple fractures
What does “expectant/black” triage mean?
- deceased or expected to die
- massive head injury, shock with multiple injuries
- no pulse or respirations
What is primary survey?
Organizes the approach to the patient so that immediate threats to life are rapidly identified and effectively managed
What are the 3 main nursing interventions?
- airway
- breathing
- circulation
How long can a person go without oxygen before having a hypoxic injury?
3 minutes
How can oxygen be given to someone?
- oxygen therapy (endotracheal intubation and bag-valve-mask (BVM))
- supplemental oxygen - mask, cannula
What does the breathing part of the assessment comprise of?
- determines whether or not ventilatory efforts are effective
- assess for breath sounds, chest expansion, respiratory effort, and chest wall trauma
- may need supplemental oxygen (mask, cannula)
- may need bag-valve mask (BVM)
- may need intubation (mechanical ventilator)
What is the circulatory part of the assessment composed of?
- assess heart rate, blood pressure, and overall perfusion (skin colour and temp, peripheral pulses, capillary response)
- threats to circulation (MI, shock, hemorrhage)
- address bleeding with bandages and pressure
- IV access: large bore if possible (antecubital AC location, isotonic solution, blood should be warmed to prevent hypothermia)
What is the alphabetical emergency nursing assessment?
A - airway B - breathing C - circulation D - disability (neuro assessment) E - examine (look for injuries) F - Fahrenheit/Celsius (temperature) G - get vital signs frequently H - head to toe assessment I - interventions
What is terrorism?
Intentional, overt actions for the expressed purpose of causing harm in the service of political, religious, or ideological goals
What is bioterrorism?
The deliberate spreading of microbes or toxins to cause disease and death in living organisms
What are some examples of biological agents?
- anthrax (treated with antibiotics)
- smallpox (prevented with a vaccine and supporting treatments)
- botulism (treated with antitoxin)
- plague/Yersinia Pestis (treated with antibiotics
- hemorrhagic fever/Ebola (depends on the virus, treatments in development)
What is a CBRN event?
Any situation in which which weapons of a chemical, biological, radiological, or nuclear nature are used with the goal of causing harm?
What letter was recently added to the CBRN and what does it stand for?
E - explosive or incendiary device
Where does decontamination ideally occur?
Outside the hospital
What is sarin?
- a toxic nerve gas that can cause death within minutes of exposure
- enters the body through the eyes and skin
- acts by paralyzing respiratory muscles
What is mustard gas?
- yellow to brown in colour with a garlic like odor
- irritates eyes and causes skin burns and blisters
What are RDD’s?
Radiological Dispersal Devices
What is a radiological dispersal device?
- dirty bomb
- mix of explosives and radioactive material
- when detonated, blast scatters radioactive dust, smoke, and other material into environment, resulting in radioactive decontamination
- the main danger is the explosion
What is a blast injury?
Damage to the lungs, middle ear, and GI tract
What is a crush injury?
Injuries result from explosions that occur in confined spaces and result from structural collapse
What is a penetrating injury?
Injuries from explosive devices that contain materials that are projected during the explosion (shrapnel)
What is an outbreak?
- when diseases occur among a cluster of individuals
- hand foot and mouth disease in daycare
- influenza cases within a hospital or nursing home
What is a epidemic?
- when number of cases of a communicable disease exceeds the normal expected occurrence during a given time period
- outbreak of chicken pox in Ottawa school district
What is a pandemic?
- if transmission is widespread and affects large numbers of people globally
- COVID-19
- national and worldwide nursing resources
What is COVID-19?
- a mild to severe respiratory illness that is caused by a coronavirus, is transmitted chiefly by contact with infectious material (respiratory droplets) or contaminated surfaces
- characterized by new or worsening cough, shortness of breath or difficulty breathing, temperature >38C, fatigue or weakness, new loss of smell or taste
- number of cases = 2142310
- number of deaths = 30280
How to prevent outbreak?
- surveillance (contact tracing)
- reportable diseases - public health units
- isolation (staying home)
- vaccines
- quarantine ( 5 days for vaccinated and 10 days for vaccinated or until symptoms resolve)
