Risk Management & Emergency Management and Disaster Planning Flashcards

1
Q

What’s a hospital acquired infection?

A

An infection that you get while in the hospital. Precautions are taken to minimize these infections.

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2
Q

What are the risks for medication administration?

A
  • verbal orders
  • high patient loads
  • multiple distractions
  • transcription errors
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3
Q

What is a sentinel event?

A

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

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4
Q

What is root-cause analysis?

A

A problem solving method which is used to pinpoint the exact cause of a problem or event

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5
Q

What happens when you remove the cause from a specific problem?

A

It removes the undesirable effect from occurring

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6
Q

What is alarm fatigue?

A

Ignoring the machines beeping or alarming

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7
Q

How much more likely are IV medications to harm patients?

A

Twice more likely

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8
Q

What are some risk management strategies for falls?

A
  • beds in low position
  • call bell in reach
  • identification of high risk patients
  • improve proximity to nurses station
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9
Q

What can cause pressure ulcers?

A
  • age
  • medications
  • immobility issues
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10
Q

What are some risk management strategies for pressure ulcers?

A
  • 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
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11
Q

What is an emergency?

A

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

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12
Q

What is a disaster?

A

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

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13
Q

What are the two main approaches for disaster planning?

A
  1. Agent-Specific Approach

2. All-Hazards Approach

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14
Q

What is the agent-specific approach?

A

Planning for threats in a specific geographic area

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15
Q

What is the all-hazards approach?

A

A comprehensive strategy in which both natural and human-induced hazards are considered possibilities (fire, transportation mass casualties)

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16
Q

Is an all-hazards approach to emergency management used all across Canada?

A

Yes

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17
Q

What is a hazard?

A

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

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18
Q

What are 3 examples of hazards?

A
  1. substances
  2. human activities
  3. physical events
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19
Q

What is emergency preparedness?

A

Having plans of action, supplies, and resources in place to respond in a timely manner inevitable emergency events

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20
Q

What does EMO stand for?

A

Emergency Management Organization

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21
Q

Does every province have an emergency management organization in place?

A

Yes

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22
Q

What is an emergency management organization responsible for?

A

Developing, coordinating, training, and responding organizations in their jurisdiction

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23
Q

What is an emergency management organization composed of?

A

Government and non-government organizations

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24
Q

What scale of emergencies would the emergency management organization respond to?

A

Large scale

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25
Q

What government is more likely to respond to disasters?

A

Federal government

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26
Q

Who is responsible for addressing and responding to emergencies in First Nation’s communities?

A

The First Nation’s Government

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27
Q

What are the 3 phases of disaster management?

A
  1. Pre-Incident
  2. Incident
  3. Post-Incident
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28
Q

What is pre-incident?

A

Activities designed to plan, prevent, and mitigate emergencies or disasters

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29
Q

What is the incident phase?

A

All activities involved in the response and management of the emergency or disaster

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30
Q

What is post-incident?

A

Recovery and rehabilitation of the incident along with an evaluation of the response

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31
Q

What phase is mitigation involved in?

A

Pre-incident

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32
Q

What is mitigation?

A
  • 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
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33
Q

What phase is preparedness involved in?

A

Pre-Incident

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34
Q

What is preparedness?

A
  • a proactive activity that occurs pre-incident

- pre-planning; agencies have assigned duties within the emergency plan

35
Q

What phase is the response involved in?

A

Incident

36
Q

What is involved in the response phase?

A
  • 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
37
Q

What phase is the recovery and rehabilitation involved in?

A
38
Q

What is involved in the recovery and rehabilitation phase?

A
  • 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?
39
Q

What does EOP stand for?

A

Emergency Operations Plans

40
Q

What does EOP do?

A

Describes how emergencies will be handled (identified, initiated, managed and terminated)

41
Q

What are the two types of emergency operations plans?

A
  1. internal disasters

2. external disasters

42
Q

What are internal disasters?

A

Situations that threaten or disrupt the daily or routine services of a health care facility (outbreaks or power outage)

43
Q

What are external disasters?

A

Originate outside the healthcare facility (mass causality accident)

44
Q

What are the contents of the healthcare emergency operations plans?

A
  • 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)
45
Q

What is the Canadian IMS based on?

A

The ICS (Incident Command System)

46
Q

What is the Canadian IMS?

A

It is an integrated and flexible framework that identifies disaster response roles

47
Q

What is the goal of the Canadian IMS?

A

Ensure effective communication, command structure, and control during disaster responses

48
Q

What are some roles in the Canadian IMS?

A
  • public information officer
  • safety officer
  • liaison officer
  • medical-technical officer
49
Q

What is IMS referred to in the hospital?

A

Hospital Incident Command System

50
Q

What does the hospital incident command system do?

A

Enables quick action, provides access to needed resources, and ensures continuation of essential services through all phases of disaster

51
Q

What does triage allow for?

A
  • 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
52
Q

What does the CTAS stand for?

A

Canadian Triage and Acuity Scale

53
Q

Where is the Canadian Triage and Acuity Scale used?

A

Emergency departments

54
Q

How many levels are there in the Canadian Triage and Acuity Scale?

A

5 levels

55
Q

What does “immediate/red” triage mean?

A
  • 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
56
Q

What does “delayed/yellow” triage mean?

A
  • 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
57
Q

What does “minor/green” triage mean?

A
  • walking wounded, minor injuries

- sprains, strains, colds, simple fractures

58
Q

What does “expectant/black” triage mean?

A
  • deceased or expected to die
  • massive head injury, shock with multiple injuries
  • no pulse or respirations
59
Q

What is primary survey?

A

Organizes the approach to the patient so that immediate threats to life are rapidly identified and effectively managed

60
Q

What are the 3 main nursing interventions?

A
  1. airway
  2. breathing
  3. circulation
61
Q

How long can a person go without oxygen before having a hypoxic injury?

A

3 minutes

62
Q

How can oxygen be given to someone?

A
  • oxygen therapy (endotracheal intubation and bag-valve-mask (BVM))
  • supplemental oxygen - mask, cannula
63
Q

What does the breathing part of the assessment comprise of?

A
  • 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)
64
Q

What is the circulatory part of the assessment composed of?

A
  • 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)
65
Q

What is the alphabetical emergency nursing assessment?

A
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
66
Q

What is terrorism?

A

Intentional, overt actions for the expressed purpose of causing harm in the service of political, religious, or ideological goals

67
Q

What is bioterrorism?

A

The deliberate spreading of microbes or toxins to cause disease and death in living organisms

68
Q

What are some examples of biological agents?

A
  • 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)
69
Q

What is a CBRN event?

A

Any situation in which which weapons of a chemical, biological, radiological, or nuclear nature are used with the goal of causing harm?

70
Q

What letter was recently added to the CBRN and what does it stand for?

A

E - explosive or incendiary device

71
Q

Where does decontamination ideally occur?

A

Outside the hospital

72
Q

What is sarin?

A
  • 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
73
Q

What is mustard gas?

A
  • yellow to brown in colour with a garlic like odor

- irritates eyes and causes skin burns and blisters

74
Q

What are RDD’s?

A

Radiological Dispersal Devices

75
Q

What is a radiological dispersal device?

A
  • 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
76
Q

What is a blast injury?

A

Damage to the lungs, middle ear, and GI tract

77
Q

What is a crush injury?

A

Injuries result from explosions that occur in confined spaces and result from structural collapse

78
Q

What is a penetrating injury?

A

Injuries from explosive devices that contain materials that are projected during the explosion (shrapnel)

79
Q

What is an outbreak?

A
  • when diseases occur among a cluster of individuals
  • hand foot and mouth disease in daycare
  • influenza cases within a hospital or nursing home
80
Q

What is a epidemic?

A
  • 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
81
Q

What is a pandemic?

A
  • if transmission is widespread and affects large numbers of people globally
  • COVID-19
  • national and worldwide nursing resources
82
Q

What is COVID-19?

A
  • 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
83
Q

How to prevent outbreak?

A
  • 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)