Risks within the healthcare environment exam 3 Flashcards
1
Q
what are common risks within the healthcare environment
A
- medical errors
- mistaken PT identification
- falls
- client inherited accidents (seizures)
- procedure related incidents
- equipment related incidents
- workplace violence
2
Q
what are the national PT safety goals?
A
- identify clients correctly
- improve staff communication
- med safety
- Use alarms safely
- Prevent hospital acquired infections (HAI’s) (c.diff, MRSA)
- Identify client safety risks reduce pt suicides
- Universal protocol reduce surgical errors (time out, nurses say pt name, the procedure, ect, to reduce medical errors)
- 2024 pt safety goal: everyone has equity to healthcare
3
Q
what practices can we as nurses use to properly communicate to each other to ensure safety?
A
- hourly rounding
- bedside shift report
- RRT (rapid response team) (an time there’s a change in PT condition, and you need more help and experience you can call a RRT)
- use ISBARR communication tool
4
Q
what does ISBARR stand for?
A
- Identify self
- Situation
- Background (of pt)
- Assessment findings
- Recommendation (mine as a nurse)
- Read back any providers orders
- used as a communication tool for healthcare providers
5
Q
what are the 4 types of unexpected events?
A
- near miss
- client safety
- adverse event
- sentinel event
- they all need to be reported
6
Q
what is a near miss event? & and ex?
A
- types of errors or situations that were almost indecent that could have led to patient harm
- need to be documented for policy changes
- ex: when you fall risk patient having another fall
7
Q
what are examples of “client safety” unexpected events
A
- falls
- med errors
- ex: pt gets a food tray but they are NPO
- anything that will put the patient at risk
8
Q
what is an adverse event & and example of it?
A
- something did happen to the Pt, and they were injured
- ex = pt got the wrong med and their BP won’t come up, then that pt fell and needs surgery
9
Q
what is a sentinel event and an example of it.
A
- unanticipated event in healthcare setting that results in death or serious injury that is not related to natural course of the patients illness
- ex = patient that got the wrong medication passed away or a pt fell bc of wrong med is permanently disabled
10
Q
what is occurrence reporting? and what are examples of things that need to be reported?
A
- process referring to collecting healthcare indecent data w/ the goal of improve patient outcomes
- Accident or injury
- Vaccine / drug reaction
- Medication admin error
- Property or damage loss
- Exposure to anything
- Not following hospital policy
11
Q
what is the definition of safety?
A
- Safety is the condition of being free from physical or psychological harm and injury
12
Q
what are unintentional injuries?
A
- results from incidents such as falls, motor vehicle crashes, poisings, drownings, fire associated injuries, suffocation by ingested objects, fire alarms
13
Q
what is an intentional injury?
A
- typically a result from deliberate acts of violence or abuse and often have fatal consequences such as suicide and homicide
14
Q
what is the “joint commission” & what do they do?
A
- an independent non for profit group in the US that accredits hospitals and other healthcare related agencies
15
Q
what are the 10 evidence-based recommendations
A
- Prevent infection
- Simplifying discharge instructions
- Prevent PTV
- Med education
- Limit continuous direct pt care time
- Identify client risk
- Improve design to assist client safely
- Improved communication
- Assess culture of safety
- Use evidence-based practice guidelines
16
Q
what assessments do nurses preform that assess for environment relating to safety?
A
- patient history
- risk assessment (do you feel safe at home, have any stairs, how is the food at home, ect)
- assessment of the clients home, workplace, and community
- healthcare setting = does the pt have access to healthcare? ect
17
Q
what are induvial risk factors that put pt’s at safety risks?
A
- lifestyle
- impaired mobility
- sensory or communication impairment
- lack of safety awareness
- domestic violence
18
Q
how can patients implement of safety in the home
A
- Temperature and humanity (ex; when running a bath for their kids, making sure it’s not too hot)
- Lighting
- Safety features (grab bar slip guards)
- Security measures
- Food & storage preparation
- Asepsis: cleanliness
- Fire safety
19
Q
what does the anacronym “RACE” stand for?
A
- used to remember what to do incase of a fire
- R = rescue
- A = Alarm
- C = contain
- E = extinguish
20
Q
what does PASS stand for?
A
- to remember how to use a fire extinguisher
- P = pull
- A = aim
- S = squeeze
- S = sweep
21
Q
what nursing interventions can nurses use to prevent falls?
A
- Keeping a call light within reach
- Keeping frequently used items close to pt
- Making hourly rounds to check on pt
- Keeping ps who are high risk for falling in rooms close to the nurses station
- Orient client to surroundings and explain the call system
- Keep beds in lowest position & locked
- Watch closely
- Encourage client to use call light, and have call light be near
- Place bedside tabled by them
- Grab bars in the bathroom
- Closely supervise the clients at risk for falls, especially at night
22
Q
what questions may a nurse ask when doing a fall risk assessment?
A
- history of falls?
- mobility problems?
- Can client ambulate independently?
- Confusion
- Over 65
- Sensory deficits
- Poor cooperation
- Increased frequency of elimination
- Perfusion / oxygenation problems
- Postural hypotension/ dizziness
- Up at night a lot
- Meds at bedtime
23
Q
what are the two reasons for using patient restraints?
A
- avoid purposeful or accidental harm
- doing what is necessary for medical treatment
24
Q
what are the 5 different types of restraints?
A
- physical restraints
- mechanical restraint
- chemical restraints (meds)
- barrier restraint (seen w/ babies, so they can’t climb out of a crib)
- seclusion (door is locked and they can’t come out)
24
what are the legal implications of restraints?
- Restraints restrict the individuals freedom
- Orders renewed daily
- Order must state reason for time needed
- PRN order prohibited
- need to be ordered by doctor
25
what are some examples of alternatives to restaints?
- assess for pain/problem and treat appropriately
- TV
- coloring books
- personal items near
- constant monitoring
26
what are nursing interventions for restraints?
- frequent rounding
- skin assessment
- voiding & bowel movement opportunities
- range of motion exercises
27
what care does a nurse provide during seizures?
- Call for help asap
- NOTE TIME IT STARTED & STOPPED
- Assist client to assume side lying position
- Protect clients head from injury
- Don't try to stop it
- Loosen any tight clothes around neck
- Don't leave
- Monitor the seizure for time
- Identify which body parts are involved
