Safety and Security

Question 1

what is QSEN?

Answer 1

quality and safety of education of nurses

Question 2

what is IOM?

Answer 2

institute of medicine

Question 3

what is TJC?

Answer 3

the joint commission

Question 4

what are the 3 failures?

Answer 4

to recognize: doesn’t see anything wrong
to rescue: sees something wrong but does nothing
to plan: what to do during infrequent events (CPR, fire drills)

Question 5

what are med mistakes often due to?

Answer 5

misreading orders

Question 6

course specific preparations?

Answer 6

skills check offs
simulation grading
med calc quizzes

Question 7

what is code pink?

Answer 7

baby missing

Question 8

what are the QSEN competencies?

Answer 8

patient centered care
teamwork/collaboration
evidence based practice
quality improvement
safety
informatics

Question 9

QSEN defines safety as “minimizing risk of harm to patients and providers through”

Answer 9

both system effectiveness and individual performance

Question 10

what is individual performance?

Answer 10

controlling yourself
*don’t talk or think about other things

Question 11

what is NPSG?

Answer 11

national patient safety goals

Question 12

patient safety goal to correctly identify patients?

Answer 12

checking ID bands
*name and DOB

Question 13

patient safety to improve staff communications?

Answer 13

knowing and following up on orders
*SBAR, correct reporting

Question 14

patient safety goals that help safe medication use?

Answer 14

labelling meds
med reconciliation: missing info
4 checks

Question 15

patient safety goals for alarm safety?

Answer 15

answer alarms
“alarm fatigue”: figure out problem and fix it, don’t silence it

Question 16

safety goal to prevent infection?

Answer 16

hand hygiene

Question 17

what is fire safety? “RACE”

Answer 17

R: rescue: anyone in immediate danger
A: activate: fire code and notify person
C: confine: the fire by closing doors and windows
E: evacuate: patients and others to safe area

Question 18

what is a medication error?

Answer 18

breakdown or failure at any point in the med use process

Question 19

how many are injured each year from med errors?

Answer 19

1.5 million injured
440,000 die
*$3 billion annually

Question 20

what are the types of medication errors?

Answer 20

omission
commission
communication

Question 21

what is omission?

Answer 21

something missed or left out
*not prescribed, dispensed, administered, or taken

Question 22

what is commission?

Answer 22

doing something wrong, making a mistake
*wrong drug/dose prescribed, dispensed, administered
*wrong patient, timing, route
*allergic or drug reaction

Question 23

what is the most common type of drug error made by students?

Answer 23

omission

Question 24

what are the contributing factors to student med errors?

Answer 24

inexperience and distraction

Question 25

med pass communication error example?

Answer 25

duality of patient assignments -you think nurse is passing med, nurse think you are, no meds passed -nurse thinks she is passing med, you think you are passing med, 2x meds given NURSE NEEDS TO KNOW WHAT WHEN AND WHO

Question 26

what are insulin errors?

Answer 26

selecting wrong insulin wrong dose/wrong patient

Question 27

med error examples?

Answer 27

-administering on hold or discontinued meds -not monitoring labs or VS -preparing oral meds in parenteral syringes and giving IV

Question 28

what color are oral syringes?

Answer 28

brown

Question 29

what color are parenteral syringes?

Answer 29

clear

Question 30

parenteral vs enteral?

Answer 30

parenteral: into vein delivered straight to bloodstream enteral: into stomach

Question 31

what is one of the major never events?

Answer 31

falls

Question 32

what ID band is for falls?

Answer 32

yellow *predicting is important in preventing

Question 33

what gender is more at risk for falls?

Answer 33

females

Question 34

at what age does fall risk increase?

Answer 34

65+

Question 35

what are three things that increase risk for fatal falls?

Answer 35

surviving stroke surviving heart attack taking multiple meds

Question 36

if you are 75 years and older and fall you are ___-___x more likely to be admitted to a end care facility

Answer 36

4-5

Question 37

fall risk factors?

Answer 37

>65 fall history cognitive impairment altered gait - using cane/walker meds incontinence unsafe environment sensory deficits - glasses/hearing aids orthostatic hypotension depression assistive devices confusion/disorientation new environment

Question 38

fall prevention interventions

Answer 38

complete assessments frequent rounding fall precautions toiletting assistance Q2 no slip socks bed in low and alarms on personal items in reach call light in reach/answer promptly

Question 39

when do most people fall?

Answer 39

going to toilet

Question 40

low risk score?

Answer 40

0-44

Question 41

medium risk score?

Answer 41

45-75

Question 42

high risk score?

Answer 42

76-100

Question 43

what is a restraint?

Answer 43

any involuntary method chemical or physical of restricting an individual's freedom of movement, physical activity, or normal access to body

Question 44

when should restraints be employed?

Answer 44

only when no other viable option is available

Question 45

restraints don't _____, usually ______

Answer 45

don't protect, usually hurt

Question 46

recommended use of restraints? (when to use)

Answer 46

-ensure immediate safety of patients and staff -prevent interruption of therapy -prevent confused or combative patient from removing life support equipment or unsafe attempts at mobility

Question 47

posey vest used?

Answer 47

to prevent patients from injuring themselves by falling out of bed/chair

Question 48

mitts use?

Answer 48

to prevent pulling/picking at IVs

Question 49

wrist restraints use?

Answer 49

prevent interference with care

Question 50

upper arm restraint?

Answer 50

to stop bending of elbow

Question 51

four side rails up considered?

Answer 51

restraints *cannot use

Question 52

hazards of restraints/side rails?

Answer 52

impaired circulation altered skin integrity altered nutrition/hydration aspiration/difficulty breathing incontinence increased possibility of injury from falls depression/anxiety death

Question 53

does routine restraint use lower risk of falls?

Answer 53

no

Question 54

how often do we check non violent restraints?

Answer 54

Q2 Q4 for food

Question 55

how often do we check violent restraints?

Answer 55

every 15 mins Q2 for ROM/fluid/elimination Q4 for food

Question 56

should safety event reports be put in EMR documentation?

Answer 56

no