TOPIC 2 Flashcards
AHRQ culture of safety
reduces the risk for illness and injury
-helps contain costs of healthcare by preventing extended lengths of hospitalization, improving and maintaining patients functional status and increasing patient well being
The QSEN safety competency for nurse is defined as
Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
environmental safety
identifying and correcting potential hazards that can cause accidents and injuries (to both client and health care workers)
patient education and oxygen
supplemental oxygen poses a fire risk and is combustible
what must be met before physical and psychological safety and security can be addressed
maslows basic needs
nutrition
meet nutritional needs adequately (requires knowledge about healthy food and food safety)
Food and Drug Administration (FDA)
a federal agency responsible for regulating food and drug products sold to the public (TO PROTECT THE PUBLIC)
what is a persons comfort zone when it come to temperature?
18.3-23.9C (65-75 F)
poison
any substance that impairs health or destroys life when ingested, inhaled, or absorbed by the body
falls and older adults
-older adults at increased risk due to decreased strength, impaired mobility and balance, and endurance limitations combined with decreased sensory perception
-fall prevention is a major nursing priority
pathogen
any microorganism capable of producing an illness
immunization
primary prevention: reduces/ can prevent the transmission of disease from person to person
-NURSES RESPONSIBILITY TO EDUCATE THE BENEFITS OF IMMUNIZATION
pollutant
harmful material that can enter the biosphere through the land, air, or water
what are the factors that influence patient safety
patients developmental level
mobility, sensory, and cognitive status
lifestyle choices
knowledge of common safety precautions
what is adult safety revolved around?
lifestyle habits (smoking, drinking, hazardous work)
what is older adult safety revolved around?
injury related to physiological changes of aging
multiple medications
cognitive factors
acute/chronic disease increase risk for FALLS
falls
increase risk of premature death
patients who have underlying disease states are more susceptible to fall related injury
Patient-inherent accidents
classified as self-induced. (need to ascertain whether a patient-inherent accident is caused by seizure activity)
Procedure-related accidents
occur during therapy (med errors, IV therapy errors, improper application of external device, improper performance procedure)
potential for infection is reduced when…
surgical asepsis is used for sterile dressing changes or invasive procedures
equipment related accidents
result from malfunction, disrepair, or misuse of equipment or from an electrical hazard
successful critical thinking
Requires a synthesis of knowledge, experience, information gathered from patients, critical thinking attitudes, and intellectual and professional standards
what do you consider when taking a thorough patient assessment?
-threats to patient safety (environment and individual risk factors)
nursing history
Includes data about a patient’s level of wellness to determine if any underlying conditions exist that pose threats to safety
what should be performed in the patients home?
a hazard assessment
what is included in a hazard assessment?
lighting
presence of safety devices
placement of furniture
condition of flooring
planning and safety
minimize threats and increase safety
fall prevention
- Keep the bedside environment free from clutter.
- Explain how to use the call light.
- Yellow wristbands mean risk for fall.
what is it important to routinely check on assertive aids
rubber tips and integrity of the aid
Physical Restraints
-only use as last resort
-usually only two side rails can be put up
chemical restraint
any drug that is used for discipline or convenience and not required to treat medical symptoms (anxiolytics)
Fire safety acronym
R- rescue patient
A- alarm (pull alarm)
C- contain (contain fire close doors, turn off oxygen)
E- extinguish fire
seizure safety
Safety.. Airway…suction oral secretions..turn on side post seiz…side lying.. Check vital signs .. Assess for injuries ..allow rest protect head
aura
often a bight light smell or taste that is a warning to sense that a seizure is about to occur
infection
the invasion of a susceptible host by pathogens or microorganisms, resulting in disease
colonization
the presence and growth of microorganisms within a host but without tissue invasion or damage
communicable disease
the infectious process transmitted from one person to another
symptomatic
clinical signs and symptoms are present
asymptomatic
clinical signs and symptoms are not present
What is the chain of infection?
infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
How do you break the chain of infection?
hand washing
(infection happens when the chains intact, so prevent infection to break the chain)
reservoir
source for pathogen growth, where microorganisms survive, multiply, and await transfer to a susceptible host
what are some examples of frequent reservoirs
for HAI- healthcare workers, especially their hands, patients, equipment and environment
human reservoirs
-those with acute symptomatic disease
-those who show no signs of disease
ideal temperature for human pathogen
20-43C (68-109F)
preference pH range for microorganisms
5.0-7.0
portal of exit
after microorganisms find a site to grow and multiply, the must find a portal of exit if they are to enter another host and cause disease
what are examples of portals of exit
blood, skin, mucous membranes, respiratory tract, GU tract, GI tract, transplacental (mother to fetus)
what is the major route of transmission in the health care setting
-unwashed hands of the health care worker
-equipment
portal of entry
organisms enter the body through the same routes they use for exiting
susceptible host
a person likely to get an infection or disease, usually because body defenses are weak
infectious process (4 stages)
incubation period
prodromal stage
illness stage
convalescence
incubation period
the time interval between entrance of the pathogen and appearance of first symptoms
prodromal stage
interval from onset of nonspecific signs and symptoms to more specific symptoms
illness stage
interval when patient manifests signs and symptoms specific to type of infection
convalescence stage
interval when acute symptoms of infection disappear
what supportive therapy helps defends the body against the infectious process
adequate nutrition
rest
normal flora
microorganisms that reside in the body and so not usually cause disease
the use of broad spectrum antibiotics can cause
superinfection
inflammation
a protective vascular reaction that delvers fluid, blood products, and nutrients to an area of injury
what are the signs of localized inflammation
swelling, redness, heat, pain or tenderness, and loss of function in the affected body part
exudates
fluid, cells, and other substances (pus) that filter from cells or capillaries ooze into lesions or areas of inflammation
serous exudate
clear, like plasma
-normal progression of healing
sanguineous exudate
containing red blood cells (bloody drainage)
Health care-associated infections (HAIs)
Results from delivery of health services in a health care facility (can occur as the result of invasive procedures, antibiotic admin, presence of multidrug resistant organisms, and breaks infection prevention and control activates)
what patients are a greater risk for HAIs
multiple illnesses
older adults
poorly nourished
compromised immune system
what are the types of HAIs
iatrogenic, exogenous, endogenous
iatrogenic
from a procedure
exogenous
from microorganisms outside the individual
endogenous
when the patient’s flora becomes altered and an overgrowth results
factors that influence infection prevention and control
age
nutritional status
stress
disease process
treatments or conditions that compromise the immune response
localized infection
an infection that is limited to a specific location in the body and has local symptoms (common areas of skin, mucous membrane breakdown, surgical traumatic wounds, pressure ulcers, oral lesions, abscesses)
systemic infection
an infection throughout the body
Increase in WBC indicates what
infection
what increases risk for infection
imbalance nutrition
impaires oral mucous membrane
risk for impaired skin integrity
social isolation
impaired
tissue integrity
readiness for enhanced immunization status
health promotion
Preventing an infection from developing or spreading
acute care
Treating an infectious process includes eliminating the infectious organisms and supporting the patient’s defenses
asepsis
absence of pathogenic (disease-producing) microorganisms
medical asepsis
clean technique, includes procedures for reducing the number of organisms present and preventing the transfer of organisms
Standard Precautions
recommendations that must be followed to prevent transmission of pathogenic organisms by way of blood and body fluids
when can you use alcohol based hand rub?
if your hands are not visibly soiled
disinfection
A process that eliminates many or all microorganisms, with the exception of bacteria spores, from inanimate objects
sterilization
the complete elimination or destruction of all microorganisms, including spores
what factors influence the efficacy on disinfecting and sterilization methods?
concentration of solution
type and number of pathogens
surface areas to treat
temperature of environment
presence of soap
presence of organic materials
barrier precautions
appropriate use of gowns, gloves, masks, eyewear, devices
contact precautions
practices used to prevent spread of disease by direct or indirect contact (gowns and gloves)
Droplet precautions
Must be followed for a patient known or suspected to be infected with pathogens transmitted by large-particle droplets expelled during coughing, sneezing, talking, or laughing.
(surgical mask within 3 feet of the patient, proper hand hygiene)
Airborne precautions
Methods of infection control that must be used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei.
(negative air flow room, N95)
Protective environment
Room with positive airflow. Used for highly susceptible, immunocompromised patient such as Transplant and gene therapy.
what are the psychological implications of isolation?
loneliness because of lack of sisal relationship
*take time to listen to patients concerns and issues
surgical asepsis
sterile technique prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery
When is surgical asepsis used?
Dressing changes
Catheterizations
Surgical procedures
what is something a nurse should remember when looking at a sterile field
never turn their back of a sterile field
open a sterile package on work area above waist level
A sterile object remains sterile only
when touched by another sterile object
Only sterile objects may
be placed on a sterile field
A sterile object or field out of the range of vision or an object held below a person’s waist is
contaminated
a sterile object or field becomes contaminated by
prolonged exposure to air
body mechanics
coordinated efforts of the musculoskeletal and nervous systems
Body balance occurs when…
a relatively low center of gravity is balanced over a wide, stable base of support and a vertical line falls from the center of gravity through the base of support.
Nurses use balance to maintain proper body alignment and posture through two simple techniques.
· First, widen the base of support by separating the feet to a comfortable distance.
· Second, increase balance by bringing the center of gravity closer to the base of support.
Physical activity (PA) is
any movement produced by skeletal muscles that results in energy expenditure.
Safe patient handling and mobility (SPHM)
Involves improved assessment, the use of mechanical equipment, and safety procedures to lift and move patients
-Nurses often provide care for immobilized patients whose position must be changed, who must be moved up in bed, or who must be transferred from a bed to a chair or from a bed to a stretcher.
assessment for activity and exercise
o Ask questions related to the patient’s exercise and activity tolerance to gather important information.
o Assess the patient’s expectations concerning activity and exercise and determining individual perceptions of what is normal or acceptable is of utmost importance in developing a plan of care.
nursing diagnosis for activity and exercise
o Activity intolerance
o Risk for injury
o Impaired mobility in bed
o Impaired mobility
o Acute or chronic pain
goal of activity and exercise in a patient
improve or maintain the patient’s motor function and independence
when using a cane
Have the patient keep the cane on the stronger side of the body.
crutch gait
alternately bearing weight on one or both legs and on the crutches.
restoration of activity and chronic illness
Coronary heart disease, hypertension, chronic obstructive pulmonary disease, diabetes mellitus (Exercise reduces systolic and diastolic blood pressure readings)
