Week 1: Clinical Governance Flashcards
Why do we needs nurses in the periop environment?
Risk minimisation: research and evidence, policies and procedures
Identify patient needs and risk factors - reduce risk associated with surgery
Advocacy: ethics, morals, values
Deeper understanding as opposed to technician model: pre-empt, know what to do when things go wrong
Where do perioperative nurses work?
Preop: identify risks and communicate Anaesthetics Circulating Instrument PARU Central Sterilisation Service Department
What influences perioperative practice?
Policy
Standards
Guidelines
Research
Who writes periop guidelines, standards and policy?
Quality and Safety Commission NMBA NSW Health ACORN CEC HETI
What are the four levels of governance in periop practice?
Policy: general management standards, what must be done, compliance
Standards: specific mandatory controls, minimum criteria
Guidelines: recommendation/best practice, instructions for how we do things
Procedures: step by step instructions
Research behind all
Which organisations provide a national framework for periop governance?
ACHS ACSQHS ISO ACORN NMBA AS/NZS RACS ANZCA
What are some periop medicolegal issues?
Consent Code of conduct Accountability Scope of practice Coroner's court Organ transplant Specimen collection Sentinel events
What factors influence consent?
Capacity: > 14, intellectually capable, free of mental illness, dementia, intellectual disability, brain damage, drugs or alcohol
Freely given: not pressured by staff or family
Specific to treatment
Informed
What periop actions constitute negligence?
Incorrect positioning RSI Lost tissue specimen WSS Medication error Equipment failure
What are the National Safety & Quality in Healthcare Standards?
- Governance for safety & quality in health service organisations
- Partnering with consumers
- Preventing and controlling healthcare associated infections
- Medication safety
- Patient identification and procedure matching
- Clinical hand over
- Blood and blood products
- Preventing and managing pressure injuries
- Recognising and responding to clinical deterioration in acute healthcare
- Preventing falls and harm from falls
What is ACSQHC NS&QHS 1?
Governance for safety & quality in health service organisations:
Compliance with policies and protocols
Implementing effective incident management reporting
What is ACSQHC NS&QHS 2?
Partnering with consumers:
Patient input through consumer review
What is ACSQHC NS&QHS 3?
Preventing and controlling healthcare associated infections: WHO Surgical Safety Checklist AS/NZS Antimicrobial stewardship 5 moments of hand hygiene Aseptic technique
What is ACSQHC NS&QHS 4?
Medication safety:
Safe handling of intraop meds
Regulations regarding dispensing and prep
Labelling
What is ACSQHC NS&QHS 5?
Patient ID and procedure matching:
Safe surgical checklist
Time out
What is ACSQHC NS&QHS 6?
Clinical hand over:
ISBAR
Nursing and medical
Ward to OR, OR to PARU, PARU to ward
What is ACSQHC NS&QHS 7?
Blood and blood products: BloodSafe Safe admin and monitoring Recognition of transfusion related events ANZCA guidelines
What is ACSQHC NS&QHS 8?
Preventing and managing pressure injuries:
Identify anticipated risk
Waterlow assessment
What is ACSQHC NS&QHS 9?
Recognising and responding to clinical deterioration in acute healthcare:
CICO
Malignant hyperthermia
What is ACSQHC NS&QHS 10?
Preventing falls and harm from falls:
WHS
Patient positioning
PARU staged recovery
What is the purpose of ACORN?
Peak professional body in Australia
Position statements
Practice guidelines
Leading influence for policy directives
What is the purpose of ANZCA?
Peak professional body in Australia
Position statements
Practice guidelines
Leading influence for policy directives
What is the purpose of RACS?
Peak professional body in Australia
Position statements
Practice guidelines
Leading influence for policy directives
