WK 2 Quality and Safety Flashcards
what is safety?
freedom from injury
what are the three types of safety?
home safety, client safety, and environment safety
what is To Err is Human?
institute of medication publication that identified that healthcare systems need to be aware of errors and how they affect patients
common errors in healthcare
medications, surgery, diagnostic inaccuracy, equipment failure, transfusion error, laboratory, system failure, and environment
medication errors
wrong dose, wrong person, wrong time, wrong route
surgery errors
wrong site
diagnostic inaccuracy errors
wrong treatment
equipment failure errors
IV pump
transfusion errors
blood type inaccuracy, wrong patient
laboratory errors
incorrect labeling
system failure errors
insufficient staffing
environment errors
spills, exposure
MAJOR nursing repsonsibilities
providing safety and preventing injury
QSEN
quality and safety education for nurses
organization that oversees the work that nurses do to ensure patient safety
quality improvement
how nurses implement and change the quality of CARE that we give to patients and families
how is quality improvement implemented?
data is used to monitor OUTCOMES of care that helps to improve patient care using systematic and developmental processes
examples of quality improvement
alarms going off constantly = decrease alarms by changing settings on alarm
COPD O2 stats are 88% normally, so we change setting on alarm to go off when O2 is below 88%
pulling out a foley catheter if it has been in too long
7 national patient safety goals
- identify patients correctly
- improve staff communication
- use medications safely
- use alarms safely
- prevent infections
- patient safety risks
- prevent surgical mistakes
who endorses the 7 national patient safety goals?
the joint commission
elements of client safety
falls, patient-related accidents, procedure-related accidents, equipment-related accidents, ensure clients have access to assistive devices, patient education
what are the leading cause of fatal and nonfatal injuries?
falls
who are more susceptible to fall-related injuries?
patients with underlying conditions, such as a stroke
how can we prevent falls?
fall risk assessments, call light, fall-risk alert signs/wrist bands, hourly rounding, orientation and cognitive assessments, bed low and locked position
how do we assess elements of client safety?
environmental surveys
CAUTI
catheter associated urinary tract infection
catheters increase risk for UTI
quality improvement: early removal
CLABSI
central line associated blood stream infection
patients with central lines are at a high risk for bacterial infection in their blood streams
quality improvement: central line bundles = set of guidelines that tell nurses and providers how to care for patients with these lines
seizure precautions
helps protected client from injuries related to uncontrollable body movements
rescue equipment at bedside, pad side rails, IV access on patient, bed low and locked, remove item from room that are not necessary, teaching family members and caregivers to not restrain client during a seizure, protect their head and remove nearby furniture
seizure
sudden surge of electrical activity in the brain
can be caused by epilepsy, fever
restraints
safety concern to self or staff
only use when ABSOLUTELY necessary
use for shortest duration possible, and only after less restrictive measures have been implemented
what kind of patients need restraints?
confused and disoriented (non-violent), and violent
what can we do before administration of restraints?
redirection, distraction, activity belts, family member assistance
chemical restraints
narcotics and sedatives
physical restraints
mittens, soft wrist restraints, ankle restraints, belt restraints, 4-points violent restraints
nursing considerations for restraints
- always explain to patient and family the need for restraints
- need verbal consent from caregiver restraints
- assess and reassess
- make sure they are not too tight, fit 1-2 fingers between skin and restraint
nursing home laws for restraints
patient must give written consent prior to implementation
critical skin assessment protocol for restraint use
must document AT LEAST q1 hour while in restraints
offer toileting, repositioning, nutrition, at regular intervals
delegation
multi-step, continuous process
entrusting a task or responsibility to another person
who do nurses delegate to?
NCTs, LPNs, nursing students, other nurses, other healthcare professionals
5 rights of delegation
right task, right circumstance, right person, right direction/communication, right supervision
what do nurses not delegate?r
assessment, teaching, evaluation
new admissions, patients being discharged, transfers in or out, education of clients, unexpected outcomes, patients with potential problems
what are appropriate tasks for nurses to delegate?
routine tasks and skills, skills that the person has been taught, tasks in job description, routine care, care to stable patients with predictable outcomes
