WK 2 Quality and Safety

Question 1

what is safety?

Answer 1

freedom from injury

Question 2

what are the three types of safety?

Answer 2

home safety, client safety, and environment safety

Question 3

what is To Err is Human?

Answer 3

institute of medication publication that identified that healthcare systems need to be aware of errors and how they affect patients

Question 4

common errors in healthcare

Answer 4

medications, surgery, diagnostic inaccuracy, equipment failure, transfusion error, laboratory, system failure, and environment

Question 5

medication errors

Answer 5

wrong dose, wrong person, wrong time, wrong route

Question 6

surgery errors

Answer 6

wrong site

Question 7

diagnostic inaccuracy errors

Answer 7

wrong treatment

Question 8

equipment failure errors

Answer 8

IV pump

Question 9

transfusion errors

Answer 9

blood type inaccuracy, wrong patient

Question 10

laboratory errors

Answer 10

incorrect labeling

Question 11

system failure errors

Answer 11

insufficient staffing

Question 12

environment errors

Answer 12

spills, exposure

Question 13

MAJOR nursing repsonsibilities

Answer 13

providing safety and preventing injury

Question 14

QSEN

Answer 14

quality and safety education for nurses

organization that oversees the work that nurses do to ensure patient safety

Question 15

quality improvement

Answer 15

how nurses implement and change the quality of CARE that we give to patients and families

Question 16

how is quality improvement implemented?

Answer 16

data is used to monitor OUTCOMES of care that helps to improve patient care using systematic and developmental processes

Question 17

examples of quality improvement

Answer 17

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

Question 18

7 national patient safety goals

Answer 18

1. identify patients correctly
2. improve staff communication
3. use medications safely
4. use alarms safely
5. prevent infections
6. patient safety risks
7. prevent surgical mistakes

Question 19

who endorses the 7 national patient safety goals?

Answer 19

the joint commission

Question 20

elements of client safety

Answer 20

falls, patient-related accidents, procedure-related accidents, equipment-related accidents, ensure clients have access to assistive devices, patient education

Question 21

what are the leading cause of fatal and nonfatal injuries?

Answer 21

falls

Question 22

who are more susceptible to fall-related injuries?

Answer 22

patients with underlying conditions, such as a stroke

Question 23

how can we prevent falls?

Answer 23

fall risk assessments, call light, fall-risk alert signs/wrist bands, hourly rounding, orientation and cognitive assessments, bed low and locked position

Question 24

how do we assess elements of client safety?

Answer 24

environmental surveys

Question 25

CAUTI

Answer 25

catheter associated urinary tract infection

catheters increase risk for UTI

quality improvement: early removal

Question 26

CLABSI

Answer 26

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

Question 27

seizure precautions

Answer 27

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

Question 28

seizure

Answer 28

sudden surge of electrical activity in the brain

can be caused by epilepsy, fever

Question 29

restraints

Answer 29

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

Question 30

what kind of patients need restraints?

Answer 30

confused and disoriented (non-violent), and violent

Question 31

what can we do before administration of restraints?

Answer 31

redirection, distraction, activity belts, family member assistance

Question 32

chemical restraints

Answer 32

narcotics and sedatives

Question 33

physical restraints

Answer 33

mittens, soft wrist restraints, ankle restraints, belt restraints, 4-points violent restraints

Question 34

nursing considerations for restraints

Answer 34

1. always explain to patient and family the need for restraints
2. need verbal consent from caregiver restraints
3. assess and reassess
4. make sure they are not too tight, fit 1-2 fingers between skin and restraint

Question 35

nursing home laws for restraints

Answer 35

patient must give written consent prior to implementation

Question 36

critical skin assessment protocol for restraint use

Answer 36

must document AT LEAST q1 hour while in restraints

offer toileting, repositioning, nutrition, at regular intervals

Question 37

delegation

Answer 37

multi-step, continuous process

entrusting a task or responsibility to another person

Question 38

who do nurses delegate to?

Answer 38

NCTs, LPNs, nursing students, other nurses, other healthcare professionals

Question 39

5 rights of delegation

Answer 39

right task, right circumstance, right person, right direction/communication, right supervision

Question 40

what do nurses not delegate?r

Answer 40

assessment, teaching, evaluation

new admissions, patients being discharged, transfers in or out, education of clients, unexpected outcomes, patients with potential problems

Question 41

what are appropriate tasks for nurses to delegate?

Answer 41

routine tasks and skills, skills that the person has been taught, tasks in job description, routine care, care to stable patients with predictable outcomes