Patient Safety

  1. What are the steps in the nursing plan for safety?
    • Assess environment for safety.
    • Analyze and make appropriate nursing diagnoses.
    • Plan for maintaining patient safety.
    • Implement safe practices.
    • Evaluate safety behaviors, nursing diagnosis, and nursing care.
  2. What are the 6 areas to assess in a patient's environment?
    • 1. Physical safety
    • 2. Microbial safety
    • 3. Chemical safety
    • 4. Thermal safety
    • 5. Environmental safety
    • 6. Psychological safety
  3. How do you implement safe practices for physical safety of a patient?
    • Use side rails in accordance with patients condition.
    • Keep call light within reach.
    • Keep bed in lowest position.
    • Keep floors dry and free of clutter.
    • Provide adequate lighting.
    • Use restraints as appropriate.
    • Transfer patient accordingly.
    • Ambulate patient accordingly.
  4. How do you implement safe practices for microbial safety of a patient?
    • Medical asepsis (hand washing, handling of food and linens, cleaning of equipment)
    • Standard precautions
    • Surgical asepsis
  5. How do you implement safe practices for chemical safety of a patient?
    • Keep all hazardous ingestible substances out of reach of patient.
    • Administer medication according to the 9 rights.
  6. What are the 9 rights of medication administration?
    • Right patient
    • Right drug
    • Right route
    • Right time
    • Right dose
    • Right documentation
    • Right action
    • Right form
    • Right response
  7. How do you implement safe practices for thermal safety of a patient?
    • Heat and/or cold treatments accordingly.
    • Properly ground electrical equipment.
    • Know fire procedures as well as locations of alarms and extinguishers.
  8. How do you implement safe practices for environmental safety of a patient?
    • Properly handles and disposes of hazardous waste.
    • Minimize noise in patient's environment.
    • Control odors.
    • Smoke free environment.
  9. How do you implement safe practices for psychological safety of a patient?
    • Identify emotional responses to illness.
    • Assess for coping resources and defense mechanisms.
    • Use facilitative communication when appropriate.
  10. What do you think of first when tackling a patient problem?
  11. ANA
    American Nursing Association
  12. IOM
    Institute of Medicine
  13. What are the 6 aims to improve health care?
    • Patient safety
    • Patient centered care
    • Effectiveness
    • Timeliness
    • Efficiency
    • Equity
  14. What is the leading cause of both fatal and nonfatal injuries?
  15. QSEN
    Quality and Safety Education for Nurses
  16. What are a patient's most basic needs?
    • Oxygen
    • Nutrition
    • Temperature
  17. What is Mazlow's Criteria?
  18. What are the intrinsic patient safety risk factors?
    • Chronic conditions (postural hypotension)
    • Alcohol use
    • Previous falls
    • Drug treatment/polypharmacy
  19. What are the extrinsic patient safety risk factors?
    • Lighting
    • Obstacles
    • Bathroom hazards
    • Security
    • Pathogens
    • Pollution
    • Terrorism
    • Medications/chemicals
  20. What are the developmental risks for adults?
    • Lifestyle habits (medications, alcohol)
    • Stress (work)
  21. What are the developmental risks for older adults?
    • Physiological changes
    • Falls, accidents
  22. How does the musculoskeletal system change for an older adult?
    • Decreased bone mass, muscle fiber size, strength, range of motion
    • Gait and postural changes
  23. What is the leading cause of functional impairment in older adults?
  24. What are a large proportion of fall deaths caused from?
    Hip fracture complications
  25. How often are nursing rounds?
    Every hour
  26. How often do you reposition a patient?
    Every 2 hours
  27. What is the Morse scale?
    Fall risk scale, score of over 50 is high risk
  28. How often do you renew a restraint order?
    Every 24 hours
  29. How often do you check restraints on a patient?
    Within 15 minutes of placing them and every 2 hours after that
  30. What is the 15 minute restraint check?
    • Level of consciousness
    • Respiratory status
    • Circulation
    • Patient comfort
    • Body alignment
    • Position of restraints
  31. What is the 2 hour restraint check?
    • Continued need for restraints?
    • Skin integrity/circulation
    • Release extremities
    • Change position/ROM
    • Nutrition/hygiene/elimination
  32. What is the RACE acronym?
    • Fire safety:
    • R: Rescue/remove
    • A: Alarm/activate
    • C: Confine/contain
    • E: Extinguish/evacuate
    • Close all doors.
    • Don't use elevators.
  33. SRE
    Serious reportable events
  34. What are the nursing-sensitive quality indicators?
    • HAI's
    • Falls/with injury
    • Pressure ulcer
    • Restraint use
    • Pediatric peripheral intravenous infiltration
  35. Just Culture
    Errors have just as serious of consequences
  36. RCA
    Root cause analysis for errors
  37. Sentinel events
    Never events, should never happen and are preventable
  38. CMS
    • Centers for Medicare & Medicaid Services
    • Oversees many programs
  39. JCAHO
    Joint Commission on Accreditation of Healthcare Organizations
  40. Near Miss
    A potential safety issue that was stopped by intevention
  41. System Error
    Equipment error
Card Set
Patient Safety
Patient Safety Lecture Notes