question

Unintentional injury

answer

The fifth leading cause of death

question

Falls

answer

Leading cause of unintentional death for adults older than 64 years old.

question

Bioterrorism

answer

The use of anthrax, smallpox, pneumonic plague, and botulism

question

Nurse Knowledge base that influence safety

answer

developmental immobility sensory Cognitive lifestyle choices common safety precautions special risk to safety

question

Risk factors that pose a threat to safety

answer

lifestyle choices impaired mobility mobility and cognitive status sensory/communication impairment lack of sensory awareness

question

Four major risk of safety in a healthcare environment

answer

Falls Patient inherent accidents Procedure related equipment related

question

Pt. assessment to perform when considering possible threats to the pt. safety

answer

Nursing history Pt. hm environment risk for falls risk for medical errors (medication)

question

Features that should alert nurses to the possibility of bioterrorism-related outbreak

answer

a. disease or strain not endemic b. antibiotic resistance c. atypical clinical presentation d. clusters of pt. same local e. motility rates, morbidity rates and inconsistent elements.

question

Identify actual or potential nursing diagnosis that apply to pt. whose safety is threatened

answer

a. risk for falls b. impaired home maintenance c. risk for injury d. lack of knowledge e. risk for poisoning f. risk of contamination g. risk for suffocation h. risk of thermal injury i. risk for trauma

question

Identify the plan for a pt. who has a "high risk for falls"

answer

a. select nursing interventions for safety according to the pt. developmental and health care needs. b. consult with OT and PT for assistive devices c. Select interventions that will improve the safety of the pt. home environment

question

Strategies to provide safe nursing care

answer

a. demo-device proper safety b. demo-effective use of strategy c. Strategies to reduce reliance on memory

question

Physical restraint is:

answer

any manual method physical/mechanical device, material or equipment that immobilizes or reduces ROM; extremities, body or head.

question

Restraints must meet the following objectives

answer

a. reduce risk of pt. injury b. prevent interruption of tubing, foley cath and iv c. Confused/combative pt. from removing life support equipment. d. reduce the risk of injury to others by the pt.

question

Define ambularm

answer

used to alert staff when a pt. is up and out of bed

question

Mnemonic Race: define

answer

R:escue A:larm C:onfine E:xtingish

question

Seizure precautions

answer

nursing interventions to protect pt. from traumatic injury, positioning for adequate ventilation and drainage or oral secretions, and providing privacy and support after the event.

question

Exposure to radiation measures

answer

confinement, limiting exposure and shielding devices.

question

Joint Commission 2011 requires that hospitals have an emergency management plan that addresses:

answer

a. natural disasters b. fire c. chemical hazards.

question

SAFETY

answer

freedom from psychological & physicological injury, basic human need

question

#1 MEDICAL ERRORS -CAUSES

answer

poor communication hectic work environment missing medications improper drug selection look alike/sound alike

question

MEDICAL ERRORS OCCUR

answer

nurses are held accountable and perfer timeout but dealing with human life the punishment is severe

question

PREVENTION

answer

is the key stay focus realize how serious it is know the drug given

question

PROFESSIONAL NURSES

answer

follow the rules & policies regarding medication preparation & administration

question

OTHER PREVENTION WAYS

answer

not satisfied work w/in scope of pratice make wise decisions conscientious understand consequences of actions

question

#2 FIRE PREVENTION

answer

hospitals are non smoking promote health & fires

question

CAUSES OF FIRE

answer

smoking in beds or bathrooms electrical Anesthetic related

question

FIRE NURSING ACTIONS

answer

remove pt from danger call code red take measures to contain or extinguish fire(closing doors, turn off oxygen, use fire extinguisher) if fire drill, shut the pt's door

question

#3 FALLS

answer

bone most vascular organs results-minor to sever injuries causes- unfamiliar environment, acute illness, mobility status, medications, placement tubes, surgery

question

ASSESSMENT OF FALL

answer

check fall risk daily based on results, nurse should implement evidence based interventions inform the pt and family members of fall risk

question

OTHER CAUSES OF FALL

answer

limited vision & hearing elderly pt. medications

question

PREVENT FALLS

answer

fall risk bracelet none skid socks leaf on door bed lowest pos. 3 side rails call light in reach keep door open bed alarm check pt every hour clean room bed locked

question

#4 RESTRAINTS

answer

physical restraint-immobilize or reduces the ability of a patient to move arms, legs, or body freely

question

RESTRAINTS NURSING ACTIONS

answer

use of restraints must be clinically justified physicians order is required based on face to face assessment orders must be reviewed every 24 hours or more freq restraints must be removed periodically(feeding, toileting, skin assessment) nurse must determine if restraint are still needed check w/ pt every hour if restraints necessary the nurse should explain the purpose, the care while restrained, precatutions that will be taken, & restraints are temporary & protective

question

#5 PATIENT ACCIDENTS(PT FAULT)

answer

self inflicted cuts, injuries, & burns ingestion or injection of foreign substances self multilation or fire setting pinching fingers in drawers or doors document the problem & bring to the attention of nursing adminstration

question

#6 PROCEDUCER RELATED ACCIDENT(NURSES & HEALTH CARE WORKERS)

answer

improper application of external devices fluid administration errors incorrect dressing changes improper urinary catheter insertion distraction & interruption contribute-need to be limited

question

List factors that contribute to the risk of falls

answer

History of previous falls Gait, balance, and mobility problems Difficulty communicating because of impaired vision, hearing, or speech Impaired cognition

question

What is an NAP?

answer

nursing assistive personnel

question

What are risk factors in the health care facility that pose a threat to patient's safety

answer

attached to equipment, poor lighting, cluttered pathways, wet floors

question

List the steps in the timed "Get Up and Go" test.

answer

-Have patient rise from sitting position without using arms for support. -Instruct patient to walk 10 feet (3 m), turn around, and walk back to the chair. -Have patient return to chair and sit down without using arms for support. Look for unsteadiness in patient's gait.

question

What is the purpose of a wedge cushion?

answer

protects patient from sliding out of chair

question

Side rails should be up if the patient is ...

answer

weak, sedated, or confused

question

What should the nurse do if the patient is unable to identify safety risks?

answer

Reinforce identified risks with the patient or involve a family member/friend and review the safety measures needed to prevent a fall.

question

What should the nurse do if the patient starts to fall while ambulating with a caregiver?

answer

-Put both arms around the patient's waist or grasp the gait belt. Stand with feet apart to provide a broad base of support. -Extend one leg and let the patient slide against it to the floor. -Bend your knees to lower the body as the patient slides to the floor.

question

What should the nurse do it the patient suffers a fall despite all measures taken?

answer

-Call for assistance. -Assess the patient for injury. -Stay with the patient until assistance arrives to help lift the patient to the bed or to a wheelchair. -Notify the physician. -Document pertinent events related to the fall and resultant treatment in the medical record. -Follow the institution's incident reporting policy. -Reassess the patient and environment to determine if the fall could have been prevented. -Reinforce the identified risks with the patient, family, and health care professionals and review the safety measures needed to prevent a fall.

question

What should the nurse do if the patient displays behaviors that substantially increase the risk for falls?

answer

-Intensify supervision of the patient and notify the physician. It may be necessary to have one-on-one staff to patient supervision. -Review the episodes for a pattern (e.g., activity, time of day) that indicate alternatives that could eliminate the behavior. -Engage in creative thinking with all caregivers and support service personnel for alternative interventions that promote safe, consistent care.

question

Which of the following patients is at greatest risk for experiencing a fall?

answer

A confused patient with a history of a previous fall.

question

restraint

answer

any manual method, physical, or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely

question

The Centers for Medicare and Medicaid Services requires that a restraint be used only under what circumstances?

answer

()(1) to ensure the immediate physical safety of the patient, a staff member, or others; (2) when less restrictive interventions have been ineffective; (3) in accordance with a written modification to the patient's plan of care; (4) when it is the least restrictive intervention that will be effective to protect the patient, staff member, or others from harm; (5) in accordance with safe and appropriate restraint techniques as determined by a hospital's policies; and (6) it is discontinued at the earliest possible time.

question

List the serious complications that can happen with the use of restraints.

answer

()Pressure ulcers Hypostatic pneumonia Constipation Urinary and/or fecal incontinence Death

question

Each original restraint order and renewal are limited to ....

answer

4 hours for adults, 2 hours for children ages 9 through 17, and 1 hour for children under age 9. Original orders may be renewed up to a maximum of 24 hours. If a nurse or qualified health practitioner restrains a patient in an emergency situation because of violent or aggressive behavior that presents an immediate danger, a face-to-face physician assessment within 1 hour is necessary.

question

Before the application of restraints, conduct a focused patient assessment that includes the following:

answer

1. Assess patient's behavior for signs of confusion, disorientation, restlessness, or combativeness; repeated removal of tubing, dressings or other therapeutic devices; and inability to follow directions. 2. Review agency policies regarding restraints. Check the physician's order for the purpose, type, location, and time or duration. Determine if a signed consent is needed. 3. Review the manufacturer's instructions for restraint application and determine the most appropriate size restraint. 4. Inspect the area where the restraint is to be placed, including the condition of the skin, presence of sensation, ROM, and the adequacy of circulation.

question

List types of restraint options.

answer

Elbow Restraint Belt restraint Extremity (ankle or wrist) restraint Mitten restraint

question

What is required to use restraints?

answer

physician's order

question

If a patient has restraints, how often should they be released?

answer

Every 2 hours

question

Who may require a temporary restraint?

answer

()-A patient who is at risk for falls when nonrestrictive measures have failed. -A patient who may be at risk to self or others. -A confused patient who may interrupt prescribed therapy, such as a nasogastric tube.

question

The nurse has applied extremity restraints on a patient. What should the nurse assess on a regular basis?

answer

-Skin integrity and ROM. -Pulse and temperature of restrained body part. -Readiness for discontinuation of restraint. -Therapy (e.g., IV catheters, drainage tubes) remains uninterrupted. (It is not necessary with an extremity restraint to assess patient's breathing.)

question

Why are many health care agencies no longer using vest (jacket) restraints?

answer

Because they have been associated with fatal injuries.

question

Joint Commission 2011 Patient Safety Goals

answer

A. two identifiers b. improve staff communication C. use medicines safely d. reduce the risk infectious disease e. Medication reconciliation f. identify patient safety risk

question

Environment

answer

Includes all of the physical and psychosocial factors that influence the life and the survival of the patient

question

Carbon Monoxide

answer

Low concentrations cause nausea, dizziness, headache and fatigue

question

Poison

answer

A substance that impairs health or destroys life when ingested, inhaled or absorbed by the body.

question

FDA

answer

Federal agency responsible for regulating the manufacture, processing, and distribution of foods, drugs and cosmetics

question

Hypothermia

answer

Core temp is 35 C or below

question

Frostbite

answer

Surface area of the skins freezes as a result from exposure to extreme cold temperatures

question

Unintentional injury

answer

The fifth leading cause of death

question

Pollution

answer

Harmful chemical or waste material discharged into the water, soil, or air

question

Rear facing car seats

answer

Recommended for all children younger than 2yrs old.

question

Water Pollution

answer

Contamination of lakes, rivers, and streams by industrial pollutants

question

Falls

answer

Leading cause of unintentional death for adults older than 64 years old.

question

Bioterrorism

answer

The use of anthrax, smallpox, pneumonic plague, and botulism

question

Nurse Knowledge base that influence safety

answer

developmental immobility sensory Cognitive lifestyle choices common safety precautions special risk to safety

question

Risk factors that pose a threat to safety

answer

lifestyle impaired mobility sensory/communication impairment lack of sensory awareness

question

Four major risk of safety in a healthcare environment

answer

Falls Patient inherent accidents Procedure related equipment related

question

Pt. assessment to perform when considering possible threats to the pt. safety

answer

Nursing history Pt. hm environment risk for falls risk for medical errors (medication)

question

Features that should alert nurses to the possibility of bioterrorism-related outbreak

answer

a. disease or strain not endemic b. antibiotic resistance c. atypical clinical presentation d. clusters of pt. same local e. motility rates, morbidity rates and inconsistent elements.

question

Identify actual or potential nursing diagnosis that apply to pt. whose safety is threatened

answer

a. risk for falls b. impaired home maintenance c. risk for injury d. lack of knowledge e. risk for poisoning f. risk of contamination g. risk for suffocation h. risk of thermal injury i. risk for trauma

question

Identify the plan for a pt. who has a "high risk for falls"

answer

a. select nursing interventions for safety according to the pt. developmental and health care needs. b. consult with OT and PT for assistive devices c. Select interventions that will improve the safety of the pt. home environment

question

Strategies to provide safe nursing care

answer

a. demo-device proper safety b. demo-effective use of strategy c. Strategies to reduce reliance on memory

question

Physical restraint is:

answer

any manual method physical/mechanical device, material or equipment that immobilizes or reduces ROM; extremities, body or head.

question

Restraints must meet the following objectives

answer

a. reduce risk of pt. injury b. prevent interruption of tubing, foley cath and iv c. Confused/combative pt. from removing life support equipment. d. reduce the risk of injury to others by the pt.

question

Define ambularm

answer

used to alert staff when a pt. is up and out of bed

question

Mnemonic Race: define

answer

R:escue A:larm C:onfine E:xtingish

question

Seizure precautions

answer

nursing interventions to protect pt. from traumatic injury, positioning for adequate ventilation and drainage or oral secretions, and providing privacy and support after the event.

question

Exposure to radiation measures

answer

confinement, limiting exposure and shielding devices.

question

Joint Commission 2011 requires that hospitals have an emergency management plan that addresses:

answer

a. natural disasters b. fire c. chemical hazards.

question

QSEN

answer

Quality and Safety Education -improves system effectiveness and individual performance

question

Standards have been developed by...

answer

American Nurses Association The Joint Commission

question

Never Events

answer

-foreign object retained after surgery -air embolism -blood incompatibility -stage III or IV pressure ulcers -falls and trauma -catheter associated urinary tract infection -vascular catheter infections -manifestations of poor glycemic control -Surgical site infections -mediastinitis after coronary artery bypass graft -certain orthopedic procedures (spine, neck, shoulder, elbow) -Bariatric surgery for obesity -deep vein thrombosis and pulmonary embolism following certain orthopedic procedures (knee replacement, hip replacement)

Fundamentals: Chapter 27, Patient Safety – Flashcards

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