question

Minimizes risk of harm to patients and providers through both systems effectiveness and individual performance

answer

QSEN Safety competency for a nurse

question

Vulnerable group swho often require help in achieving a safe envioronment include

answer

-Infants -Children -Older adults -the ill -Physically and mentally -The illiterate -The poor

question

A safe environment includes

answer

-Meeting basic needs -Reducing physical hazards -Reducing transmission of pathogens -Controlling pollution

question

According to Maslow's hierarchy of needs what must be meet first

answer

Basic needs must be met before physical and psychological safety and security can be addressed

question

What is the leading cause of burns, reported fires, deaths, and injuries involving home medical oxygen

answer

Smoking

question

What is a common environmental hazard in the home

answer

Improperly functioning heating system

question

What are the groups at the highest risk for foodborne illness

answer

-Children -Pregnant women -Older adults -People with compromised immune systems

question

What is the fifth leading cause of death for Americans of all ages

answer

Unintentional deaths

question

What is the leading cause of death

answer

Motor vehicles, followed by poisonings and falls

question

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

answer

Poison

question

In the home accidental poisoning is a greater risk for

answer

-Toddlers -Preschoolers -Young Children

question

What is the best resource for patients and parents needing information about the treatment of an accidental poisoning

answer

Poison control center

question

Poisoning occurs from

answer

-Swallowing or inhaling lead -Fetuses, infants, and children are more vulnerable to lead poisoning than adults because their bodies absorb lead more easily and small children are more sensitive to the damaging effects of lead

question

Exposure to excessive levels of lead affects a child's

answer

Growth or causes learning and behavioral problems and brain and kidney damage

question

Among adults 64 years or older _____ are the leading cause of unintentional deaths

answer

Falls

question

What are some common physical hazards that lead to falls

answer

-Inadequate lighting -Barriers along normal walking paths & stairways -Lack of safety devices in the home

question

Often a fall leads to serious injury such as

answer

Fractures or internal bleeding -Patients most at risk for injury are those with bleeding tendencies resulting from disease or medical treatments and osteoporosis

question

The use of biological agents to create fear and threat, is the most likely from of a terrorist attack to occur. Threats of this type come in the form of biological, chemical, and radiological attacks

answer

Bioterrorism -Although terrorist could use any agent, health officials are most concerned with biological agents such as anthrax, smallpox, pneumonic plague, botulism, tularemia, and viral hemorrhagic fevers

question

What is the most common means of transmission of pathogens

answer

By hands

question

Reduces, and in some cases prevents, the transmission of disease from person to person

answer

Immunization

question

Injection of a small amount of weakened or dead organisms or modified toxins from the organisms into the body

answer

Active Immunity

question

Occurs when antibodies produced by other persons or animals are introduced into a person's bloodstream for protection against a pathogen

answer

Passive Immunity

question

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

answer

Pollution

question

The leading cause of death in children over age 1 and causes more death and disabilities than do all diseases combined

answer

Injuries

question

The threats to an adult's safety and frequently related to _______.

answer

-Lifestyle habits Likewise, the adult experiencing a high level of stress is more likely to have an accident or illness, such as headaches, gastrointestinal disorders, and infections

question

Older patients are more likely to fall in the

answer

-Bedroom -Bathroom -Kitchen

question

What is the eight leading cause of death

answer

Medical errors

question

Specifically directed to reduce the risk of medical errors. The goals are designed to promote specific improvements in patient safety and highlight ongoing problematic areas in health care.

answer

National Patient Safety Goals of TJC

question

A confidential document that completely describes in patient accident occurring on the premises on a healthcare agency.

answer

Incident report

question

Focusing on the root cause of an event instead of the individual involved promotes a ________ that helps in specifically identifying what contributed to an error

answer

"Cultural of Safety"

question

Required resources available in any health care agency. Provides detailed information about the chemical, heath hazards imposed, first aid guidelines, and precautions for safe handling and use. Gives information on the steps to take in case the material is released or spilled

answer

Material Safety Data Sheets (MSDS)

question

Specific risk to a patients safety within the health care environment include

answer

-Falls -Patient-Inherent Accidents -Procedure-Related Accidents -Equipment-Related Accidents

question

Accidents (other than falls) in which the patient is the primary reason fro the accident

answer

Patient-Inherent Accidents ex. Self-inflicted cuts, injuries, and burns; Ingestion or injection of foreign substances; self mutilation or fire setting; and pinching fingers in drawers or doors

question

What is one of the more common precipitating factors for a patient-inherent accident

answer

A seizure

question

Caused by health care providers and include medication and fluid administration errors, improper application of external devices, and accidents related to improper performance of procedures such as dressing changes or urinary catheter insertion

answer

Procedure-related accidents

question

Accidents that are equipment related result from

answer

The malfunction, disrepair, or misuse of equipment or from an electrical hazard

question

Your assessment needs to be ______ and include the patients own perception of his or her risk factors, knowledge of how to adapt to such risks, and previous experience with any accidents

answer

Patient Centered

question

Helps you assess important risk factors

answer

A fall assessment tool

question

When caring for a patient in the home what is a necessary

answer

A home hazard assessment -Know where medications and cleaning supplies are located. walk through the home with the patient and discuss how he or she normally conduct daily activities and whether the environment posses problems. -Getting a sense of the patients routines helps you recognize less obvious hazards

question

Assessment for risk of food infection or poisoning includes

answer

Assessing a patients knowledge of food preparation and storage practices

question

Assess for clinical signs of infection by conducting an examination of

answer

-GI and central nervous system function -Observing for a fever -Analyzing the results of cultures of feces and emesis

question

When oxygen is use, precautions must be taken to prevent fire. Contact with heat or a spark is required to trigger combustion; Therefore certain precautions are necessary, regardless of the setting where oxygen is in use

answer

-Post "no smoking" and "oxygen in use" signs in patient rooms -Do not use oxygen around electrical equipment or flammable products -Store oxygen tanks upright in carts or stands to prevent tipping or falling or place the tanks flat on the floor when not in use -Check tubing for kink that would affect the oxygen flow -Maintain oxygen at the prescribed liter flow and do not change without a health care providers order

question

Teach basic techniques for food handling and preparation so nutritional needs are met safely

answer

-Proper refrigeration, storage, and preparation of food decreases the risk of foodborne illness -Wash hands before preparing foods -Rinse fruits and vegetables thoroughly -And more

question

The American Hospital Association issued an advisory recommending that hospitals standardize wristband colors

answer

-Red= Patient allergies -Yellow= Fall risk -Purple= Do not resuscitate preferences

question

A secure way to steady or guide patients who need assistance with ambulation when transferring or walking

answer

Gait belt

question

What kind of patients often require the temporary use of restraints to keep them safe

answer

Patients who are confused, disorients, or repeatedly fall or try to remove medical devices (oxygen equipment, IV lines, or dressing)

question

Restraints are not a solution to a patient problem but rather a

answer

Temporary means to maintain patient safety. They are either chemical, physical, or human

question

Chemical restraints are medications such as

answer

Anxiolytics and sedatives used to manage a patients behavior and are not standard treatment or dosage for the patients condition

question

A physical restraint is any

answer

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

question

The optimal goal for all patients is a restraint free environment.

answer

Always consider and implement alternatives to restraints first -Restraint alternatives include more frequent observations, involvement of family during visitation, frequent reorientation, and the introduction of familiar and meaningful stimuli (knitting or crocheting or looking at family photos)

question

In the hospital each original restraint order and renewal is limited to

answer

-4 hours for adults -2 hours for ages 9 through 17 -1 hour for children under age 9

question

Orders may be renewed tot he time limits for a maximum of _____ hours. Restraints are not to be ordered PRN (as needed). You must conduct on going assessment of patients who are restrained

answer

24 hours

question

Use of restraints must meet one of the following objectives

answer

1. Reduce the risk of patient injury from falls 2. Prevent interruption of therapy such as traction, IV infusions, nasogastric tube feeding, or Foley catheterization 3. Prevent patients for are confused or combative from removing life-support equipment 4. Reduce the risk of injury to others by the patient

question

Electronic devices are also sometimes used as alternatives to restraints.

answer

For example the Ambularm, worn on the leg, signals when the leg is in a dependent position such as over the side rail or on the floor.

question

The _____ is a less restrictive restraint. It is a soft-sided, self-contained enclosed bed that is much less restrictive than chemical or physical restraints

answer

-Posey bed

question

What is the most common used physical restraint

answer

Side Rails

question

Use the mnemonic RACE to set priorities in case of fire:

answer

R- Rescue and remove all patients in immediate danger A- Activate the alarm. Always do this before attempting to extinguish even a minor fire C- Confine the fire by closing doors and windows and turning off oxygen and electrical equipment E-Extinguish the fire using an appropriate extinguisher

question

If a fire occurs in a health care agency you want to

answer

-Protect patients from immediate injury -Report the exact location of the fire -Contain it -Extinguish it if possible

question

If a patient is on life support you need to

answer

Maintain his or her respiratory status manually with a bag-valve mask device until he or she I moved away from the fire

question

After a fire is reported and patients are out of danger, nurses and other personnel take measures to contain or extinguish it such as

answer

-Closing doors and windows -Placing wet towels along the base of doors -Turning off sources of oxygen and electrical equipment -Using a fire extinguisher

question

Fire extinguishers are categorized as

answer

-Type A: used for ordinary combustibles (wood, cloth, paper, plastic) -Type B: Used for flammable liquids (gasoline, grease, paint) -Type C: Used for electrical equipment

question

Patients who have experienced some form of neurological injury or metabolic disturbance are at risk for a

answer

Seizure

question

Hyperexcitation and disorderly discharge of neurons in the brain leading to a sudden, violent, involuntary series of muscle contractions that is paroxysmal and episodic, causing loss of consciousness, falling, tonicity, and clonicty

answer

Seizure

question

During a fall or as a result of muscle jerking, ______ injuries can occur

answer

Musculoskeletal

question

Prolonged or repeated seizures indicate

answer

Status Epilepticus

question

An aura is often a

answer

Bright light, smell, or taste

question

What should you do to reduce your exposure to radiation

answer

-Limit the times spent near the source -Make the distance from the source as great as possible -Use shielding devices such as lead aprons

question

An important aspect of care for patients who have a bioterroism -related illness is

answer

Postexposure Management

question

Safety in the health care setting

answer

- Freedom from danger, harm or risk -A paramount (more important than anything else) concern -Underlies all nursing care -Responsibility of all healthcare providers

question

Medical errors are the ____ leading cause of death in the US

answer

8th -May be different

question

At least ______ and perhaps as many as ______ people die in hospitals each year as a result of medical errors that could have been prevented, according to the ______

answer

-44,000 -98,000 -Institute of Medicine

question

What brought patient safety to the forefront

answer

Institute of Medicine

question

What are the 9 Joint Commission National Patient Safety Goals

answer

1. Improve the accuracy of patient identification 2. Improve effectiveness of communication among caregivers 3. Improve the safety of using medication s 4. Complete medication reconciliation 5. Reduce the risk of health care associated infections 6. Reduce the risk of patient harm resulting from falls 7. Prevent heath care associated pressure ulcers 8. Identifies safety risks inherent in its patients population 9. Universal protocol for preventing wrong site, wrong procedure, wrong person survey

question

Goal #1- Improve the accuracy of patient identification

answer

- Use at least 2 patient identifiers when providing care, treatment, and services (every time you enter a room need to identify patients) -Name , DOB, Hospital assigned medical number (check bracelet)

question

When identify a patient what do you NOT want to identify the patient with

answer

- Patients room number - Be aware of confused patients when asking their name (in this case always check bracelet)

question

Goal #2- Improve the effectiveness of communication among care givers (staff)

answer

- Repeat/verify orders - Use standard abbreviation list - Timely reporting of critical test/lab results - Use a reporting off guide- such as ISBAR

question

What is the #1 reason for medication errors

answer

Poor communication

question

What does the accroynm ISBARR stand for and why was it developed

answer

* Developed to help improve communication between nurses and doctors I- Identify S- Situation "the reason I am calling is because" B- Background on patient (History, examination, test results.. relevant info only) A- Assessment (patients vital signs, lab results, etc.) R- Recommendation ("Could Mr. Smith get an IV?"/ "Do you think we should..") R- Repeating order from doctor (always do this!)

question

Goal #3- Improve the safety of using medications

answer

-Reduce the risk of medication errors - Use "6 rights" with each medication administration (Patient, Drug, Route, Time, Dose, Documentation) -Provide patient education

question

Goal #4- Medication Reconciliation

answer

-Checking and verifying patients are on the correct medication - Investigation of discrepancies & documentation of changes (medication do change while being in the hospital so nurse needs to make sure these changes are documented) -Comparing patients medication orders to all of the medications that the patient has been taking

question

A procedure that seeks to prevent med errors through ongoing assessment and updating of the patients list of meds

answer

Medication Reconciliation

question

Medication Reconciliation - Verification

answer

Collection of all current meds from patient (prescription, OTC, herbals)

question

Medication Reconciliation- Clarification

answer

Professional review of meds - Sorting out the patients meds and organizing them

question

Medication reconciliation should be done on

answer

- Admission - Status change - Transfers - Discharge- Patients should be provided with an accurate list of current medication (need to know what may have been changed)

question

Goal #6- Reduce the risk of patient harm from falls

answer

-Complete a fall-risk assessment on all patients -Administer the "Get Up and Go Test" - Identify high fall risk patients on door, chart and arm band

question

What is the "Get Up and Go Test"

answer

Have patient sit up from chair and walk a short distance to determine their ability to walk

question

What does a red bar mean

answer

Patient is at risk for falling

question

What factors can increase the risk for falling

answer

- Medications (Narcotics, Sedatives, Blood pressure med, Diuretic) - Unfamiliar enviornment - Immobility -Confusion (change in mental status) -Medical equipment (IV, Catheter, etc..) - Age (Older you are higher the risk) -*Having history of falls= HIGH risk for falling again

question

What is a diuretic increase the risk for falling

answer

Because it makes you have to use the restroom immediately and patient will just hop out of bed because they dont want to use the restroom on themselves

question

What is the #1 reason elderly people fall

answer

They are tying to get to the restroom

question

Interventions to decrease fall risk

answer

-Decluter their room (make a clear pathway) - Proper lighting - Ambulatory device - Toilet schedule (especially for older patients) - Bed alarms - Non- slide socks (gripper socks)- - Bed in lowest position (3 bed rails) - Keep things withing reach (glasses, water, etc..) - Gait belts

question

When it comes to socks, what should you never do

answer

Never get patient up while they are bear foot or have on slippers. Must always have on gripper socks

question

What to do in the event a patient falls in order

answer

1. Always assess patient (while on floor, if safe enough to get up than put them on the bed) 2. Check safety 3. Call physician 4. Make an incident report

question

Fire safety. What does the acronym RACE stand for

answer

R= Rescue and remove all patients in immediate danger A= Activate fire alarm C= Contain the fire; Close doors, windows, turn off oxygen supply and electrical equipment E= Evacuate patients and others to a safe area/ Extinguish the fire if trained to do so

question

"Meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems within which they work"

answer

QSEN- Quality and Safety Education for Nurses

question

What are the 6 QSEN competencies

answer

1. Patient-Centered Care 2. Teamwork and collaboration 3. Evidence-Based practice 4. Quality improvement 5. Safety 6. Informatics

question

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based onrespect for patients preferences, values, and needs

answer

Patient- Centered Care

question

Ways to practice patient- center care

answer

- Encourage patients/family to be involved in their care - Listen to patients/familys concerns

question

Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care

answer

Teamwork and Collaboration

question

Ways to practice teamwork and communciation

answer

- Patient safety is the responisbility of all members of the health care team -Communication is key to prevent errors - Work with everyone on the team if you need to. More people working with the patient the better (social workers, physical therapist, nurse aid, speech, etc..)

question

Minimizes risk of harm to patients and providers through both systems effectiveness and individual performance

answer

Safety

question

There are two types of errors

answer

- Human error -System error

question

Human errors occur because of

answer

-Inattention -Distractions -Failure to communicate -Poorly designed equipment -Exhaustion -Ignorance -Noisy work conditions

question

Ways to prevent System errors

answer

-Redesign systems (Bar coding, Time-Out, Check list) -Design safer processes

question

What are ways to design safer processes

answer

- Try to decrease the risk for human error - Make it easier to do the right thing - Have safe guards in place to prevent harm to patients

question

What does it mean to have a Time-Out in the hospital

answer

- In the operating room before any incision is made ask 1. Do we have the right patient 2. Are we doing the right procedure

question

An unexpected occurrence involving death or serious physical or psychological injury, or the risk therof -Signal the need for immediate investigation and response

answer

Sentinel Events

question

Some examples of sentinel events

answer

- An unanticipated death - Unanticipated death of full term infant - Major permanent loss of function, not related to the natural course of the patients illness or underlying condition - Suicide of a patient in a setting where the patient receives arount the clock care - Infant abduction or discharge to the wrong family - Surgery on the wrong patient or wrong body part -Rape

question

A proces for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurence of a sentinel event

answer

RCA- Root Cause Analysis

question

When a sentinel event occurs you want to use the

answer

Root Cause Analysis - Get to the root of the problem -Figure out where errors occured

question

Root cause analysis is a

answer

Reactive resposne

question

A systemic evaluation of a process and a look at each step in the process that can fail

answer

FMEA- Failure Modes and Effect Analysis

question

Failure Modes and Effect Analysis is a

answer

Pro-Active approach

question

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care

answer

Evidence-Based Practice

question

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems

answer

Quality Improvement

question

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making

answer

Informatics

Patient Safety- Chapter 27 – Flashcards

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