RAD 113 - PT Care Exam 1

Ch. 7: saftey, Ch. 8: PT transfer, Ch. 9: infection control, Ch. 10:preventing disease transmission, Ch. 11: surgical asepsis

name the 3 patient safety organization?

1. IHI: institute for healthcare improvement

2. OSHA: occupational safety and health administration

3. TJC or JCAHO: the joint commission / joint commission of accreditation of healthcare organizations

what is the IHI?

institute for healthcare improvement

non-profit organization associated with major healthcare quality improvement initiatives

what is the 5 million lives campaign?

national initiative led by IHI & protected PTs from 5 million potential harmful medical incidents b/t dec ‘06-dec ‘08

how many hospitals participated in the campaign?

3,100

what is the TJC / JCAHO?

1. the joint commission / joint commission of accreditation of healthcare organizations

2. accredits hospital organizations and sets standards for patient safety

how did TJC help with the IHI campaign?

by promoting and enforcing safety standards

what is OSHA?

occupational safety and health administration

federal agency that governs safety in the workplace; sets and enforces workplace standards

how does OSHA ensure patient & employee safety?

training, outreach, education, assistance

what is the first step in fire prevention?

be aware of potential fire hazards & knowing facility’s fire plan

what are the 3 components necessary for a fire to occur? (fire triangle)

1. fuel (combustible material)

2. heat (ignition source)

3. oxygen (fuel)

how can a fire be avoided?

by ensuring that fuel, oxygen, and heat do not occur at the same time or place

how do you stop a fire once its started?

remove one of the sides of the fire triangle: cool (water) , smoother, remove fuel

what are the 4 causes in which most hospital fires are traced?

1. spontaneous combustion

2. open flames

3. smoking

4. electricity——-MOST COMMON

how can you tell if an electrical fire is about to occur?

1. smoke

2. unpleasant odor

oxygen does not burn by itself, but it supports_________ _________?

spontaneous combustion

what are the 4 common infractions in fire safety?

1. blocking fire doors

2. storing equipment in corridors

3. improperly storing flammable items

4. using unapproved extension cords

what are the steps in the RACE method?

Rescue

Alarm

Contain

Extinguish / evacuate

fires are classified based on what?

1. fluid types

2. Class A, B, C, D, K

what fuel is involved in Class A fires?

solid combustibles (wood/paper)

what fuel is involved in Class B fires?

flammable liquids or gases

what fuel is involved in Class C fires?

electrical equipment

what fuel is involved in Class D fires?

combustible metal alloys

what fuel is involved in Class K fires?

cooking oils or animal fats

what is the steps in the PASS method?

Pull

Aim

Squeeze

Sweep

what fire classes are the most common?

A, B, C

what are other common hazards?

1. electric shock

2. falls / collisions

3. spills

4. eye splashes

what are the components of a spill kit?

1. kitty litter

2. heavy duty plastic bags

3. broom , dust pan

4. nitrile gloves

what are the steps in a spill response?

1. limit access

2. evaluate risk

3. determine if you have proper equipment / skill

4. clean immediately if safe ——- if not call sup

what does the abbreviation MSDS stand for and what are they?

material safety data sheets

fact sheets provided from manufacturer describing the chemical properties of any product

what are eye splashes and how are they treated?

when a chemical splashes and comes in contact with the eyes

require immediate attention and flushing for 5 minutes at eye station or any running water

what is the most common injury reported by healthcare workers?

MSDs —— musculoskeletal disorders

what are the MSD categories?

1. RMI — repetitive motion injury

2. RSI — repetitive strain injury

3. CTD — cumulative trauma disorder

what is ergonomics?

the study of the body in the work environment to prevent injuries

why are healthcare workers at increased risk for these injuries?

1. lifting, transporting, repositioning PTs

2. bending, twisting, reaching

3. standing / walking long periods

4. repetitive movements

5. pushing, pulling, lifting heavy objects

what is body mechanics?

principle of alignment, movement, & balance to reduce strain

what are the 3 body mechanics concepts?

1. base of support

2. center of gravity

3. line of gravity

what is the base of support?

portion of the body in contact with the floor / horizontal surface

what is the center of gravity?

point around which the body is balanced

what is the line of gravity?

imaginary vertical line passing through the center of gravity

what are the rules of proper body mechanics?

1. broad base of support

2. work at a comfortable height

3. bend knees / keep back straight

4. keep load close to body

5. roll / push instead of lift

why is it important to use proper body mechanics?

1. prevents injury to you, pt, coworker

2. reduces MSDs

3. sets safe example

what is a draw sheet?

single sheet folded in half to place under pt to assist w/ moving them

what is a gait belt?

a belt fastened around a PTs waist to help stabilize / move them

what is orthostatic hypotension?

sudden drop in BP caused by a person standing/ sitting up from a lying position too quickly causing them to feel lightheaded or faint

what is sedation?

administration of drugs to calm a patient or induce sleep

what is a slider board?

a strong smooth board of plastic used to slide patients b/t surfaces

what is a sliding mat?

a flexible cushioned board used to assist with sliding PTs

all patients must be moved from one department to another by _____ & ______?

1. wheelchair

2. stretcher

what are the steps for patient transfer?

1. Inspect wheelchair.

2. check-in at nurses' station to verify pt condition and confirm wheelchair use is appropriate.

3. enter the pts room, introduce yourself, identify the pt using two identifiers and explain transfer and imaging procedures.

4. review any necessary precautions or restrictions, including fall risk, weight-bearing, oxygen, IVs, drains, or other equipment that may effect the transfer.

5. assess the pts ability to assist with the transfer.

6. position the wheelchair close to the bed.

7. lock the wheelchair and move the footrests.

8. assist the patient into an upright position on the side of the bed.

9. allow the pt to sit with their feet on the floor, asses for dizziness/weakness.

10. assist the pt to stand using proper body mechanics and appropriate assistance/transfer equipment.

11. assist the pt to pivot until the back of legs touch the wheelchair.

12. assist the pt to slowly lower into the wheelchair.

13. position the pts feet securely on to the footrests and ensure any IVs, oxygen, drains or other equipment are secure.

14. ensure the pt is properly positioned, covered, and comfortable for transport.

15. unlock wheelchair and transport to x-ray department.

how many identifiers must be used?

2—— name & DOB

what else other than the 2 identifiers should be verified before performing an exam?

Verify the exam with the requisition and the pts illness/injury as related to the ordered exam

all patient moves should be towards the patient’s ____ side?

strong

What side of the patient should we assist on?

weak

what things can we look for to determine a PTs mobility?

1. deviations from correct body alignment.

2. immobility or limitations in range of joint motion.

3. ability to walk.

4. respiratory, cardiovascular, metabolic and musculoskeletal problems

When is a common time for a fall during stretcher/bed to wheelchair transfer?

How do we avoid this?

When a pt backs into the wheelchair

we avoid this by locking all brakes, moving footrests, and assisting the pt in all movements

what are special considerations in transferring Stroke Pts?

1. weakness on one side of the body

2. position yourself on the weak side and use your knee as a brace

what are special considerations in transferring pts with fractures of the lower extremity?

1. elevate leg rest to support injured side

2. position yourself on injured side

3. have pt lead with strong leg

what are special considerations for transferring pts with knee/hip replacements?

1. move pt toward the strong side

2. support calf and knee - prevent stress on the hip joint

what are the special considerations for transferring pts with spinal injury/surgery?

roll pt onto their side before sitting upright

what are the 5 special considerations that should be transported by stretcher instead of wheelchair?

1. stroke pts

2. lower ext fractures

3. knee/hip replacements

4. spinal injury / surgery

5. pts. who can’t stand safely

What position should the stretcher/bed be placed in for a bed to stretcher transfer?

adjust bed and stretcher to horizontal (flat) position and at the same height as the bed, lock the wheels

what are the steps when performing a stretcher transfer alone?

1. place one arm under shoulders and the other arm under the pelvis

2. have pt push with feet and elbows as you lift / pull pt toward the stretcher.

3. repeat in several motions until transfer is complete. (DO NOT attempt alone unless pt can assist)

what are the steps when performing a stretcher transfer with an assistant?

1. one person supports the head, neck and shoulders, while the other lifts knees and pelvis.

2. use the lift-pull or lift-push method with pts assistance until safely on stretcher.

3. cover pt with sheet and secure belt and raise side rails.

4. elevate head as needed

when are side rails used?

when transporting and must remain raised when pt is left unattended

what is sepsis / septic shock?

when infection enters the blood

what is a microorganism?

Living organisms that are not visible to the naked eye

what is a pathogen?

disease causing microorganism

what is a normal flora?

Microorganisms that live in or on the body without causing disease

what are the types of microorganisms?

1. bacteria

2. viruses

3. fungi

4. prions

5. protozoa

6. parasites

7. rickettsiae

what are the 4 shapes in classifying bacteria?

1. Spherical (Cocci)

2. Rod (Bacilli)

3. Comma (Vibrio)

4. Spiral (Spirilla, Spirochetes)

what are the groups of bacteria?

1. diplococcic (two)

2. streptococci (chains)

3. staphylococci (grapelike bunches)

what are the 2 bacteria reactions to staining?

1. gram +

2. gram -

what is bacteria?

single-celled; grow independently and can replicate without a host cell

what are some examples of bacteria?

1. TB - tuberculosis

2. strep throat

3. staph infections

4. salmonella

5. gonorrhea

6. syphilis

7. tetanus

8. E.coli

9. C. diff

10. MRSA

what are 3 methods in classifying bacteria?

1. shape

2. divisional grouping

3. reaction / staining

what is rickettesiae?

atypical & smaller than most bacteria

where do rickettsiae grow?

only grow inside animals

how is rickettsiae transmitted?

ticks, fleas, lice, mites

what are 2 examples of diseases caused by rickettsiae?

1. Rocky Mountain spotted fever

2. typhus fever

what are viruses?

among the smallest known disease-causing organisms

what do viruses need to survive?

needs a host cell to survive

what are examples of a virus?

1. influenza

2. common cold

3. measles

4. mumps

5. hep A, B, C, D

6. varicella

7. epstein-barr

8. HIV

what is a fungi?

single celled yeasts or molds

what are some examples of infections caused by fungi?

1. athletes foot

2. ringworms

3. thrush

4. respiratory infections

5. yeast infections/candida

what are opportunist infections?

an illness caused by germs, bacteria, viruses, fungi, or parasites that occur in individuals with weakened immune systems

what are some types of opportunist infections?

PCP — pneumocystis carinii pneumonia

pharyngeal/esophageal candidiasis

what are prions?

smallest and least understood; misfolded infectious proteins that have no DNA or RNA

what do prions do?

transform healthy proteins in nerve cells to more prions and cause irreversible neurologic damage

what are some examples of diseases caused by prions?

1. mad cow

2. creutzfeldt-jakob

what is a protozoa?

Complex single-celled animals; can exist as free-living organisms or parasites

what are motile protozoa?

an organism that moves on its own using its own energy

what are nonmotile protozoa?

nonmotile protozoa can not move on its own

ex: Sporozoa

what are some examples of motile protozoa?

1. flagella

2. pseudopods

3. cilia

what are some examples of diseases caused by protozoa?

1. giardiasis

2. malaria

3. trichomoniasis

4. toxoplasmosis

what is normal flora?

live in/on the body without causing infection or disease

what is the role or normal flora?

aids in skin preservation & protects from harmful organisms

what is the cycle of infection?

pathogen → reservoir → portal of exit → routes of transmission → portal entry → susceptible host

what are pathogens?

infectious organism capable of causing disease; different from normal flora.

what are Virulence factors?

characteristics of pathogens that have the ability to grow and multiply rapidly

ex: toxins, enzymes, capsules

what do pathogen toxins do?

Attach to host cells and release toxins that kill or injure the cell