NURS Fundamentals Exam 3 Prep - Safety

What is a basic need?

safety

What are common safety concerns?

lack of patient centered care, poor reporting of medical errors, communication breakdwon, poor temawork and collaboration

What is lack of patient centered care?

poor patient education, not including the patient in healthcare decisions, poor communication skills especially related to conflict resolution

What is poor reporting of medical errors?

fear of punitive actions for reporting erros, fear of lawsuits for admitting errors

What is communication breakdown?

during hand-off reports, communication between members of the health care team or between facilities

What is poor teamwork and collaboration?

lack of mutual respect between disciplines, unequal sharing or decision-making power between disciplines

What are the 6 competencies of quality safe education for nurses (QSEN)?

patient centered care, teamwork and collaboration, safety, informatics, evdiences based practice, quality improvement

What was created by the joint commission?

national performance goals

What are national performance goals?

uearly update that gives healthcare environments areas of focus for patient safety (home care, hospitals, laboraotry, long-term care, beahvorial health etc.)

What is the first national performance goal?

correct client and care

What is the second national performance goal?

culture of safety

What is the third national performance goal?

emergency management

What is the fourth national performance goal?

excellent health outcomes

What is the fifth national performance goal?

infection prevention and control

What is the sixth national performance goal?

pain management

What is the seventh national performance goal?

safe, informed care

What is the eighth national performance goal?

reduce suicide risk

What is the ninth national performance goal?

safe transplant practices

What is the tenth national performance goal?

waived testing

What is the eleventh national performance goal?

workplace and client safety

What is the twelfth national performance goal?

meet client needs

What is the thirteenth national performance goal?

imaging services

What is the fourteenth national performance goal?

medication management

What is patient safety?

transforming care at the bedside plan, safety assessment, client identification

What is employee safety?

electrical safety, chemical safety, rediation safety, physical safety, workplace violence, alerts

What is C in CHAMP?

communicate clearly; repeat back/read back with clarigying quesitons, phonetic and nueric clarifications

What is H in CHAMP?

handoff effectively; SBAR

What is A in CHAMP?

attention to detail; self check use STAR

What is STAR?

stop, think, act, review

What is M in CHAMP?

mentor each other; cross check and coach teammates, speak up for safety use ARCC

What is ARCC?

ask quesiton, request a change, voice concern, go up chain of command

What is P in CHAMP?

practice and accept a questioning attitude; validate and verify, stop the line “I need clarity”

What are factors that affect safety?

the person, environement, specific risk factors, potential safety hazards, use of medical equipment, restraints, domestic violence or neglect

What is nursing history for falls?

assess for history of falls or accidents, note assistive devices, be alert to history of drug or alcohol abuse, obtain knowledge of family support systems and home environment

What are types of falls?

accidental, ancticipated physiologic fall, unanticipated physiologic fall, intentional falls

What are factors that contribute to falls?

lower body weakness, poor vision, gait and/or balance issues, problems with feet and/or shoes, use of psychoactive medications, postural dizziness, hazards in the home

What are nursing interventions for fall preventions?

non-skid footwear, bed in lowest position, locking wheels, clutter-free environment, adequate lighting, call light in reach, side rails

What is communiations about patients?

change of shift nurse to nurse, change of status, calls for consultation, calls to providers, SBAR, patient move (to new unit, home, or another facility)

When do we encounter transitions in care?

change of shift, patient status, going for a procedure, transferred, discharged to a SNF, breaks

What is S in SBAR?

situation

What is B in SBAR?

background

What is A in SBAR?

assessment

What is R in SBAR?

recommendations/request

What is SBAR?

supplies a structured method for report; universal across the disciplines of healthcare, identifies the most important informaiton

What is the situation?

identify yourself & unit you are calling from, identify the pt by name and the reason for your report, describe your concern-the specific reason you are calling/reporting

What is the background?

give patient’s reason for admission, important PMH, overview of the patient’s background: admitting diagnosis, date of admission, prior procedures, current emdications, alelrgies, partinent lab results and other relevant diagnostic results

What is the assessment?

vital signs, clinical impressions, concerns

What are recommendations?

explain what you need, make suggestions, clarify expectations

What is read back?

read back any clarifying information

What are patient handoffs?

face to face, ask questions, invovle client and family, walk in and check the bedside with previous RN

What are hourly or purposeful rounds?

checking on every patient every hour

What are the 5 Ps of hourly rounding?

pain, personal hygiene, position, posessions/periphery, pump

What is Pain in the 5 Ps?

assess and intervene

What is personal hygiene in the 5 Ps?

“potty” - bathroom needs

What is position in the 5 Ps?

in bed or the chair, ambulate

What is possessions/periphery in the 5 Ps?

call bell close, telephone, drink, etc

What is pump in the 5 Ps?

check the IV pump

What are other safety intiatives?

morse fall scale, braden scare, aspiration evaluations, fire plan, emergency operations, restraints — use and notification, infection control

What are restraints?

raise the risk of injury; may only be used to protect the patient, staff or others from risk of injury to self or others

What must always be done with restraints?

least restrictive, remove ASAP, assess/reasses

What are physiologic hazards with restraints?

increased possibility of serious injury due to fall, skin breakdown, contractures, incontinence, depression, delirium, anxiety, aspiration and respiratory difficutlies, death, loss of mobility, lactic acid/CK levels