NURS 202 - Unit 3, Sept. 16th (Nursing Safely: Client Safety, Infection Control, Hygiene, Mobility & Immobility)

What does quality of care mean? What 6 qualities do we strive for?

Means doing the right thing, at the right time, in the right way for the right person - and having the best possible results.

-accessibility

-effectiveness

-efficiency - eliminate waste of ideas, info, physical things, etc.

-patient safety

-patient-centered care - respectful

-equitable - regardless of gender, sexual orientation, socioeconomic status

What is patient safety?

It is generally agreed upon that the meaning of patient safety is Please do not harm.

What are the 3 types of patient safety incidents (or adverse event)?

1. Harmful incident - an incident that resulted in injury to the patient

2. Near miss - an incident that did not reach the patient (no harm resulted)

3. No-harm incident - an incident that reached the patient but caused no discernable harm

What would be some factors influencing patient safety?

-proper training of staff

-double check; pay attention

-clean work area

-proper staffing

-know your weak areas/where you are missing knowledge

-good lighting

-have the right equipment

-PPE

-maintain patient confidentiality

-take your time, don't rush

etc.

What are 3 risks to staff safety in health care settings?

1. Chemicals - who sets the standards for the control of hazardous substances? WHMIS

2. Microorganisms - what is the main infection prevention and control practice that we use? Hand Hygiene.

3. Violence - between patients and health care professionals, family and health care professionals, patient and patient, staff and staff

What are 3 risks to patient safety in the health care settings?

1. Procedure related accidents

2. Equipment related accidents

3. Falls

What is the biggest risk to infants and children? What are three interventions?

Focus: Unintentional injuries

Interventions: education of parents, toddler proofing environments, supporting safety education

What is the biggest risk to adolescents? What are some interventions?

Focus: sense of identity; peers; risk-taking behaviours

Interventions: sexual health education, seat belts, health screening (ex. depression/suicide), protective equipment in sports

What is the biggest risk to adults? What are some interventions?

Focus: Lifestyle habits; stress

Interventions: stress management, promotion around exercise

What is the biggest risk to older adults? What are some interventions?

Focus: Changing physiological status (ex. decreased vision, hearing, reaction time), chronic conditions

Interventions: reducing risk of falling/accidents, management of chronic conditions (polypharmacy)

Draw the nursing process to ensure patient safety.

See notes, page 7.

When are restraints used? What are they used for? Do you need doctors orders for restraints?

Used as a last resort.

Device used to immobilize a client or an extremity.

A temporary means to control behaviour.

Restraints are used to:

-prevent falls and wandering

-protect from self-injury (pulling out tubes)

-prevent violence toward others

Restraints deprive a fundamental right to control your own body.

When do restraints become necessary?

-While restraint-free care is ideal, there are times that restraints become necessary to protect the patient and others from harm.

-ex. highly agitated, violent individual

-intubated patient

-suicide patient - try something other than restraint first

Name 3 types of restraints.

1. Physical restraints - side rails, straps (anything that PHYSICALLY immobilizes a patient or an extremity)

2. Chemical restraint (medication)

3. Environmental (locked doors)

What are the hazards of immobility?

death - strangulation

pressure sores, pneumonia, constipation, incontinence, contractures, decreased mobility, decreased muscle strength, increased dependence

humiliation, fear, anger & decreased self-esteem

What are the four goals of restraint use?

-to avoid the use of restraints whenever possible

-encourage alternatives - watch tv, play cards, family member to sit with patient, geri chair vs. bed, non restraint measures - safety belt, wedge pillows, lap tray

-consider restraints as a temporary measure - decrease likelihood of injury from restraint use

-remove restraints as soon as the patient is no longer at risk for injury