“The protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy of individuals or populations.”
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Essential Concepts
Core/fundamental values (Communication, evidence-based practice, health promotion, management of care, nursing process, patient-centered care, pharmacology, safety)
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General Concepts
Topics to enhance learning experiences. (Biophysical, psychophysical, healthcare, and professional nursing)
The nurses’ expectation and initial grasp of the situation. (Barebones information.)
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Noticing Example
A patient’s vitals are:
BP= 140/90
HR= 95
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Interpreting
Analytical or intuitive interpretation of data.
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Interpreting Example
A blood pressure of 140/90 indicates a high blood pressure.
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Respond
Course of action (or lack thereof) based on interpretation.
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Respond Example
Administer a vasodilator to lower a patient’s blood pressure.
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Reflect-in-action
A nurse’s ability to “read” the patient. Response to the nursing intervention which can lead to adjustments based on the data found in the assessment.
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Reflection-on-action
Reassessment of the response. Contributes to the knowledge gained or learned from the experience.
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Reflection-in-action Example
Monitoring the patient for any side effects.
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Reflection-on-action Example
Reassessing the patient’s BP and heart rate.
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The Joint Commission
Regulate hospitals and assess them on patient safety. Run the “Speak Up” program which helps teach patients and family members how to advocate for themselves.
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Safety Culture
An essential component of a successful patient safety system is a crucial starting point for hospitals striving to become learning organizations, as well as a general feeling of shared attitudes that foster patient safety.
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Nursing Responsibilities in Safety Culture
* First priorities * Value transparency, accountability, and mutual respect * Avoid behaviors that undermine a culture of safety * Collective mindfulness is present * Do not deny or cover up errors * Report and learn from patient safety events
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Disruptions in Safety Culture
* Inappropriate words * Shaming others for negative outcomes * Unjustified negative comments * Refusal to comply with practice standards * Not working collaboratively or cooperatively with other members * Creating rigid or inflexible barriers * Not returning pages or calls promptly
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Patient Safety/Adverse Event
An event, incident, or condition that could have or did result in (any) harm to a patient.
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Omission
Harm caused by a lack of ______.
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Commission
Harm caused by excess ______.
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Sentinel Event (Never Event)
A patient safety event that reaches the patient and results in the following:
* Death * Permanent harm * Severe temporary harm
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Examples of Sentinel Events
* Suicide while on suicide watch * Discharging an infant to the wrong family * Rape * Reaction to the wrong blood type * Loss of a limb * Infant Abduction * Surgery on the wrong body part
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Close Call
A patient safety event that did not cause harm as defined by the term sentinel event.
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Close Call Example
Giving a patient the wrong medication, but it passes through their system and does not cause any adverse reactions.
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Hazardous Conditions
A circumstance (other than the preexisting condition) that increases the probability of an adverse event.
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Trust-Report-Improve Cycle
Trust promotes reporting, which leads to improvement, which in turn fosters more trust.