Leadership and Management

Culture of Safety

• Service Occurrences: Relate to client services; can include:

  • Slight delay in service

  • Unsatisfactory service

• Near Misses: Situations where negative outcomes nearly occur (e.g., accidents, illnesses, injuries).

• Serious Incidents: Include minor injuries, losses of equipment/property, or significant service interruptions.

• Sentinel Events: Unexpected deaths or major injuries; require major investigations. Classified as:

  • Failure to Rescue: Most severe sentinel event; client indicators are missed, leading to death.

QSEN Competencies in Nursing Programs

• Culture of Safety: Promotes openness and error reporting. Reduces adverse events.

• Risk Management Department: Identifies hazards, prevents adverse events, and tracks negative incidents.

• Types of Reported Events:

  • Major loss of function/death not expected with medical condition

  • Suicide attempts, transfusion reactions, surgical errors, etc.

Quality and Safety in Health Care

• Concerns: Poor communication identified as a key factor in sentinel events.

• Institute of Medicine (IOM) Report: "To Err is Human" identifies preventable medical errors as a major issue.

• QSEN Project Competencies:

  • QPCC: Patient-Centered Care

  • QTC: Teamwork and Collaboration

  • QEBP: Evidence-Based Practice

  • QQI: Quality Improvement

  • QS: Safety

Handling Infectious and Hazardous Materials

• Infection Control: Important to prevent cross-contamination and healthcare-associated infections.

• QS Safety Measures: Protect clients, nurses, and others.

• Staff Education: Nurses responsible for infection prevention education.

• Isolation Procedures: Required for suspected communicable diseases.

Hazardous Materials Handling

• Safety Needles/Needle-less IV Systems: Minimize injuries.

• Biomedical Waste Disposal: Proper disposal in sharps containers; report needlestick injuries.

• Precautions: Follow four levels of precautions based on exposure risks.

Safe Use of Equipment

• Equipment Safety: Proper operation to prevent injuries; check equipment regularly.

• Nurse Responsibilities:

  • Ensure electrical safety (grounding, proper handling)

  • Maintain life-support equipment readiness during outages.

Specific Risk Areas: Fall Prevention

• Screening Clients: For fall risk factors. Ensure safe environment.

• Risk Factors: Physiological changes, environmental hazards, cognitive awareness.

Seizure Precautions

• Protective Measures: Clear paths, adequate lighting, and necessary rescue equipment availability.

• Seclusion and Restraints: Used for protective measures; must be justified and noted properly.

Fire Safety Procedures

• Fire Response: Follow RACE (Rescue, Alarm, Confine, Extinguish) sequence.

• Fire Extinguisher Use: PASS (Pull, Aim, Squeeze, Sweep) method.

Nursing Responsibilities for Restraints

• Prescription Requirement: Must be obtained promptly post-application.

• Monitoring: Regular checks for patient welfare and restraint necessity.

• Documentation: Required before, during, and after restraint application.

Security Plans

• Emergency Designations: Familiarize with facility emergency codes (e.g., Code Red for fire).

• Active Shooter Situations: Follow recommended actions to enhance safety: Run, Hide, Fight.

Emergency Response in Healthcare

• Emergency Operating Plan (EOP): Essential for internal and external emergencies. Staff must be trained in EOP activities.

• Mass Casualty Incidents (MCI): Follow triage principles to optimize patient outcomes.

Reporting Incidents

• Incident Reports: Document unexpected events in adherence to facility protocols; maintain confidentiality.

• Client Safety: Secure valuables and assess for injuries promptly following incidents.

Food Poisoning Prevention

• Risk Groups: Infants, toddlers, elderly, pregnant women, immunocompromised.

• Safe Food Handling: Emphasize proper hygiene, cooking temperatures, and storage practices.

Handling Hazardous Materials and Chemicals

• Response Strategies: Proper decontamination of affected clients; follow facility emergency plans.

Carbon Monoxide Awareness

• Client Education: Highlight dangers and prevention strategies for carbon monoxide exposure.

Ergonomics in Nursing

• Body Mechanics: Use proper techniques to prevent injury when lifting and moving clients.

• Avoid Repetitive Movements: Take regular breaks and maintain good posture to reduce injury risk.

Disaster Management Fundamentals

• Disaster Planning: Establish clear roles and responsibilities for staff in emergency situations.

• Community Coordination: Collaborate with local agencies for comprehensive disaster response.