Fundamentals of Nursing 300

Foundations of Nursing

• Topic 2: Chapter 27 - Patient Safety and Quality

Scientific Knowledge Base

• Environmental Safety

  • Basic human needs include:

    • Oxygen

    • Nutrition

    • Temperature

Environmental Safety Hazards

• Common environmental hazards include:

  • Motor vehicle accidents

  • Poison

  • Falls

  • Fire

  • Disasters

• Transmission of Pathogens:

  • Importance of immunizations to prevent diseases.

Case Study - Mr. Gonzales (Part 1)

• Profile:

  • 68-year-old man living alone in a senior apartment post his wife's death 6 months ago.

  • Immigrant from Mexico, worked in a produce warehouse for 37 years.

  • Has three sons; closest son, Carlos, visits weekly.

• Safety Concerns:

  • Anticipate risks related to living alone and age-related issues.

Test Your Understanding - Child Safety Issues

• Identify the statement needing additional safety teaching:

  • A. Teenagers need to practice safe sex.

  • B. A 3-year-old can safely sit in the front seat of the car.

  • C. Children need to wear safety equipment when bike riding.

  • D. Children need to learn to swim even if they do not have a pool.

Nursing Knowledge Base

• Factors influencing patient safety:

  • Developmental Stages and Risks:

    • Infant, toddler, preschooler, school-age child, adolescent, adult, older adult.

  • Individual Risk Factors:

    • Lifestyle and workplace culture

    • Impaired mobility

    • Sensory, cognitive, or communication impairment

    • Lack of safety awareness

  • Risks in Healthcare Agencies:

    • Procedure-related accidents

    • Equipment-related accidents

    • Chemical exposure

    • Falls.

Case Study - Environmental Hazards (Part 2)

• Joani Green (25-year-old nursing student) assesses Mr. Gonzales’ home environment for hazards, focusing on:

  • Safety risks present in the apartment setting.

Nursing Process: Assessment

• Key Components:

  • Through the patient’s eyes

  • Nursing history and examination

  • Healthcare environment

    • Risk for medical errors, disasters

  • Patient's home environment

    • Risk for falls.

Analysis and Nursing Diagnosis

• Examples of diagnoses related to patient safety:

  • Risk for injury

  • Impaired cognition: confusion

  • Lack of knowledge

  • Risk for poisoning.

Case Study - Visual Acuity and Safety (Part 3)

• Insights into Mr. Gonzales' condition:

  • Decreased visual acuity, not updated glasses for 3 years

  • Recent fall without injury

  • Gait assessment shows difficulty in foot clearance and stiff movements.

Planning and Outcomes Identification

• Outcomes:

  • Patient participation is key

• Setting Priorities:

  • Based on risk and patient characteristics

• Teamwork and Collaboration:

  • Communication is essential.

Case Study - Medication Safety (Part 4)

• Carlos purchased a medication organizer for Mr. Gonzales, but he hesitates to use it due to fear of mistakes.

• He cannot read medication labels.

• Interventions Needed:

  • Simplifying medication management and reinforcing safety education.

Implementation of Care

• Focus areas include:

  • Acute care and restorative care

  • Fall prevention strategies

  • Use of restraints and side rails

  • Fire, electrical hazards, seizures, and disaster preparedness.

Testing Your Understanding - Fall Prevention

• Suitable nursing interventions for a wandering patient include:

  • A. Raise all four side rails at night.

  • B. Use an electronic bed monitoring device.

  • C. Place near the nursing station.

  • D. Use a loose-fitting vest-type restraint.

Case Study - Health Promotion for Mr. Gonzales (Part 5)

• Encouraged health behaviors may improve Mr. Gonzales' overall safety, self-efficacy, and quality of life.

Safety Guidelines for Nursing Skills

• Anticipate fall risks and involve clients and families in prevention strategies.

• Always consider restraint alternatives prior to implementation.

• Educate clients and families about fall prevention protocols.

Case Study - Care Plan Evaluation (Part 6)

• Joani reassesses Mr. Gonzales' environment and evaluates:

  • Elimination of safety threats

  • Motor, sensory, and cognitive status.

Testing Your Understanding - Medication Error

• Determine the classification of a medication error:

  • A. Poisoning accident

  • B. Equipment-related accident

  • C. Procedure-related accident

  • D. Time management-related accident.

Case Study - Improved Health Outcomes (Part 7)

• Mr. Gonzales shows progress through exercise, successful medication management, and improved vision

  • Plans to maintain safety and independence in living.

Reference

• Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2023). Fundamentals of Nursing (11th ed.). Elsevier.