Module 7 Safety

Safety in Healthcare

Learning Objectives

• Identify person-centered aspects of safety and security.

• Recognize patients at risk for injury.

• Describe health-teaching interventions to promote safety for adults and older adults.

• Explain strategies to reduce injury risks in the hospital.

• Discuss systems-based aspects of safety and security related to healthcare settings.

• Evaluate the effectiveness of safety interventions.

Importance of Safety in Nursing

• Safety is defined as freedom from danger, harm, or risk, and is fundamental to nursing care.

• Nursing responsibilities focus on:

  • Promotion & Prevention:

    • Patient-specific measures.

    • Institution-wide policies.

    • State & federal measures.

• Critical Thinking Question:

  • Are medical errors more often due to systems problems or human errors?

National Safety Guidelines

• National Patient Safety Goals (Joint Commission)

  • Previously known as JCAHO (Joint Commission on Accreditation of Healthcare Organizations).

• Standard Precautions (CDC Guidelines)

• Quality and Safety Education for Nurses (QSEN) Competencies

• Health Insurance Portability and Accountability Act (HIPAA) compliance.

Attributes of a Positive Safety Culture

• Acknowledgment of healthcare's high-risk nature and commitment to safe operations:

  1. Foster a blame-free environment for safety reporting.

  2. Promote teamwork and collaboration for safety solutions.

  3. Adopt a systems-based perspective to allocate resources for safety issues.

Nurses' Risks in Patient Safety

• Factors that affect patient safety:

  • Toxic chemicals and vapors.

  • Needle sticks and sharp injuries.

  • Drug exposures and radiation.

  • Infectious diseases and workplace violence.

• Considerations:

  • Developmental and occupational factors.

  • Social behavior and sensory perception.

  • Assess client communication abilities and health status.

Safety Concerns in Healthcare Settings

General Concerns

• Restraints:

  • Definition: Physical or chemical means to limit patient movement, used as a last resort.

  • Alternatives to restraints.

• Falls:

  • Identify at-risk individuals and interventions to prevent falls.

• Fire Safety (RACE):

  • Rescue, Alarm, Contain, Extinguish.

• Alarm management:

  • Concerns regarding alarm fatigue.

Equipment and Procedure-Related Accidents

• Strategies to reduce equipment-related accidents:

  • Check patient identification and avoid medication errors.

Fall Statistics and Prevention

• Injury Statistics:

  • Leading cause of injury-related deaths in older Americans.

  • 50% of nursing facility residents fall annually (average 2.6 falls per resident).

  • 1 million hospital falls yearly.

  • Cost associated with non-fatal fall injuries: $50 billion.

• Keys to Fall Prevention:

  • Patient education and environmental assessment.

  • Implement safety measures like bed alarms and risk assessments.

Emergency Codes in Healthcare

• Understanding Emergency Codes:

  • Code Red (Fire/Smoke) - Call 911.

  • Code Blue (Adult Medical Emergency) - CPR Team response.

  • Other emergency codes (Pink, Purple, Gray, etc.) for various situations (e.g., abductions, bomb threats).

2025 National Patient Safety Goals by Joint Commission

• Patient Identification:

  • Use at least two identifiers (e.g., name and date of birth).

• Improve Staff Communication:

  • Timely sharing of test results.

• Medication Safety:

  • Labeling unlabeled medications and ensuring proper medication reconciliation.

• Infection Prevention:

  • Adhere to CDC handwashing guidelines.

• Patient Safety Risks:

  • Identifying and managing suicide risks.

Safety Event Reporting

Reportable Events

• Pressure injuries

• Surgical and equipment errors

• Delays in care and missing property

• Communication errors

Types of Safety Incidents

• Near Miss: Potential error avoided.

• Patient Safety Event: Unexpected events without injury.

• Sentinel Event: Critical events leading to severe harm.

Barriers to Reporting Safety Events

• Fear of repercussions or backlash.

• Lack of time and unclear facility policies.

• Insufficient training and bullying behaviors.

• Favoritism and influence within teams.