Safety Ch_28. 1 pptx

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Information about Safety Ch_28. 1 pptx

Published on March 16, 2016

Author: dwanfai


Slide1: Chapter 28 Safety Slide2: Objectives Describe environmental hazards that pose risks to patient safety. Discuss specific safety risks for patients at each developmental age. Discuss the importance of national patient safety resources and standards for promoting patient safety. Describe factors that create a culture of safety. Explain the concept of never events and a nurse’s role in prevention. Assess risks to patients’ safety within health care settings and the home. 2 Slide3: Objectives cont. 7. Identify relevant nursing diagnoses associated with risks to safety. 8. Explain approaches for establishing a restraint-free environment. 9. Identify factors to consider in the use of restraints. 10. Develop a nursing care plan for patients whose safety is threatened. 11. Describe nursing interventions specific to a patient’s age for reducing risk for falls, fires, poisonings, and electrical hazards. 12. Describe methods to evaluate interventions designed to maintain or promote safety. 3 Safety Initiatives: Safety Initiatives The Institute of Medicine (IOM) reports To Err is Human: Building a Safer Health System Crossing the Quality Chasm: a New Healthcare System for the 21st Century Regulatory and accreditation agencies The Joint Commission (TJC) Centers for Medicare and Medicaid Services (CMS) TJC 2014 National Patient Safety Goals: TJC 2014 National Patient Safety Goals Hospitals Identify patients correctly. Improve staff communication. Use medicines safely. Use alarms safely. Prevent infection. Identify patient safety risks (e.g., suicide). Prevent mistakes in surgery. Home care Identify patients correctly. Use medicines safely. Prevent infection. Prevent patients from falling. Identify patient safety risks (e.g., patients on oxygen, risk of fire). The National Quality Forum (NQF) : The National Quality Forum (NQF) National Voluntary Consensus Standards for Public Reporting of Patient Safety Events Patient safety measures Serious reportable events (SREs ) Never Events Safety in the Workplace: Safety in the Workplace A culture of safety Acknowledges risk Pursues safety Fosters a blame-free environment Commits resources Quality and Safety Education for Nurses (QSEN): Quality and Safety Education for Nurses (QSEN) Future nurses need knowledge, skills, and attitudes to promote safety. Continuous improvement is essential. QSEN minimizes risk of harm to patients and providers by System effectiveness Individual performance Scientific Knowledge Base: Scientific Knowledge Base Meet basic human needs. Reduce physical hazards. Reduce transmission of pathogens. Basic Human Needs: Basic Human Needs Oxygen Risk for fire Low concentration High concentration Carbon monoxide Nutrition Proper storage Proper refrigeration Preparation area Temperature Normal Hypothermia Hyperthermia Heat stroke Heat exhaustion Physical Hazards: Physical Hazards Motor vehicle accidents Poison Fires Falls Physical Hazards (Cont.): Physical Hazards (Cont.) Disasters Natural Man-made Pathogen transmission Immunization Pollution Nursing Knowledge Base: Factors Influencing Patient Safety: Nursing Knowledge Base: Factors Influencing Patient Safety Developmental level Infant toddler, and preschooler School-age child Adolescent Adult Other risk factors Lifestyle Impaired mobility Sensory impairments Cognitive impairments Safety awareness Risks in Health Care Agencies: Risks in Health Care Agencies Chemical exposure Material Safety Data Sheets Falls Intrinsic risk factors Extrinsic risk factors Patient-inherent accidents Procedure-related accidents Equipment-related accidents Critical Thinking: Critical Thinking Knowledge Safety risks and developmental stage Experience Clinical and personal Attitudes Perseverance, responsibility, and discipline Standards American Nurses Association’s (ANA’s) Nursing: Scope and Standards of Practice (2010) ANA Code of Ethics Regulatory agencies Nursing Process: Assessment: Nursing Process: Assessment Risks to patient safety Risk factors Home environment Fall assessment Hospital equipment Older adult considerations Patient expectations Nursing Process: Diagnosis: Nursing Process: Diagnosis Nursing diagnoses for patients with safety risk: Risk for F alls Impaired Home Maintenance Risk for Injury Deficient K nowledge (regarding safety risks) Risk for Poisoning Risk for Suffocation Risk for Trauma Nursing Process: Planning : Nursing Process: Planning Goals and outcomes Prevent and minimize safety threats Are measurable and realistic May include active patient participation Setting priorities Collaborative care Patient, social worker, occupational/physical therapist Nursing Process: Implementation: Nursing Process: Implementation Health promotion Passive and active strategies Developmental interventions Environmental interventions Basic needs General preventive measures Nursing Process: Implementation (Cont.): Nursing Process: Implementation (Cont.) Acute care Falls Restraints (Use only as a last resort) Chemical Physical Side rails Fires Electrical accidents Radiation Disasters Safe Patient Room Environment: Safe Patient Room Environment Nursing Process: Evaluation: Nursing Process: Evaluation Patient care R eassess the patient’s condition. Apply evaluative measures. Revise or discontinue interventions as needed. Patient expectations Have the patient’s expectations been met? Have the family’s expectations been met? Safety Guidelines for Nursing Skills: Safety Guidelines for Nursing Skills To ensure patient safety: Communicate clearly with the health care team. Assess patient’s risks and use the best evidence. Incorporate priorities of care and preference.s When performing the skill in this chapter: Always try alternatives before using a restraint. If a restraint is needed, always use the least restrictive device. Because restraints limit a patient’s ability to move freely, make clinical judgments appropriate to the patient’s condition and agency policy. Quick Quiz!: Quick Quiz! While caring for a child, you identify that additional safety teaching is needed when a young and inexperienced mother states that 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. Quick Quiz!: Quick Quiz! A nurse floats to a busy surgical unit and administers a wrong medication to a patient. This error can be classified as A. A poisoning accident. B. An equipment-related accident. C. A procedure-related accident. D. An accident related to time management. Quick Quiz!: Quick Quiz! A newly admitted patient was found wandering the hallways for the past 2 nights. The most appropriate nursing interventions to prevent a fall for this patient would include A. Raise all four side rails when darkness falls. B. Use an electronic bed monitoring device. C. Place the patient in a room close to the nursing station. D. Use a loose-fitting vest-type jacket restraint.

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