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10011204
Patient Safety and Quality by Erin Bates-Meehan
Descripción
P and P Chapter 27
Sin etiquetas
fundamentals of nursing
nursing
Mapa Mental por
Erin Bates-Meehan
, actualizado hace más de 1 año
Más
Menos
Creado por
Erin Bates-Meehan
hace casi 7 años
14
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Resumen del Recurso
Patient Safety and Quality by Erin Bates-Meehan
Environment = Physical/Psychosocial Factors Across Various Settings ( ex. community, home, hospital, school, etc.)
SAFE ENVIRONMENT=Reduced hazards & transmission of pathogens, controlled pollution, maintained sanitation & basic needs met
BASIC NEEDS (Maslow)
OXYGEN (Assess Risk: Smoking, Functioning Heat/Co2 Monitor)
NUTRITION (FDA Regulates@Risk FoodBorne Illness=Peds, Pregnancy, Elderly, Immunocompromised/Poor sanitation, storage)
TEMP (WNL= 18.3-23.9C @Risk Hypothermia=peds, elderly, homeless, excess ETOH/drug, Cardiovascular Cond./@Risk Hyperthermia=infant, elderly, chronic ill
Safety = adequate food sanitization
PHYSICAL HAZARDS (Nurse Role=Education&Prevention)
MVA (seatbelt, airbag, helmet law)
POISON (lock cleaning solutions, know poison control number)
FALLS(adequate light, clear clutter, remove loose rugs, secure home)*
DISASTERS (flood, hurricane, bioterrorism)
FIRE (smoke and CO2 detectors, fire extinguishers, new/safe space heaters)
POLLUTION (Contaminated water, air, soil, noise-if H2O polluted, drink bottled, etc.)
TRANSMISSION OF PATHOGENS
#1 means of transmission = Hands
Good Hand Hygiene Essential!!
Always - Educate Family
Blood/Body Fluid
High Risk Behavior (HIV Hep C)
Needle Exchange Programs
IMMUNIZATION (Reduce and prevent transmission of disease)
Nurse Role-Educate Parents
Fecal-Oral Route
Medical/Surgical Asepsis
Ensure proper disposal of human waste
Identify Relevant Nursing Diagnoses Assoc. W/ Safety Risks (p.382)
Risk for falls
Risk for Injury
Deficient Knowledge
Risk for Trauma
Risks/Interventions per Developmental Stages
Infant,Toddler,Preschooler
#1 RISK = Injury (<5 =greatest risk of serious home injury
Oral Activity=choking/Poisoning
Limited Coordination=Falls(bike, playground equip)
Exploring=drowning
INTERVENTION
Educate Parents: Immunizations, Home Safety, Incorp Safety into Care Plan
School Age Child
Risks
Head Injury
Contact Sports
Intervention
Helmet/Seat belt
Safe Play/Proper Equipment
Adolescent
Risky Behavior
Peer Infuence
Substance Abuse
Suicide
Highest rate of MVA
INTERVENTION
Assess for psychosocial clues
Provide examples/Set expectations
Environmental clues
Awareness of risks
Educate no Cell/Text/Seatbelt
Adults
Risks
Lifestyle Habits
Stress/Smoking
Interventions
refer to resources
Encourage lifestyle changes
Older Adult
Risks
decreased independence
falls/accidents
wandering
physiological changes d/t aging process
multiple meds
Interventions
Provide resources on maintaining independence
Educate on safe driving
prevent burns/scalding
reduce pedestrian accidents
Pt. Safety = Serious National Health Care Challenge
Individual Risk Factors
Lifestyle
Impaired Mobility
Sensory/Communication Deficit
Lack of Saftey Awareness
4 Categories of Risks in Health Care Agency
Falls (Assess Risks/Know Interventions)
Pt. Inherent Accidents
1 Common Cause=Seizure
Seizure Precautions
protect from injury
position on side for ventilation and drainage of secretions
provide privacy/support after
POSSIBLE PREVENTION
Some Patients have an AURA
bright light, smell, taste
warning of oncoming seizure
Procedure-Related Accidents
1 example=Medication Error
PREVENTABLE!
Equipment-Related Accidents
Malfunction, misuse, disrepair, electrical hazard
Tag Faulty Equipment-Always Get Proper Instruction On Use
Sticker w/Expiration date is SAFE (Biomedical has inspected)
Safety Includes Staff
Know protocol re: working with radiation, etc
wear appropriate devices
SAFE HEALTH CARE ENVIRONMENT
Reduced injury risk (including falls)
Reduced Patient Inherent and Procedure/Equipment Related Accidents
QSEN:Quality & Safety Education For Nurses
Minimize risk of harm to patients/providers thru system effectiveness & individual performance
Critical Thinking/Nursing Process
Assess Patient and Environmental hazards
Plan and Intervene as Necessary to Maintain Safety
Factors to Assess re: USE OF RESTRAINTS
Last Resort when patient behavior = risk of injury (self/others)
What to try first/Possible Alternatives
Sensory Stimulation
Frequent Reorientation
More Frequent Observations
electronic devices
Posey Bed
Or prevent interruption of therapy/life support equipment
Temporary and for safety only
Physical
Device to immobilize or reduce ability of movement
Chemical
Medication to manage behavior (not standard for condition)
Optimal Goal=Restraint Free Environment
COMPLICATIONS
Pressure Ulcers, Pneumonia, constipation, incontinence, humiliation, agitation, EVEN DEATH d/t restricted breathing/circulation
If/When Restraints Used
Get informed consent
Educate patient/family
MD order required
Know agency specific legal policy
Current (No PRN)
Type, location, duration, circumstances
Hospital = 8 hour renewal/adults
2 hours/age 9-17
1 hour/under 9 y/o
Face-to-face assessment
Use Care w/ side rails- (can be considered restraint
Assessment Activities Pertaining to Safety
Physical
(Fall Risk) Observe gait, balance
Psychosocial
(Fall Risk) Assess adequate lighting, clutter in hallways
Cognitive
(Fall Risk) Assess Visual Acuity/Ability To Read
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