NSG 3100 Patient Safety and Restraints

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Questions and Answers

What was a key recommendation of the 'To Err is Human' report?

Increasing the use of complex medical procedures.

Implementing individual performance reviews within healthcare teams.

Establishing a culture of safety through blame-free error reporting. (correct)

Focusing primarily on disciplining healthcare workers involved in errors.

What is the primary purpose of 'near miss' reporting?

To shift responsibility of errors onto individuals, rather than the system.

To punish healthcare providers for mistakes they narrowly avoided.

To identify potential weaknesses in systems before they cause actual harm. (correct)

To allow for the collection of minor injury patient data.

According to the content, what is a common root cause of medical errors?

Lack of individual focus by medical professionals.

Errors made solely by nurses.

A lack of advanced medical technologies.

Deficiencies in the systems or processes of healthcare organizations. (correct)

What is a significant role of the National Patient Safety Goals?

To guide and improve healthcare safety using data-driven goals. Signup and view all the answers

Which of the following represents a method to improve patient safety?

Promoting transparency and open communication about medical errors. Signup and view all the answers

Which of the following is NOT a Joint Commission goal for patient safety?

Enhance staff satisfaction Signup and view all the answers

What is the primary purpose of using patient restraints?

To prevent harm to the patient or others Signup and view all the answers

Which of the following is not considered a type of restraint?

Verbal Signup and view all the answers

According to the provided material, under what circumstance are restraints most appropriately used?

When less restrictive interventions have failed Signup and view all the answers

In addition to preventing harm, what is another reason for using restraints?

To provide medically necessary treatments Signup and view all the answers

Which of the following is an appropriate reason to use restraints based on the context?

A patient is pulling at their IV line Signup and view all the answers

What does the text say about the duration of using restraints?

They should be discontinued at the earliest possible time Signup and view all the answers

Which environment is explicitly NOT listed as applicable to the National Patient Safety Goals?

Residential Care Homes Signup and view all the answers

What specific information MUST a Primary Care Physician (PCP) include in a restraint order?

Reason for restraints, specific time frame and type of restraint needed. Signup and view all the answers

A nurse finds a PRN ('as needed') order for restraints in the patient's chart. What action should the nurse take?

Disregard the order, inform the PCP, and obtain a valid order. Signup and view all the answers

Which of the following is a critical guideline for applying physical restraints?

Pad bony prominences and allow for free, safe movement. Signup and view all the answers

How often must a restraint order be renewed by a Primary Care Physician (PCP)?

Every 24 hours. Signup and view all the answers

What must always be done when applying restraints?

Obtain informed consent and an order prior to application. Signup and view all the answers

What is the MOST important step to take when handing a firearm to another person?

Ensure the firearm is unloaded and the action is open. Signup and view all the answers

Why is it important to avoid referring to medicine as 'candy' or acting as if it’s a treat?

It confuses children, making them think medicine is safe and enjoyable for them to use. Signup and view all the answers

Which of the following is NOT a recommended practice for electrical safety at home?

Using extension cords for all appliances. Signup and view all the answers

What should you do if you are concerned that your child has been exposed to a poisonous plant?

Contact the county’s cooperative extension agency. Signup and view all the answers

Where is the MOST appropriate place to store bullets when firearms are kept at home?

In a separate, locked location away from the firearms. Signup and view all the answers

What is a crucial safety practice to follow when cleaning a firearm?

Remove all ammunition to another room. Signup and view all the answers

Why should one avoid overloading electrical outlets?

It can increase the risk of an electrical fire. Signup and view all the answers

What is one rule that children should be taught regarding gun safety?

Never touch a gun or stay in a friend's house where guns are accessible. Signup and view all the answers

Which of these factors does NOT directly affect patient safety, according to the provided information?

The patient's employment status Signup and view all the answers

What is a key component of fall prevention that should be used by patients?

Using non-skid, well-fitting footwear Signup and view all the answers

During a seizure, which action is NOT recommended?

Placing an object between the client's teeth Signup and view all the answers

According to the content, what is critical for proper fire safety?

Maintaining smoke detectors with regularly checked batteries Signup and view all the answers

Which of these situations presents the greatest risk of carbon monoxide poisoning?

Being in close proximity to a generator inside the house Signup and view all the answers

What is the universal action that must be taken to prevent falls?

Having handrails available in rooms, bathrooms, and hallways Signup and view all the answers

Which of the following scenarios shows the best practice for a client at risk of falls?

Ensuring the bed is in a low position and locked Signup and view all the answers

When should family members or carers check smoke detector batteries?

On a regular basis Signup and view all the answers

What is the FIRST action you should take if a client begins to have a seizure?

Call for assistance and remain with the client Signup and view all the answers

Which of these is a specific risk factor which increases a patient's chances of falling?

Orthostatic hypotension Signup and view all the answers

Study Notes

Patient Safety and Restraints

NSG 3100 course
Patient safety and restraints are covered
Restraints are protective devices that limit physical activity
Three types of restraints: Physical, Chemical, and Seclusion
Restraints used for two reasons:
- Prevent purposeful or accidental harm to a client
- Provide medically necessary treatments
Restraints should be used as a last resort
Use less restrictive interventions if possible
Interventions are used to protect client, staff, or others from harm
Restraints must be discontinued as soon as possible
Restraints are used under two situations:
- Nonviolent behavior, non self-destructive
- Violent behavior, self-destructive behavior (harm to self, staff or others)
Primary Care Physician (PCP) order is required and needs to include reason for restraints and specific time frame
PCP allows for the possible sooner removal of restraints if warranted
Restraint orders must be renewed every 24 hours
Restraint orders (PRN) are not allowed
Continuous monitoring of patients in restraints is needed

Factors Affecting Patient Safety

Age and development, lifestyle, mobility, and health status influence safety
Cognitive awareness
Emotional state
Ability to communicate
Safety awareness
Environmental factors (healthcare settings, workplaces, home, bioterrorism, disaster planning).
Sensory-perceptual alterations
Specific factors influencing safety throughout the lifespan
- Developing fetuses
- Newborns/Infants
- Toddlers
- Pre-schoolers
- Adolescents
- Older adults

Risk Factors for Falls

Poor vision
Cognitive dysfunction
Mobility restrictions
Orthostatic hypotension
Urinary frequency
Weakness from disease process or therapy
Current medication regimen (sedatives, hypnotics, tranquilizers, narcotic analgesics, diuretics)

Universal Fall Precautions

Familiarize the client with the environment
Teach back use of call light
Keep call light within reach
Keep personal possessions within reach of the client
Handrails in room, bathroom, and hallways
Bed in low position and locked
Non-skid, well-fitting footwear
Nightlights
Keep floor clean and dry
Keep areas uncluttered

Seizure Precautions

Pad the side rails
Put oral suction equipment at the bedside
Remain with client and call for assistance during a seizure
Do not restrain client
if not in bed lower the client to the floor and pad surroundings for safety
Turn the client to the lateral position if possible
Move items in environment to ensure there is no injury
Loosen any restrictive clothing
Do not put anything in the client's mouth
Provide oxygen and suction as needed
Prepare seizure medications
Time and record any movements of seizure
Document seizure in a timely manner after it occurs

Environmental Hazards

Fires & Burns
Poisoning (Carbon Monoxide, Suffocation, Choking)
Excessive Noise
Electrical Hazards
Firearms
Radiation
Bioterrorism Attack
Procedure/Equipment related accidents

Fire Considerations

Check batteries in smoke detectors regularly
Keep fire extinguisher in kitchen and handy
No smoking inside the home

Prevent Poisoning

Store harmful agents away from children
Store in locked cabinets
Do not store in different containers or remove labels
Teach children not to eat unknown substances
Do not refer to medications as "candy"
Always read product labels before using medication
Have poison control phone numbers readily available
Contact county's cooperative extension agency for poisonous plants

Steps to Take for Child Poisoning

Identify the poison and remove it from the child's reach
Try to make the child spit out any remaining substances
Do not induce vomiting
If unconscious or with severe reactions, call 9-1-1
If conscious and not severe, contact your local poison center

Gun Safety

Store guns in locked cabinets without glass and keys inaccessible to children
Store bullets separately from the gun
Teach children never to touch a gun or enter a home with accessible guns
Teach children to never point a gun barrel at anyone
Ensure firearms are unloaded and action is open when handing them to someone else
Do not use firearms while impaired by alcohol or drugs
Keep all ammunition separate for cleaning and in another room
Inspect regularly used firearms at least every 2 years

Reducing Electrical Hazards

Check cords for fraying or damage
Avoid overloading outlets with too many appliances
Use only grounded outlets and plugs
Never use appliances near sinks, tubs, showers, or wet areas
Keep cords and appliances out of reach of young children
Use protective covers over outlets

Medical Errors/Sentinel Events

Reports released in 1999 from Institute of Medicine, on errors, are typically not due to individual error, but system process error.
Healthcare errors are preventable
Encourage reporting without retribution
Implement strategies to promote a safety culture
"Near miss" reporting: an event or situation that did not produce client injury, but could have
Examples: putting wrong ID band on a client, errors in drug preparation

Number of Deaths in the United States

Leading causes of death: Heart disease, Cancer, Respiratory Disease, Accidents, Stroke, Alzheimer's disease, Diabetes, Influenza and Pneumonia, Kidney disease, Suicide

The National Patient Safety Goals

Use data to set goals for improvement in safety and updated annually
Covers various healthcare settings, including ambulatory care, behavioral health, hospitals, laboratories, and nursing care centers

Joint Commission Goals for Patient Safety

Patient identification
Improve communication
Improve safety of using medications
Reduce HCAIs
Reduce risk of harm from falls
Prevent pressure ulcers
Identify safety risks in patient population

Activity - Go to NPSG

Group work on National Patient Safety goals
Review different healthcare settings and associated goals
Discuss these goals with colleagues

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Description

This quiz covers key concepts of patient safety and the use of restraints in the NSG 3100 course. It discusses the types of restraints including physical, chemical, and seclusion, emphasizing their application as a last resort to ensure the safety of clients and staff. Understanding both the ethical and legal implications of restraints is crucial for nursing practice.