Nursing Standards and Patient Safety Quiz

Nursing Standards

• Define the scope of nursing practice, outlining responsibilities and expectations for nurses.
• Provide guidelines for safe and effective patient care.
• Influence various aspects of nursing care, including best practices, patient safety, ethical practice, competency, and legal frameworks.

Establishing Best Practices

• Standards are derived from evidence-based knowledge, guidelines, and recommendations from professional organizations.
• Outline appropriate procedures, interventions, and care plans for specific conditions, ensuring care is based on the latest research and best practices.

Promoting Patient Safety

• Standards emphasize patient safety by providing guidelines for procedures (e.g., intravenous therapy, infection control, medication administration).
• Following these standards minimizes risks and prevents complications, improving patient outcomes.

Maintaining Ethical Practice

• Nursing standards incorporate ethical principles and values.
• Guide nurses in ethical decision-making, respecting patient autonomy, promoting beneficence, and upholding professional integrity.

Ensuring Competency

• Standards outline expected knowledge, skills, and behaviors for nurses.
• Help nurses maintain competency and professionalism.
• This includes effective communication, collaboration, and continuous professional development.

Providing a Legal Framework

• Standards serve as legal references for evaluating the quality of nursing care.
• Used as benchmarks in legal cases involving nurses, ensuring actions are consistent with accepted professional standards.

Nurses and Healthcare Professionals

• Provide primary, secondary, and tertiary healthcare in various settings.
• Primary care focuses on outpatient clinics, physician offices, community health centers, etc.
• Secondary care involves specialized treatment for acute illnesses and injuries in hospitals, emergency departments, and specialty clinics.
• Tertiary care addresses complex, rare, or high-risk conditions (e.g., children's hospitals, cancer centers).
• Nurses play vital roles across all care levels in assessment, treatment, education, care coordination, and patient/family support throughout the healthcare continuum.

Evidence-Based Practice (EBP), Research, and Performance Improvement (PI)

• Interrelated processes along a continuum of clinical scholarship.
• All three aim to use the best available evidence for high-quality patient care.
• Similarities: Identify problems, gather & analyze evidence, to enhance patient care and outcomes.
• Differences: EBP implements research evidence in clinical practice, research generates new knowledge, PI monitors and evaluates organizational processes.
• EBP and Pl often reveal problems that create opportunities for research.

Fall Risk Assessment

• Use validated tools/scales (Morse Fall Scale, STRATIFY, Hendrich II Fall Risk Model).
• Assess patient-related (intrinsic) factors (balance, gait, vision, cognition, medications).
• Assess environmental risk factors (cluttered rooms, lighting, obstacles).
• Involve patient and family for valuable information.
• Complete assessment upon admission, condition change, or fall incidents.
• Assign a risk score (low, moderate, high).
• Implement appropriate interventions (patient education, modifications, assistive devices).
• Reassess regularly for evolving risks.

Assessing Mobility Alterations

• Observe gait pattern (shuffling, unsteadiness), lower extremity strength, range of motion, proprioception, balance (eyes open & closed).
• Check for orthostatic hypotension.
• Note use of assistive devices.
• Assess dizziness, vision problems, pain, numbness.
• Review medications (drowsiness, dizziness).
• Evaluate cognitive status.
• Evaluate footwear and environmental hazards.
• Document findings, calculate fall risk score, and implement appropriate interventions.
• Regularly reassess mobility status.

Preventing Procedure-Related Events

• Adhere strictly to policies, standards.
• Review protocols before performing high-risk procedures.
• Take "time-outs" before high-risk procedures.
• Reflect on steps, resources if needed.
• Minimize distractions. Designate "no interruption zones."
• Perform "rights" of medication administration (patient, drug, dose, route, time, documentation).
• Report errors/near misses/safety concerns.
• Participate in ongoing education/training.
• Foster a culture of safety (open communication, teamwork, learning from mistakes).

Standard Precautions

• Handwashing, PPE (gloves, gowns), safe injection practices.
• Applies to all patient interactions.

Contact Precautions

• Wear gown and gloves for interactions involving contact with the patient or environment.

Droplet Precautions

• Wear a surgical mask within 6 feet of the patient.
• Indicated for respiratory infections spread by large droplets.

Airborne Precautions

• Wear N95 respirator, patient care in airborne infection isolation room.
• Indicated for infections spread over long distances.

Signs and Symptoms of Localized/Systemic Infections

• Localized: confined to specific area (redness, warmth, swelling, pain, drainage).
• Systemic: generalized symptoms (fever, fatigue, nausea/vomiting, malaise, enlarged lymph nodes).
• Specific symptoms may vary depending on affected body systems

Infection Control Measures (Home vs. Hospital)

• Hospitals: Sterile technique, sterilization equipment, strict hand hygiene protocols (sanitize).
• Homes: Clean technique, limited resources, handwashing (soap & water).
• Hospitals: Negative pressure rooms, specialized PPE. Homes: limited PPE availability, patient/family follow proper techniques, and monitoring.

Medical Asepsis

• Reduce infection risk by eliminating many microorganisms.
• Thorough handwashing, clean technique (wound care).

Impaired Skin Integrity Risk Factors

• Immobility, incontinence, poor nutrition/hydration, vascular disease, neurological impairments, and age (thinning skin).

Assessing Vital Signs

• Blood pressure (position, cuff size, palpate brachial artery), pulse (locate artery, count for 60 seconds), respirations (observe/count), temperature (oral, tympanic), pulse oximetry (appropriate fit, good blood flow).

Exercise and Activity

• Strengthens cardiovascular system.
• Builds and maintains muscle strength.
• Promotes weight management, reduces obesity risk.
• Reduces inflammation, improves mood, reduces stress.
• Lowers risk of chronic conditions (heart disease, diabetes, osteoporosis).
• Helps maintain mobility, balance, and cognitive function (older adults)

Preventing DVT (Deep Vein Thrombosis) in Patients with Reduced Mobility.

• Encourage early ambulation.
• Assist with range-of-motion exercises and positions changes.
• Use sequential compression devices, or antiembolism stockings.
• Administer appropriate anticoagulants.
• Educate patients on DVT risk factors, signs/symptoms.
• Provide support to maintain and promote mobility aids or assistive devices.
• Collaborate with team to develop personalized prevention plans.
• Monitor and implement preventive therapies.