Podcast
Questions and Answers
A nurse is caring for a patient who has a history of falls. Which of the following interventions is most crucial to implement?
A nurse is caring for a patient who has a history of falls. Which of the following interventions is most crucial to implement?
- Ensuring the patient's call light is always within easy reach. (correct)
- Applying physical restraints to prevent the patient from ambulating independently.
- Administering sedative medications at night to promote sleep.
- Instructing the patient to remain in bed at all times.
A nurse is assessing a patient's risk for falls. Which of the following findings would indicate the highest risk?
A nurse is assessing a patient's risk for falls. Which of the following findings would indicate the highest risk?
- Patient demonstrates confusion and disorientation. (correct)
- Patient reports needing assistance to ambulate.
- Patient is currently prescribed an antihypertensive medication.
- Patient has a history of one fall in the past year.
In which scenario is the use of restraints considered ethically justifiable?
In which scenario is the use of restraints considered ethically justifiable?
- As a routine measure to prevent falls in elderly patients.
- When a patient is at risk of harming themselves or others. (correct)
- When a patient's family requests them for ease of care.
- To prevent a patient from removing necessary medical devices.
A nurse is preparing to administer medication. What is the MOST important step to ensure patient safety?
A nurse is preparing to administer medication. What is the MOST important step to ensure patient safety?
Which action demonstrates a nurse's understanding of QSEN's safety competency?
Which action demonstrates a nurse's understanding of QSEN's safety competency?
After implementing a new protocol, the data reveals an increase in adverse drug events (ADEs). What is the nurse's MOST appropriate next step?
After implementing a new protocol, the data reveals an increase in adverse drug events (ADEs). What is the nurse's MOST appropriate next step?
A patient with impaired mobility is being transferred from the bed to a chair. Which intervention demonstrates the nurse's understanding of safety principles?
A patient with impaired mobility is being transferred from the bed to a chair. Which intervention demonstrates the nurse's understanding of safety principles?
Which action exemplifies a healthcare organization's commitment to fostering a culture of safety?
Which action exemplifies a healthcare organization's commitment to fostering a culture of safety?
How should the nurse prioritize interventions to maintain environmental safety for a patient with a history of seizures?
How should the nurse prioritize interventions to maintain environmental safety for a patient with a history of seizures?
A nurse is teaching a community group about strategies to prevent falls in older adults. Which suggestion is MOST appropriate?
A nurse is teaching a community group about strategies to prevent falls in older adults. Which suggestion is MOST appropriate?
A nurse finds a patient unresponsive and not breathing. What action should the nurse take FIRST?
A nurse finds a patient unresponsive and not breathing. What action should the nurse take FIRST?
A patient is receiving oxygen therapy. What safety precaution is MOST important for the nurse to implement?
A patient is receiving oxygen therapy. What safety precaution is MOST important for the nurse to implement?
A nurse is caring for a confused patient who is repeatedly attempting to remove their IV line. What is the initially MOST appropriate action?
A nurse is caring for a confused patient who is repeatedly attempting to remove their IV line. What is the initially MOST appropriate action?
A visitor spills water on the floor in a patient's room. What action should the nurse take FIRST?
A visitor spills water on the floor in a patient's room. What action should the nurse take FIRST?
A nurse is implementing a "time-out" procedure before a surgical procedure. What action is MOST important for the nurse to perform during this process?
A nurse is implementing a "time-out" procedure before a surgical procedure. What action is MOST important for the nurse to perform during this process?
To prevent medication errors, what is the MOST effective strategy a nurse can employ when receiving verbal orders from a physician?
To prevent medication errors, what is the MOST effective strategy a nurse can employ when receiving verbal orders from a physician?
A nurse discovers a small fire in a patient's room. Following the RACE acronym, what action should the nurse take FIRST?
A nurse discovers a small fire in a patient's room. Following the RACE acronym, what action should the nurse take FIRST?
A nurse is using a fire extinguisher. Following the PASS acronym, what should the nurse do FIRST?
A nurse is using a fire extinguisher. Following the PASS acronym, what should the nurse do FIRST?
When administering medications, what is the MOST critical step to avoid medication errors related to patient identification?
When administering medications, what is the MOST critical step to avoid medication errors related to patient identification?
What is the nurse's PRIMARY responsibility in preventing healthcare-associated infections (HAIs)?
What is the nurse's PRIMARY responsibility in preventing healthcare-associated infections (HAIs)?
A hospital implements a new electronic health record (EHR) system to improve patient safety. What action is MOST crucial during the initial rollout?
A hospital implements a new electronic health record (EHR) system to improve patient safety. What action is MOST crucial during the initial rollout?
A patient with a known allergy to peanuts is served a meal containing peanut oil. Despite not consuming the meal, the patient experiences a severe allergic reaction due to cross-contamination in the kitchen. What type of medical error is this?
A patient with a known allergy to peanuts is served a meal containing peanut oil. Despite not consuming the meal, the patient experiences a severe allergic reaction due to cross-contamination in the kitchen. What type of medical error is this?
What is the most effective strategy to reduce the risk of wrong-site surgery?
What is the most effective strategy to reduce the risk of wrong-site surgery?
How frequently should a nurse assess a patient in restraints for skin integrity, circulation, and psychological well-being?
How frequently should a nurse assess a patient in restraints for skin integrity, circulation, and psychological well-being?
A patient is deemed at "high risk" for falls using the Hendrick II Fall Risk Assessment. What indicates this determination?
A patient is deemed at "high risk" for falls using the Hendrick II Fall Risk Assessment. What indicates this determination?
According to the Morse Fall Scale, what score qualifies a patient as "high risk"?
According to the Morse Fall Scale, what score qualifies a patient as "high risk"?
A patient is restrained. According to the guidelines, which task may be performed by a UAP?
A patient is restrained. According to the guidelines, which task may be performed by a UAP?
When providing care for a patient in restraints, what complication is most likely to be associated with long periods of immobilization?
When providing care for a patient in restraints, what complication is most likely to be associated with long periods of immobilization?
An older adult patient, who has weakness on their left side has a high risk of falling. Which nursing intervention would be appropriate?
An older adult patient, who has weakness on their left side has a high risk of falling. Which nursing intervention would be appropriate?
When is it appropriate to use restraints?
When is it appropriate to use restraints?
When assessing a client in restraints, what is the minimum frequency skin integrity should be assessed?
When assessing a client in restraints, what is the minimum frequency skin integrity should be assessed?
What must be included in the documentation regarding a client in restraints?
What must be included in the documentation regarding a client in restraints?
Which of the following BEST defines a "restraint alternative"?
Which of the following BEST defines a "restraint alternative"?
What is the appropriate way to determine if a patient understands how to request assistance?
What is the appropriate way to determine if a patient understands how to request assistance?
According to the safety guidelines, what factor increases the risk of fire when using supplemental oxygen?
According to the safety guidelines, what factor increases the risk of fire when using supplemental oxygen?
What activity is the leading cause of fire-related deaths?
What activity is the leading cause of fire-related deaths?
What patient accidents are ranked the second leading cause of accidental death worldwide?
What patient accidents are ranked the second leading cause of accidental death worldwide?
Which factor does NOT require consideration when implementing safety strategies?
Which factor does NOT require consideration when implementing safety strategies?
When evaluating the effectiveness of a new fall-prevention program, which metric offers the MOST comprehensive insight into its success?
When evaluating the effectiveness of a new fall-prevention program, which metric offers the MOST comprehensive insight into its success?
A patient with a history of unpredictable agitation requires a safety plan. What is the MOST critical INITIAL nursing intervention to ensure both the patient's and staff's safety?
A patient with a history of unpredictable agitation requires a safety plan. What is the MOST critical INITIAL nursing intervention to ensure both the patient's and staff's safety?
Which statement best reflects the relationship between system effectiveness and individual performance in maintaining patient safety, according to the QSEN safety competency?
Which statement best reflects the relationship between system effectiveness and individual performance in maintaining patient safety, according to the QSEN safety competency?
A nurse is caring for a patient who reports feeling increasingly anxious and unsafe despite the implementation of standard safety protocols. What action should the nurse prioritize?
A nurse is caring for a patient who reports feeling increasingly anxious and unsafe despite the implementation of standard safety protocols. What action should the nurse prioritize?
An elderly patient with cognitive impairment is at risk for falls. The care team explores the use of technology to enhance safety. Which approach balances patient autonomy with safety MOST effectively?
An elderly patient with cognitive impairment is at risk for falls. The care team explores the use of technology to enhance safety. Which approach balances patient autonomy with safety MOST effectively?
In designing a safe patient care environment, which strategy is MOST effective in mitigating risks associated with shared medical equipment?
In designing a safe patient care environment, which strategy is MOST effective in mitigating risks associated with shared medical equipment?
A healthcare organization is implementing a new "speak-up" campaign to encourage staff to report safety concerns. Which organizational action is MOST likely to undermine the campaign's success?
A healthcare organization is implementing a new "speak-up" campaign to encourage staff to report safety concerns. Which organizational action is MOST likely to undermine the campaign's success?
When prioritizing interventions to minimize environmental risks for a patient with a seizure history, what is the MOST proactive and preventative approach?
When prioritizing interventions to minimize environmental risks for a patient with a seizure history, what is the MOST proactive and preventative approach?
A nurse is teaching a family how to create a safer home environment for their visually impaired relative. Which recommendation reflects the BEST understanding of the interaction between mobility and environmental safety?
A nurse is teaching a family how to create a safer home environment for their visually impaired relative. Which recommendation reflects the BEST understanding of the interaction between mobility and environmental safety?
In the event of a facility-wide power outage, what action BEST reflects a proactive approach to ensuring patient safety?
In the event of a facility-wide power outage, what action BEST reflects a proactive approach to ensuring patient safety?
A patient receiving oxygen therapy in their home suddenly becomes dyspneic and agitated. Despite checking the device settings, the nurse suspects a malfunction. What is the BEST immediate action?
A patient receiving oxygen therapy in their home suddenly becomes dyspneic and agitated. Despite checking the device settings, the nurse suspects a malfunction. What is the BEST immediate action?
A patient with dementia is repeatedly attempting to climb out of bed despite the use of non-pharmacological interventions. What is the MOST ethical and clinically sound next step?
A patient with dementia is repeatedly attempting to climb out of bed despite the use of non-pharmacological interventions. What is the MOST ethical and clinically sound next step?
While walking through the hallway, a nurse notices a significant spill of an unidentified liquid. What action demonstrates the HIGHEST level of accountability and proactive safety management?
While walking through the hallway, a nurse notices a significant spill of an unidentified liquid. What action demonstrates the HIGHEST level of accountability and proactive safety management?
During a pre-operative 'time-out,' a discrepancy is identified: the patient states they are having surgery on their left knee, but the consent form indicates the right knee. What action is MOST critical to ensuring patient safety?
During a pre-operative 'time-out,' a discrepancy is identified: the patient states they are having surgery on their left knee, but the consent form indicates the right knee. What action is MOST critical to ensuring patient safety?
A provider gives a telephone order for a medication that the nurse believes is contraindicated based on the patient's known allergies. What is the nurse's BEST course of action?
A provider gives a telephone order for a medication that the nurse believes is contraindicated based on the patient's known allergies. What is the nurse's BEST course of action?
Upon discovering a fire, after rescuing a patient, what is the NEXT action the nurse should take, according to the RACE acronym?
Upon discovering a fire, after rescuing a patient, what is the NEXT action the nurse should take, according to the RACE acronym?
When operating a fire extinguisher, after pulling the pin, what does aiming the extinguisher involve, according to the PASS acronym?
When operating a fire extinguisher, after pulling the pin, what does aiming the extinguisher involve, according to the PASS acronym?
To ensure correct patient identification during medication administration, what is the MOST reliable method for verifying patient identity, especially in complex clinical situations?
To ensure correct patient identification during medication administration, what is the MOST reliable method for verifying patient identity, especially in complex clinical situations?
What is the MOST crucial strategic intervention for nurses to minimize the occurrence of healthcare-associated infections (HAIs) across a healthcare system?
What is the MOST crucial strategic intervention for nurses to minimize the occurrence of healthcare-associated infections (HAIs) across a healthcare system?
Following the go-live of a new electronic health record (EHR) system, which action is MOST critical for ensuring a smooth transition and minimizing patient safety risks?
Following the go-live of a new electronic health record (EHR) system, which action is MOST critical for ensuring a smooth transition and minimizing patient safety risks?
Flashcards
Define Safety
Define Safety
Freedom from psychological and physical injury; prevention of patient injury from health care errors.
Medical errors
Medical errors
Medical errors are the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim.
Patient Identification
Patient Identification
The first and best way to check you have the RIGHT patient is to have them STATE their name and birthday.
Environmental Safety
Environmental Safety
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Basic human needs
Basic human needs
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Falls
Falls
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Influences on Patient Safety
Influences on Patient Safety
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Safety Risk Diagnoses
Safety Risk Diagnoses
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Patient Fall
Patient Fall
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Fall Risk Assessment
Fall Risk Assessment
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Morse Fall Scale
Morse Fall Scale
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Hendrick II Fall Risk Model factors
Hendrick II Fall Risk Model factors
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Restraints
Restraints
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Appropriate Restraint Use
Appropriate Restraint Use
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Restraint Alternatives
Restraint Alternatives
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Restraint Definition
Restraint Definition
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Ongoing Monitoring
Ongoing Monitoring
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Activities of Daily Living
Activities of Daily Living
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Instrumental Activities of Daily Living
Instrumental Activities of Daily Living
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Study Notes
- Safety means protecting from psychological and physical harm.
- Safety also prevents patient injuries caused by healthcare errors.
- Nurses should minimize harm to patients and providers through system effectiveness and individual performance.
- Preventable medical errors in hospitals exceed deaths from motor vehicle wrecks, breast cancer, and AIDS.
- Healthcare provided in a safe manner is essential for a patient's survival and well-being.
- Nurses use critical thinking to promote patient safety.
Patient Identification
- The best way to identify a patient is to have them state their name and birthday. It is secondary to check a name bracelet. This should be done before contact.
- Bar scans are used when giving medications.
Scientific Knowledge Base
- Environmental safety protects staff, while sufficient oxygen, nutrition, and temperature influence a person's safety.
- Supplemental oxygen poses a fire risk.
- Knowledge of healthy food and food safety is needed for nutrition.
- Extreme temperatures pose safety risks for vulnerable populations.
- Physical hazards often result in physical or psychological injury or death.
- Motor vehicle accidents are a physical hazard for the elderly.
- Falls are the second leading cause of accidental or unintentional injury deaths worldwide.
- The leading cause of fire-related death is careless smoking.
Nursing Knowledge Base
- Factors influencing patient safety include:
- Patient’s developmental level
- Mobility, sensory, and cognitive status
- Lifestyle choices
- Knowledge of common safety precautions
Nursing Process
- Assessment includes:
- Nursing history and examination
- Healthcare environment (risk for falls, medical errors, disasters)
- Patient's home environment
Nursing Diagnosis (Safety Risks)
- Risk for fall
- Impaired home maintenance
- Risk for injury
- Impaired cognition: confusion
- Lack of knowledge
- Risk for poisoning
- Risk for trauma
Implementation
- Environmental interventions include:
- Basic needs
- Fall safety in the home
- General preventive measures include:
- Lighting
- Changing the environment
Falls
- A patient fall is a sudden, unintentional change in position to a lower level.
- Falls are among the most commonly reported adverse hospital events with more than 1 million annually.
- Approximately 30% of falls result in injury, and 10% result in serious injury, like head trauma or fracture.
- Falls are especially dangerous for older adults due to causation of morbidity and mortality.
Fall Assessment Tools
- Fall assessment is essential in determining specific needs and developing interventions to prevent falls.
- The Morse Fall Scale and Hendricks II Fall Risk Scale are used.
Fall Precautions
- Set bed alarms while a patient is in bed.
- Apply yellow non-skid socks on patients when ambulating
- Place patients with a strong side by the handrails when walking with the patient.
- Use an electronic device to ensure the patient is safe in bed.
- DO NOT USE 4 SIDE RAILS
Bathroom Safety
- To facilitate the safety make sure there is a hand rail, the door is open, it is well lit, and there is a call light.
Restraints
- Restraints immobilize a client or extremity and are physical or chemical.
- Restraints are used temporarily to control behavior.
- Restraints protect from self-injury or prevent violence toward others.
- Restraints can be manual, physical, or mechanical and reduce the ability to move freely.
- Least restrictive and safest environment is needed for restraint free guidelines.
- Clinically appropriate restraints are not routine and are limited to 24 hours.
Restraint-Free Guidelines
- Establish a restraint-free standard.
- Use the least restrictive but safest environment.
- Apply restraints only in clinically appropriate situations, avoiding routine use - evaluate each patient individually.
- Document the rationale because orders are limited in duration to 24 hours.
Harm caused by restraints
- Injuries from improperly positioned restraints can cause patients to get tangled in straps and choke.
- The struggle to free can cause broken bones, cuts, and concussions. Long-term restraint use can cause:
- Poor circulation
- Incontinence
- Constipation
- Weak muscles
- Pressure Sores
- Mental and emotional issues with restraints:
- Humiliation
- Imprisonment
- Depression
- Agitation
Restraint Usage
- Use restraints as a last resort, only after exhausting all alternative interventions.
- Protect the patient’s rights and dignity if restraints are used.
- It is essential to:
- Choose the least restrictive method
- Document each occurrence of restraint use
- Only properly trained and authorized staff may apply and remove restraints
- Choose the correct restraint size because it may cause increased agitation or sliding, leading to asphyxiation
Initiation of Restraints
- Only a Registered Nurse(RN) can initiate the first-time application of restraints.
- A UAP or LPN may remove and reapply restraints as needed for safety and hygiene.
Restraints Monitoring
- Behavioral Restraints;
- Observe every 15 minutes for behaviors and physical conditions and document on Behavioral Restraint/Seclusion Flowsheet
- Offer liquid, nutrition, comfort, and bathroom every 2 hours
- Remove restraints every 2 hours for no less than 5 minutes for range of motion and skin care
- Medical/Surgical Restraints: ​​
- Observe every 2 hours for behaviors and physical conditions and document
- Offer liquid, nutrition, comfort, and bathroom every 2 hours
- Remove restraints every 2 hours for no less than 10 minutes for range of motion and skin care
Criteria to Discontinue Restraints:
- Able to follow directions
- Able to participate in care
- Behavior improves/changes
- Lines tubes discontinued
- Positive response to medication intervention
Examples of Restraint Alternatives:
- Freedom Splints and Soft Hand Mitts
Activities of Daily Living (ADLs):
- Activities include bathing and grooming, ambulation, transfers, toileting, eating, and dressing.
Instrumental Activities of Daily Living:
- Activities include writing, reading, cooking, cleaning, shopping, doing laundry, going up stairs, using the telephone, outside activities, managing medications and money, and transportation.
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