Safety in Nursing Practices

Study Notes

Definition of Safety

Safety is defined as freedom from danger, harm, or risk.
In nursing, safety encompasses the role of nurses as preventers of potential harm.

Promoting Safety

Patient Education
- Individual teaching includes discharge instructions and home care advice.
- Group teaching covers topics like prenatal classes and smoking cessation.
- Presentations involve specialized training (e.g., diabetic education).
Modeling Behavior
- Nurses exemplify professionalism in their conduct.
- Adherence to infection control measures such as proper hand hygiene.
- Promotion of healthy lifestyles through diet and nutrition education.

Institute of Medicine (IOM) Insights

Defines patient safety as freedom from accidental injury.
Preventable harm from healthcare leads to over 350,000 deaths annually.
"To Err is Human" published in 2000 highlighted the issue of medical errors.

Principles of Safety

Adverse Event
- Defined as unintended harm resulting from error rather than patient disease (e.g., administering wrong medication).
Types of Errors
- Errors of Commission: Wrong actions taken (e.g., administering medication despite known allergies).
- Errors of Omission: Lack of necessary actions (e.g., failing to secure a patient in a wheelchair).

Medication Errors

Defined as failures in the treatment process that can harm patients.
Essential components of medication administration include the right patient, medication, dose, route, time, reason, and proper documentation.
Common Causes of Medication Errors
- Incorrect prescription details, doses, and timing.
- Lack of awareness regarding drug interactions or patient allergies.
- Mistakes in medication preparation (e.g., incorrect dilution).

Surgical Errors

Common issues include wrong-site surgeries.
Prevention strategies include surgical time-outs that confirm patient identity and correct procedure/site.

Sentinel Events

Unexpected occurrences involving death or serious injury.
They are labeled "Sentinel" as they indicate a need for immediate investigation (e.g., a patient on suicide watch committing suicide).

Never Events

Defined as serious preventable errors that should never occur.
Examples include pressure ulcers acquired after admission and patient death due to falls.

Error Causes

Organizational System Failure: Poor staffing and insufficient training.
Technical Failures: Non-functioning alarms and equipment malfunctions.
Human Issues: Lack of knowledge or attention, and failure to comply with policies.
Latent Failures: Systemic errors, including communication lapses.
Active Failures: Errors occurring directly at the bedside (e.g., administering incorrect medication).

Human Factor Safeguards Against Medication Errors

Utilize two patient identifiers for verification.
Confirm patient identity via armbands.
Avoid using room numbers as patient identifiers.
Implement three checks for medication verification.
Adhere to the ten rights of medication administration.
Use bedside scanning for patients and their medications.
Conduct time-outs to confirm patient and necessary procedures.

Improving Healthcare Safety and Quality (STEEEP)

Safe: Focus on minimizing injury and harm to patients.
Timely: Aim to reduce patient wait times.
Effective: Ensure care aligns with evidence-based practices.
Efficient: Strive to eliminate waste in healthcare delivery.
Equitable: Guarantee quality care regardless of gender, socioeconomic status, or location.
Patient-Centered: Deliver care that is respectful and responsive to individual patient needs.

Description

This quiz explores the concept of safety in nursing, highlighting the role of nurses as preventers of danger and harm. It delves into various strategies for promoting patient safety, including education, modeling behavior, and adherence to infection control measures. Test your knowledge on how nurses can effectively ensure the safety of their patients.