Chapter 4 Patient safety and communication.pptx

Patient Safety, and Communication Learning Objectives Describe how to recognize and help resolve interpersonal or organizational sources of conflict. moving patients. Describe how to ambulate a patient and the potential benefits of ambulation. Write definitions of key terms associated with electri...

Patient Safety, and Communication Learning Objectives Describe how to recognize and help resolve interpersonal or organizational sources of conflict. moving patients. Describe how to ambulate a patient and the potential benefits of ambulation. Write definitions of key terms associated with electricity, including voltage, current, and resistance. Identify the potential physiologic effects that electrical current can have on the body. State how to reduce the risk for electrical shock to patients and yourself. Identify key statistics related to the incidence and origin of hospital fires. List the conditions needed for fire and how to minimize fire hazards. Safety Considerations • Safety is a very important part of ensuring high-quality care. • Importantly, patient safety must always be the first consideration. Safety Considerations Patient Movement and Ambulation A. Basic body mechanics B. Moving the patient in bed C. Ambulation Safety Considerations A. Basic body mechanics o person needs good posture to minimize risk of injury when moving patients or heavy equipment. o Poor posture may place inappropriate stress on joints and related muscles and tendons. o RTs should use their legs with straight spine to lift patients and heavy objects. Body mechanics for lifting and carrying objects Safety Considerations B. Moving the patient in bed • Bedridden patients with acute or chronic respiratory dysfunction often assume an upright position, with their arms flexed and their thorax leaning forward. This position helps decrease their work of breathing. • In other cases, patients may have to assume certain positions for therapeutic reasons such as when postural drainage is applied. Moving the patient in bed 🞄  Correct technique for lateral movement of a bed-bound patient:  Method to pull a bed-bound patient. Method to push a bed-bound patient Moving the patient in bed 🞄 The ideal method for moving a conscious patient toward the head of a bed with the patient’s assistance. Moving the patient in bed 🞄 The proper technique for assisting a patient to the bedside position for dangling his or her legs or transfer to a chair. Safety Considerations C. Ambulation Extended bed rest can lead to new medical problems, such as atelectasis Ambulation (walking) helps restore and maintain normal body function Ambulation should begin as soon as patient is stable and free from severe pain Ambulation can reduce length of hospital stay Electrical Safety • Fundamentals of Electricity  Electricity moves from point A to point B due to differences in voltage  Voltage is power behind electrical energy  Most homes and hospitals are powered with 110-V or 220-V power sources • Power sources with high voltage have potential to generate large amounts of electrical current • Current is directly related to voltage difference between point A and point B and inversely related to resistance of object Electrical Safety • Harmful effects of current depend on:  Amount of current flowing through body  Path it takes  Duration current is applied • High currents passing through chest can cause ventricular fibrillation, diaphragm dysfunction, and death • Electrical devices have “hot” wire and “neutral” wire Fire Hazards • 1980: about 12,000 fires were reported in health care facilities in United States • During the period 2011 to 2015, the average annual number of fires in health care facilities was 575 • Dramatic decrease due to education and strict fire-code enforcement Fire Hazards • Fires in oxygen-enriched atmospheres (OEAs) are larger, more intense, faster burning, and more difficult to extinguish • Hospital fires are more serious because evacuation of critically ill patients is difficult • Hospital fires often cause more injuries and deaths per fire than do residential fires Fire Hazards Three conditions must exist for fire to start: Flammable material must be present Oxygen must be present Flammable the conditions can stop a fire from starting or extingmaterial must be heated above its ignition temperature Removing any one of this after it has begun O2 is nonflammable, it greatly accelerates the rate of combustion Fire Hazards If you identify a fire in a patient care area, you must know what to do PASS—fire extinguisher training P—Pull pin A—Aim nozzle S—Squeeze handle S—Sweep nozzle across base of fire Fire Hazards RACE—core fire plan R—Rescue patients in immediate area of fire A—Alert other personnel to fire C—Contain the fire; shut doors to prevent spreading of fire E—Evacuate other patients and personnel Communication • Communication is essential to the quality mission of a health care organization • Strategies to enhance communication are critical to organizational success • Communication is a dynamic human process involving sharing of information, meanings, and rules • Communication has five basic components: Sender, message, channel, receiver, and feedback Elements of human communication 🞄 Communication in Health Care Effective communication: most important aspect of safe patient Care 2018 National Patient Safety Goals of TJC: Improve the accuracy of patient identification Improve the effectiveness of communicating critical test values among caregivers Factors affecting communication Verbal and internal qualities (e.g., values, experiences, etc.) of sender and receiver Nonverbal communication skills of sender 🞄 Communication in Health Care • All health care personnel must use “two patient identifier” before initiating care, which includes: 1. Patient name 2. Birth date 3. Medical record number • Read back” scenario 🞄 S O MEANING subjective objective A P assessment plan EXAMPLE "My chest hurts when I breathe." Awake, alert, and oriented. HR 98, RR 25, BP 118/80. Bronchial breath sounds in right lower lobe. Pneumonia continues. Postural drainage and percussion every 4 hours. Factors Affecting Communication Human or “internal” quality of sender and receiver that play a role Prior experiences, attitudes, values, cultural backgrounds, and selfconcepts and feelings Verbal and nonverbal components Patient's direct health care environment and their sensory or emotional state Improving Communication To enhance your ability to communicate effectively focus on improving: Sending skills Receiving skills Feedback skills Improving Communication Practitioner as sender Share information rather than telling Seek to relate to people rather than control them Value disagreement and much as agreement Use effective nonverbal communication techniques Improving Communication • The practitioner as listener • Work at listening • Stop talking • Resist distractions • Keep your mind open; be objective • Hear the speaker out before making evaluation • Maintain composure; control emotions • Active listening is a key component in health care communication Improving Communication Effective feedback needs to be provided o Attending: Involves use of gestures and confirming remarks o Paraphrasing: Repeating others’ response in one’s own words o Requesting clarification: Should be nonjudgmental o Perception checking: Done by confirming or disproving more subtle components of communication interaction o Reflecting feelings: Provide opportunity for patients to express and reflect on their emotions Minimizing Barriers to Communication • Use of symbols or words that have different meanings • Different value systems • Emphasis on status • Conflict of interest • Feelings of personal insecurity Conflict Resolution There are five basic strategies for handling conflict: 1. Competing: Represents assertive and uncooperative conflict resolution strategy (e.g., boss uses his or her authority to settle dispute) 2. Accommodating: Represents opposite of competing; conflict settled by “giving in” 3. Avoiding: Both parties do not pursue their concerns; may lead to unresolved issues 4. Collaborating: Involved parties try to find mutually satisfying solutions to conflict 5. Compromising: Middle-ground strategy that combines assertiveness and cooperation • Deciding which type of conflict resolution strategy to use requires insight into context of problem Question A RT has completed SOAP charting in the progress notes following Bronchodilator therapy. While signing the chart form, she notices that the wrong amount of medication has been entered. Which of the following actions should be done at this time? I. Draw one line through the error. II. Notify the physician of the error. III. Write “Error” and initial. IV. Recopy the progress notes A. B. C. D. I and II I and III II and IV III and IV Question A is a small current that enters the body through external catheters and may cause ventricular fibrillation. A. Microshock B. Grounding C. Macroshock Thank You