Patient Safety and Quality PDF

CHAPTER 27, PART 1 Patient Safety and Quality Copyright © 2017, Elsevier Inc. All Rights Reserved.  CLIENT SAFETY Safety- “ freedom from injury” which includes freedom from psychological and physical injury Environmental safety- Cli...

CHAPTER 27, PART 1 Patient Safety and Quality Copyright © 2017, Elsevier Inc. All Rights Reserved.  CLIENT SAFETY Safety- “ freedom from injury” which includes freedom from psychological and physical injury Environmental safety- Client’s Environment All settings (client-nurse interact) - Reduce injuries and illness - Shortens length of stay - Improves functional status and sense of well being - Protects staff to function optimally See Fig. 6.3 Maslow’s hierarchy of needs  Performance improvement Risk management and safety reports SAFETY IN Current reliable technology HEALTH CARE ORGANIZATIONS Evidence-based practice Safe work environment Adequate staff education  QUALITY AND SAFETY EDUCATION FOR NURSES (QSEN) Future nurses need knowledge, skills, and attitudes to promote safety. Continuous improvement is essential. QSEN minimizes risk of harm to patients and providers by System effectiveness Individual performance  Critical Thinking Successful critical thinking requires a synthesis of knowledge, experience, critical thinking attitudes, and intellectual and professional standards. In patient safety, critical thinking is an ongoing process. Standards have been developed by American Nurses Association and The Joint Commission. The Joint Commission National Patient Safety Goals For Hospitals- Updated Annually Use of the nursing process when planning care promotes safety.  Environmental safety SCIENTIFIC A patient’s environment includes physical and psychosocial factors that influence or affect KNOWLEDGE the life and survival of that patient BASE A safe environment protects the staff to function optimally Basic needs Copyright © 2017, Elsevier Inc. All Rights Reserved. 6  PHYSICAL HAZARDS Physical hazards in the environment threaten a person’s safety and often result in physical or psychological injury or death. Motor vehicle accidents Poison Falls Fire Disasters Copyright © 2017, Elsevier Inc. All Rights Reserved. 7  While caring for a child, you identify that additional safety teaching is needed when a young and inexperienced mother states that ​ A. Teenagers need to practice safe sex.​ B. A 3-year-old can safely sit in the front seat of the car.​ QUICK QUIZ! C. Children need to wear safety equipment when bike riding. ​ D. Children need to learn to swim even if they do not have a pool.​  ENVIRONMENTAL SAFETY Transmission of pathogens Pathogens and parasites pose a threat to patient safety Educate patients about hand hygiene Immunization Pollution Air, land, water Noise Copyright © 2017, Elsevier Inc. All Rights Reserved. 9  CASE STUDY Mr. Gonzales is a 68-year-old man who has lived alone in a senior apartment building since his wife died 6 months ago. He and his wife were born in Mexico but came to live in the United States shortly after they were married. ​ He is retired from a produce warehouse, where he worked for 37 years. They have raised 3 sons; the closest son, Carlos, is 30 minutes away by car. Carlos visits Mr. Gonzales every week to socialize and take him shopping. ​  Factors influencing patient safety NURSING Patient’s developmental level KNOWLEDGE Mobility, sensory, and cognitive status BASE Lifestyle choices Knowledge of common safety precautions Copyright © 2017, Elsevier Inc. All Rights Reserved. 11  RISKS AT DEVELOPMENTAL STAGES Infant, toddler, and preschooler School-age child Adolescent Adult Older adult Copyright © 2017, Elsevier Inc. All Rights Reserved. 12  Lifestyle Impaired mobility INDIVIDUAL RISK FACTORS Sensory or communication impairment Lack of safety awareness Copyright © 2017, Elsevier Inc. All Rights Reserved. 13  CASE STUDY (CONT. ) Joani Green, a 25-year-old married mother of two, is currently a nursing student at the local college. As part of the clinical environment, she and her study partner are conducting health screenings and providing health promotion education for the residents of apartments where Mr. Gonzales lives.​ Part of Joani’s screening will include Mr. Gonzales’ home environment.  Medical errors RISKS IN THE TJC and CMS “Speak Up” campaign HEALTH National Quality Forum mission CARE Environmental risks AGENCY Copyright © 2017, Elsevier Inc. All Rights Reserved. 15  RISK CATEGORIES Specific risks to a patient’s safety within IN THE the health care environment HEALTH Falls Patient-inherent accidents CARE Procedure-related accidents AGENCY Equipment-related accidents (CONT.) Copyright © 2017, Elsevier Inc. All Rights Reserved. 16  CRITICAL THINKING Copyright © 2017, Elsevier Inc. All Rights Reserved. 17