NRSG 110: Foundations of Psychiatric Nursing Practice Safety PDF

NRSG 110: Foundations of Psychiatric Nursing Practice Learning Outcome 2: Describe Safety Relevant to Psychiatric Nursing Care Faculty: Susan Howell Med/surgical Faculty: Susan Howell Sept 1 Med/surgical Faculty: S...

NRSG 110: Foundations of Psychiatric Nursing Practice Learning Outcome 2: Describe Safety Relevant to Psychiatric Nursing Care Faculty: Susan Howell Med/surgical Faculty: Susan Howell Sept 1 Med/surgical Faculty: S Sept 2 usan Howell What is EMPATHY!!!?  What is Nursing!!!? Med/surgical Faculty: Susan Howell Sept 3 EMPATHY  Empathy defined the power/ability to understand and imaginatively entering into another person’s thoughts and feelings in a situation from their point of view rather than your own Med/surgical Faculty: Dictionary.com Susan Howell Sept 4 EMPATHY THE HUMAN CONNECTION TO PATIENT CARE  Empathy: The Human Connection to Patient Care - YouTube Empathy: The Human Connection to Patient Care (y outube.com) https://m.youtube.com/watch?v=cDDWvj_q-o8 Med/surgical Faculty: Susan Howell Sept 5 Safety  One of the most n.b. issues in healthcare  What is safety? Safety means being Safe… ◦ Freedom from physical & psychological injury or hurt. ◦ Freedom from danger ◦ A basic human need that must be met ◦ Essential for survival & well-being Med/surgical Faculty: Susan Howell Sept 6 Proper bicycle safety equipment for school-age children. Med/surgical Faculty: Susan Howell Sept 7  Safety covers for electrical outlets Med/surgical Faculty: Susan Howell Sept 8  Infant car seat. Med/surgical Faculty: Susan Howell Sept 9 Med/surgical Faculty: Susan Howell Sept 10 Med/surgical Faculty: Susan Howell Sept 11 Basic Human Needs Oxygen Nutrition  Low concentration  Proper storage  High concentration  Proper refrigeration  Carbon monoxide  Clean preparation area Temperature Humidity  Normal  Comfort zone: 60% to 70%  Hyperthermia  Liquefies secretions  Hypothermia  Improves breathing 12 Safety  A patient’s environment includes the physical and psychosocial factors that influence or affect the life and survival of that patient.  A patient’s environment crosses the continuum of care for settings in which you and your patients interact. Med/surgical Faculty: Susan Howell Sept 13 Safe Environment  Listed below are six characteristic of a safe environment.  a. Basic needs are met.  b. Physical hazards are reduced.  c. Transmission of pathogens is reduced.  d. Sanitation is maintained.  e. Pollution is controlled.  f. A plan is in place to respond to a possible terrorist attack. Med/surgical Faculty: Susan Howell Sept 14 Physical Hazards Physical hazards that contribute to accidental injury are: ◦ a. Inadequate lighting ◦ b. Obstacles ◦ c. Fire ◦ d. Poisoning ◦ e. Security  Transmission of pathogens ◦ Exposures ◦ Immunizations Med/surgical Faculty: Susan Howell Sept 15 Safety  Safety in health care settings  reduces the incidence of illness and injury,  shortens the length of treatment and hospitalization,  improves or maintains a patient’s functional status and  increases the patient’s sense of well-being. Med/surgical Faculty: Susan Howell Sept 16 Safety bars beside a toilet and shower. Med/surgical Faculty: Susan Howell Sept 17 Safety locks on a wheelchair. Med/surgical Faculty: Susan Howell Sept 18 Equality vs Equity Do we have equality in our health care system? Med/surgical Faculty: Susan Howell Sept 19 Founder of Health Care Tommy Douglas, premier of Saskatchewan from 1944 to 1961 Med/surgical Faculty: Susan Howell Sept 20 Med/surgical Faculty: Susan Howell Sept 21 Patient Safety Defined  Patient safety is “the prevention and mitigation of unsafe acts in the health care system.” (Canadian Nurses Association) Med/surgical Faculty: Susan Howell Sept 22 Traditional Patient Safety Model  Focus is on “individual” perspective  Examines the “ERROR” in healthcare & usually front-line error  Takes a punitive approach/punishment  Incident reports & investigations Med/surgical Faculty: Susan Howell Sept 23 Safety in Health Care  Usually defined in a negative way, as the absence of hurt or injury as a result of unsafe acts…..  Canadian Patient Safety Dictionary Med/surgical Faculty: Susan Howell Sept 24  Contemporary Model/ Systems Approach  Acknowledges healthcare will always involve RISK as we look after ill people in a very complex system  Focus is on all levels of the “system” (not just front-line staff)  Tries to find out how errors occurred & solutions to minimize errors from occurring in future  Blame & shame are removed Med/surgical Faculty: Susan Howell Sept 25 Canadian Healthcare System  In the mid 1990’s safety became a big issue on the Canadian healthcare agenda  What brought patient safety to the forefront? ◦ Major adverse events that were highly publicized ◦ Other nations were focusing in on safety & identified that patient safety issues were a much bigger problem than initially thought Med/surgical Faculty: Susan Howell Sept 26 Canadian Facts  A Cdn Adverse Event study in 2023 estimated that 1 in 13 adult med/surg clients in acute care hospitals experienced an adverse event.  It is estimated that 1 in 6 meds are given in error (note: many older adults average 6-8 meds per day)  wrong, dose, wrong med, wrong time,  wrong patient Med/surgical Faculty: Susan Howell Sept 27 What is an Adverse Event? “as an unintended injury or complication that results in disability at the time of discharge, death, or prolonged hospital stay, and that is caused by healthcare management rather than by the patient’s underlying disease process.” The Canadian Adverse Events Study and Medication Safety Med/surgical Faculty: Susan Howell Sept 28 Canadain Adverse Events  Between 9,000 and 24,000 patients die per year due to adverse events.  37% of adverse events are ‘highly’ preventable.  24% of preventable adverse events are related to medication error.  Canadian Medical Association Journal (CMAJ).  The Canadian Adverse Events Study and Medication Safety  https://www.ismp-canada.org › hnews › HNews0407 Med/surgical Faculty: Susan Howell Sept 29 Canadian Hospitals  The adverse event rate in Canadian hospitals is estimated to be 7.5 per 100 adult hospital admissions.  Although only 36.9% of the events were considered preventable,  20.0% were associated with permanent disability or death.  https://health-infobase.canada.ca/hospital- adverse-events-dashboard/ Med/surgical Faculty: Susan Howell Sept 30 Canadian Statistics  In Canada, medical errors account for 28,000 deaths yearly, according to the Canadian Patient Safety Institute.  The most frequent medical errors involve medications. They may include giving a patient either the wrong one or the wrong dose, or an allergy to the drug was on the record but went unnoticed.  Lynn Desjardins 2019 Med/surgical Faculty: Susan Howell Sept 31 A few high profile Cdn cases  1992 – Nova Scotia – a peds client received Vincristine intrathecally instead of IV and dies  1997 – BC – An identical death occurs in BC Children’s Hospital  The first reported event with this drug happened in 1968 and it took until the late 1990s to get this issue on the table and realize that a “systems” problem existed – not an “individual” error problem Med/surgical Faculty: Susan Howell Sept 32 1994: Manitoba  12 children die as a result of cardiac surgery at the Winnipeg Health Sciences Centre  Inquest revealed that 5 deaths were preventable, another 4 might have been preventable & only 1 death was not preventable  Again, a serious “systems” problem – not just an individual problem Med/surgical Faculty: Susan Howell Sept 33 2004: Alberta  2 critically ill patients on dialysis die after receiving potassium chloride instead of normal saline in their dialysis solution  A pharmacy tech had mislabeled the medication & it was inadvertently administered Med/surgical Faculty: Susan Howell Sept 34 2005: Saskatchewan  51 year old severely disabled female in LTC facility, died as a result of burns she received after being put into a tub of scalding water  Two workers had lowered her into a tub without checking the temp of the water  Resulted in a 2 year legal battle & $60,000 was paid to clients’ elderly parents in 2007  Was 100% preventable  Cypress Health Region was found negligent in providing care through failures in its systems & by actions of its staff Med/surgical Faculty: Susan Howell Sept 35 2006: Saskatchewan  A pediatric client was misdx’d at a S’toon hospital & parents drove child to Edmonton for an examination  In Edmonton, she was dx’d with leukemia  A government inquiry resulted Med/surgical Faculty: Susan Howell Sept 36 Woman, 56, charged after assault at Santa Maria seniors' home  According to sources, the man had told his family he was afraid of one of the workers at the care home, but because the man has a form of dementia, it was difficult for him to communicate details. That prompted his family to have the camera set up.  The sources told CBC News the video shows the elderly man being restrained in a chair by a female worker using some sort of strap-like material and being struck in the head several times by the same worker. Med/surgical Faculty: Susan Howell Sept 37 Critical Incidents In SK  A critical incident in healthcare is one that results in serious harm to the patient (actual or potential loss of life, limb or function)  A critical incident signals the need for immediate investigation and response  In 2004, the SK gov’t. legislated that all critical incidents in the province must be reported to SK Ministry of Health.  SK was the first province to legislate mandatory reporting Med/surgical Faculty: Susan Howell Sept 38 Med/surgical Faculty: Susan Howell Sept 39 Med/surgical Faculty: Susan Howell Sept 40 Nurse Lucy Letby  Nurse Lucy Letby has been found guilty of murdering seven babies on a neonatal unit, making her the UK's most prolific child serial killer in modern times. The 33-year- old has also been convicted of trying to kill six other infants at the Countess of Chester Hospital between June 2015 and June 2016.Aug 18, 2023  https://www.google.com/search? Med/surgical Faculty: Susan Howell Sept 41  Selected Litigation Involving Psychiatric Nurses Safety Issues Med/surgical Faculty: Susan Howell Sept 42 Psychiatric Pt set self on fire  Despite 2 previous attempts to burn herself, the staff permitted the client to keep her cigarettes & lighter  Pt set fire to her clothing & suffered 3rd degree burns Med/surgical Faculty: Susan Howell Sept 43 Nurses disagreed with Psychologist’s assessment  A nursing assessment indicated that a client with depression should be put on suicide watch  An evaluation by a staff psychologist advised that suicidal precautions were not needed  Pt killed herself in a locked bathroom  Lesson: medical orders must be questioned when nursing assessment indicates changes are needed for client safety  Nurses must implement nursing actions based on their nursing assessments Med/surgical Faculty: Susan Howell Sept 44 Saskpoly Reporting Form for Adverse Event, Near Miss & Critical Incident  Student-focused, anonymous reporting form has been developed for use in Saskpoltech Nursing Division  Blame-free  Serves as a learning tool  53% of situations were Near Misses (most involved meds; most happened in LTC)  Miscommunication cited most frequently as a contributing factor Med/surgical Faculty: Susan Howell Sept 45 Quality and Patient Safety  Patient safety incident (or adverse event) ◦ Harmful incident: an incident that resulted in injury to the patient ◦ Near miss: an incident that did not reach the patient (no harm resulted) ◦ No-harm incident: an incident that reached the patient but caused no discernible harm Med/surgical Faculty: Susan Howell Sept 46 Med/surgical Faculty: Susan Howell Sept 47 Med/surgical Faculty: Susan Howell Sept 48 Critical Incident Report . What is a critical incident?  A "critical incident" is defined in the Saskatchewan Critical Incident Reporting Guideline, 2023 as "a serious adverse health event that: a) occurred while receiving a health service provided by, or a program operated by, the Saskatchewan Health Authority (SHA), a health services provider or the Saskatchewan Cancer Agency (SCA), hereinafter collectively referred to as "health services entity”, and Med/surgical Faculty: Susan Howell Sept 49 Critical Incident cont.  c) is serious and undesired, such as i. death, disability, injury or harm, or ii. unplanned admission to a health facility or an unusual extension of a stay in a health facility, or iii. a significant risk of substantial or serious harm to the safety, well-being or health of the patient, and  gov/sask.ca Med/surgical Faculty: Susan Howell Sept 50 Critical Incident  d) does not result primarily from the individual’s underlying health condition or from a known risk inherent in providing the health services.  gov/sask.ca Med/surgical Faculty: Susan Howell Sept 51  How do you achieve safety?  Psychiatric nurses are responsible for identifying & eliminating safety hazards  How? ◦ Follow agency protocols & procedures ◦ Follow best practice guidelines for nursing practice ◦ Provide ongoing communication to clients, families, staff members ◦ Assess self & ensure your nursing practice is safe Med/surgical Faculty: Susan Howell Sept 52  What can you do to protect yourself? As a psychiatric nurse, what can you do to protect yourself? Med/surgical Faculty: Susan Howell Sept 53 Med/surgical Faculty: Susan Howell Sept 54 Strategies to Influence Health Determinants  Achieving Health for All  Health Promotion …increasing the level of well-being and self-actulization  Disease Prevention (specifically primary prevention) is action to avoid or forestall illness/disease. Med/surgical Faculty: S Sept 55 usan Howell Primary Prevention  Includes activities that protect against a disease before signs & symptoms occur… e.g. Immunization (prevents infectious disease)  Reduction of risk factors… e.g. decreasing risk factors such as inactivity or social isolation, smoking, exposure to air pollution Med/surgical Faculty: S Sept 56 usan Howell Secondary Prevention  Early detection of disease & prompt tx stops the disease & limits disability as a result  e.g. screening for cancer, mammogram, PPD at early post-partum visit; BP screening to detect HTN; Blood glucose monitoring to detect diabetes, pap test…TSE  Decreasing the prevalence of a mental disorder by decreasing # of existing cases thru’ early case finding, screening & prompt effective tx Med/surgical Faculty: S Sept 57 usan Howell Tertiary Prevention  Initiated during convalescence stage of disease and  are directed toward minimizing disability and helping to live productively with limitations.  E.g. coping with side effects of meds used to tx schizophrenia (chronic mental illness); cardiac rehab following a MI  E.g. Attempts to decrease severity of a mental disorder & its associated disability thru’ rehab activities Med/surgical Faculty: S Sept 58 usan Howell Primary care First contact into the health care system focuses on education, rehabilitation, support services health promotion and disease prevention … Involves multidisciplinary teams Secondary care provision of specialized medical service Tertiary care specialized and highly technical care in diagnosing and treating complicated health problems ex. ABCC Med/surgical Faculty: S Sept 59 usan Howell Immunization is the process by which resistance to an infectious disease is produced or augmented. Active immunity is acquired by injecting a small amount of attenuated (weakened) or dead organisms or modified toxins from the organism (toxoids) into the body Antibodies produced inside the body (mumps, measles) immunity to a pathogen that occurs following exposure to all or part of that pathogen. Passive immunity occurs when antibodies produced by other individuals or animals are introduced into a person’s bloodstream for protection against a pathogen Antibodies introduced from outside the body A newborn baby acquires passive immunity from its mother through the placenta. Med/surgical Faculty: Susan Howell Sept 60 Human immunodeficiency virus (HIV)—the pathogen that causes acquired immunodeficiency syndrome—is transmitted through blood and other body fluids. Substance abusers frequently share syringes and needles; this practice increases the risk of acquiring HIV. Safer sex practices, including the correct use of condoms and engaging in monogamous relationships, reduce the risk for both of these diseases and for other sexually transmitted infections. Hepatitis B is transmitted in the same way as HIV. Med/surgical Faculty: Susan Howell Sept 61 Hepatitis B and HIV can be transmitted in similar ways, but hepatitis B is more infectious. Both are passed on by contact with body fluids that contain the virus such as blood, semen, and vaginal fluid, or from a mother to her baby during pregnancy or delivery. https://www.aidsmap.com › about-hiv › hepatitis-b The hepatitis C virus is blood borne and can be spread through injection drug use as well as with body piercing or tattooing. Med/surgical Faculty: Susan Howell Sept 62 A pollutant is a harmful chemical or waste material discharged into the water, soil, or air. Air pollution is the contamination of the atmosphere with a harmful chemical. Prolonged exposure to air pollution increases the risk of pulmonary disease. (Increase in forest fires in B.C., Alberta, Saskatchewan and Manitoba) Land pollution can be caused by the improper disposal of radioactive and bioactive waste products. Water pollution is the contamination of lakes, rivers, and streams usually by industrial pollutants. Water-treatment facilities filter harmful contaminants from the water, but these systems can contain flaws. If water becomes contaminated, the public must use bottled or boiled water for drinking and cooking. (First Nation’s; lead pipes in Cathedral district in Regina) (Flint, Michigan lead in the Flint River) Med/surgical Faculty: Susan Howell Sept 63 Med/surgical Faculty: Susan Howell Sept 64 Individuals Experiencing…  stress, anxiety, fatigue, or  alcohol or drug withdrawal as well as those taking  prescribed medications may be more accident prone.  These individuals may also be too preoccupied to notice a source of potential accidents, such as cluttered stairs  or a road intersection. Med/surgical Faculty: Susan Howell Sept 65 Clients are at risk for:  Falls  Falls account for 90% of all reported incidents in hospitals.  Accidents ◦ Client-inherent ◦ Procedure-related ◦ Equipment-related Med/surgical Faculty: Susan Howell Sept 66 Safety  Impaired mobility: Impaired mobility due to …  muscle weakness, paralysis, or poor coordination or balance is a major factor in patient falls.  Immobilization predisposes a patient to additional physiological and emotional hazards,  which can in turn further restrict mobility and independence. Med/surgical Faculty: Susan Howell Sept 67 Falls  Account for up to 90% of incidents in hospital  Why? ◦ Advanced age of clients ◦ Hx of previous falls ◦ Gait disturbances ◦ Balance & mobility problems ◦ Postural/orthotic hypotension ◦ Sensory impairment ◦ Drug use Med/surgical Faculty: Susan Howell Sept 68 Safety  The four major risks to patient safety in the  health care environment are listed below.  a. Falls  b. Patient-inherent accidents  c. Procedure-related accidents  d. Equipment-related accidents Med/surgical Faculty: Susan Howell Sept 69 Falls often occur… ◦ while transferring from beds, chairs & toilets ◦ getting into or out of bathtubs ◦ tripping over carpet edges or doorways ◦ slipping on wet surfaces ◦ going downstairs ◦ outdoors due to icy walkways Med/surgical Faculty: Susan Howell Sept 70 Prevent Falls By… ◦ Wiping up spills ◦ Cleaning slippery spots on floors ◦ Clearing obstacles ◦ Have uneven surfaces repaired ◦ No loose rugs ◦ Ensure thresholds flush with floor ◦ Have handrails & grab bars ◦ Follow TLR!! 1,2,3,and command (sit, stand, turn etc) Med/surgical Faculty: Susan Howell Sept 71  Client’s Environment  Includes all physical & psychosocial factors that influence or affect life & survival of client  Safety in the healthcare environment: ◦ decreases illness & injury ◦ shortens length of tx &/or hospitalization ◦ improves/maintains client’s functional status ◦ Increases client’s sense of well-being  A safe environment also gives protection to the staff Med/surgical Faculty: Susan Howell Sept 72  Review….What is a safe environment?  One in which: ◦ Basic needs are met ◦ Physical hazards are reduced ◦ Transmission of pathogens reduced ◦ Sanitation maintained ◦ Pollution is controlled Med/surgical Faculty: Susan Howell Sept 73 Safety A pathogen is a microorganism capable of producing an illness.  One of the most effective methods of limiting pathogen transmission is the aseptic practice of hand hygiene. Med/surgical Faculty: Susan Howell Sept 74  Risks for Adult Developmental Stage Risks often r/t lifestyle habits ◦ e.g. Excess alcohol consumption ◦ e.g. Long-term smoker ◦ e.g. Increased stress Med/surgical Faculty: Susan Howell Sept 75  Risks for Older Adult Developmental Stage  Physiological changes that occur as part of the aging process, increases the client’s risk for falls  What are those? Med/surgical Faculty: Susan Howell Sept 76  Other Risks in the Healthcare Agency  Chemicals ◦ Cleaning solutions ◦ Some medications ◦ Disinfectants ◦ Mercury in glass thermometers WHMIS (Work Place Hazardous Materials Information System) Sets the standard for control of hazardous substances (any product that could cause physical or medical problems) Goals is to reduce injury & illness through an informed staff member Med/surgical Faculty: Susan Howell Sept 77 Med/surgical Faculty: Susan Howell Sept 78 Restraints to restrain or not to restrain??? That is the Question Med/surgical Faculty: Susan Howell Sept 79 Restraints Med/surgical Faculty: Susan Howell Sept 80  Restraints  It is a false belief that restraints enhance client safety or control challenging behavior  They help staff (or not) but limit client freedom of choice & movement & threaten dignity  E.g. of restraints ◦ Mitts ◦ Posey vests ◦ Geri chairs ◦ Siderails Med/surgical Faculty: Susan Howell Sept 81 Med/surgical Faculty: Susan Howell Sept 82 Restraints Med/surgical Faculty: Susan Howell Sept 83 Med/surgical Faculty: Susan Howell Sept 84 Med/surgical Faculty: Susan Howell Sept 85 Med/surgical Faculty: Susan Howell Sept 86 Med/surgical Faculty: Susan Howell Sept 87 Med/surgical Faculty: Susan Howell Sept 88 Med/surgical Faculty: Susan Howell Sept 89 Med/surgical Faculty: Susan Howell Sept 90 Med/surgical Faculty: Susan Howell Sept 91 Med/surgical Faculty: Susan Howell Sept 92 Side rails in the up position when transporting via stretcher Med/surgical Faculty: Susan Howell Sept 93 Geri Chair Med/surgical Faculty: Susan Howell Sept 94  Myths About Restraints  They reduce the risk of injury  They meet the nurse’s moral duty to protect the client from harm  Failure to restrain results in legal liability  Older people do not mind being restrained  Inadequate staffing justifies restraining clients  There are no adequate alternatives to physical restraints Med/surgical Faculty: Susan Howell Sept 95 Complications from Restraints  Pressure injuries (ulcers)  Constipation  Pneumonia  Incontinence  Urinary retention  Contractures  Nerve damage  Circulatory impairment  Humiliation, fear, anger, loss of self-esteem  Strangulation & death Med/surgical Faculty: Susan Howell Sept 96  Least Restraint Approach  Optimal goal is a restraint-free environment  Clients who are risk for injury may require temporary use of restraints  A “least-restraint” approach is recommended  This ensures that all alternative interventions have been attempted before moving to use of restraints Med/surgical Faculty: Susan Howell Sept 97 Alternatives to Restraints  Distraction, visitors & sitters  Orientate client & family to healthcare setting  Educate & explain tests/procedures  Evaluate meds  Bed/chair alarms  Keep confused/disoriented clients close to nursing station  Relaxation techniques  Ensure exercise Med/surgical Faculty: Susan Howell Sept 98 Med/surgical Faculty: Susan Howell Sept 99 Med/surgical Faculty: Susan Howell Sept 10 0 Safety  Providing safe care is an important concern for health care providers. Med/surgical Faculty: Susan Howell Sept 10 1 Quick Quiz! 2. A patient who is being prepared for discharge after a hospitalization for frequent falls should have which of these interventions? A. Be referred to a long-term care facility B. Have a home assessment C. Remain in hospital D. Go home to live with family Med/surgical Faculty: Susan Howell Sept 10 2 Quick Quiz! A newly admitted patient was found wandering in the hallways for the past 2 nights. To prevent a fall by this patient, what would the most appropriate nursing intervention include? A. Raise all side rails when the patient is prepared for bed. B. Use an electronic bed monitoring device. C. Place the patient in a room close to the nursing station. D. Use a loose-fitting vest-type jacket restraint. Med/surgical Faculty: Susan Howell Sept 10 3 Client wearing an Ambularm device Med/surgical Faculty: Susan Howell Sept 10 4  Chapter 38: Safety   Case Study  Emmanuel is a new nurse graduate who has been hired by the local hospital to work in the ambulatory surgery centre. Emmanuel is required to attend the hospital orientation to learn about facility policies and procedures. Of particular importance are the protocols that surround patient safety.   Med/surgical Faculty: Susan Howell Sept 10 5  Emmanuel completes the two-day classroom orientation and is assigned to a preceptor to follow in the ambulatory surgery centre for three weeks. This constitutes his “hands on” orientation, during which he will be able to care for patients under the guidance of his preceptor Med/surgical Faculty: Susan Howell Sept 10 6  Emmanuel is caring for Mr. Natik, a 61- year-old male who has just had cataract surgery in his right eye. Emmanuel teaches Mr. Natik safety precautions, including preventing the risk of burns while cooking. A self- inflicted burn is referred to as a ________-____________ accident. Med/surgical Faculty: Susan Howell Sept 10 7 Quick Quiz  Emmanuel finds that Mr. Natik has postural hypotension, as well as visual impairment. Emmanuel notes that Mr. Natik is at risk for which of the following?  A. Requiring restraints.  B. Falls.  C. Procedure-related accidents.  D. Equipment-related accidents. Med/surgical Faculty: Susan Howell Sept 10 8 Quick Quiz continued  Emmanuel is reminded by his preceptor to be diligent in preventing procedure-related accidents. Which of the following is an example of a procedure-related accident? (Select all that apply.)  Med/surgical Faculty: Susan Howell Sept 10 9 Select all that Apply  A. Medication administration error  B. Improper insertion of a urinary catheter  C. Application of an incorrect bandage to a wound  D. Incorrect transcription of a telephone order Med/surgical Faculty: Susan Howell Sept 11 0 https://m.youtube.com/watch? v=cDDWvj_q-o8 Med/surgical Faculty: Susan Howell Sept 11 1