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freedom from accidental injury |
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these people in the executive suits and on the frontlines of care are instrumental in preventing harm to patients and improving patients outcomes |
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a complex and risk-prone system that can produce unintended consequences, lack of comprehensive verbal, written, and electronic communication systems, lack of standardizations, fear of punishment inhibting reporting and lack of ownership for patient safety |
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nurse is the last line of defense |
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common error of medications |
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error problem diagnostic inaccuracy |
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common error on equipment failure |
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blood type, wrong patient |
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no independent double check |
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common error system failure |
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common error on environment |
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at least 2 patient identifiers |
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we must improbe the accuracy of patient identification by using |
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the person receiving info record and readback the complete order or test result |
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to improve communication among caregiver, for verbal or telephone orders or for telephonic reporting of critical test results verify by having |
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abbreviations, acronyms, symbols, and dose designations |
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we must standardized a list __________ that are not to be used throughout the organizations |
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asking and responding to questions |
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implement a standardized approach to hand off comunications by including |
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situation, background, assessment, and recommendation |
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what is going on with the patient at the present time, what is the circumstance, why are you having this conversation
Get their attention about 5-10 seconds
Identify yourslef and your unit
Identify you who are calling about (pt's named and date of birth)
identify the problem you are calling about |
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what is the clinical background or context (key objective data, vital signs, lab trends), how did we get here, what are the circumstances leading up to this situation
Admitted for_Date of ADM_______
Pertinent history_____
pertinent lab tests and trends_____
Patient clinical information________ |
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What you think is going no, analysis, what you are concerned about
"might be....could be..." |
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What you would recommend to correct the problem |
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After every communication/conversation always |
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look-a-like-sound-alike; prevent errors |
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With medications you want to identify anf annually review a list of ___________ drugs used by the organization and take action to _________that involved the interchange of these drugs |
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Always do this to ALL medications, medication container such as syringes, medicine cups, and basins or other solutions on and off the sterile field |
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reduce the likelihood of patient harm associated with the use of ______therapy |
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fall reduction program that includes an evaluation of the effectiveness of the program |
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a way to reduce falls is by implementing a |
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I am CONCERNED, I am UNCOMFROTABLE, and this is a SAFETY issue |
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any unplanned descent to the floor |
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falls are the leading cause of feath due to an injury for people |
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loss of confidence in mobility, and reduced activity fro muscle weakening |
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other risks for the client that can fall |
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costs, insurance claims, and lawsuits |
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falls are risks to institutions because of |
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falls are the 6th leading cause of |
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rapid and simple assessment of a patient's likelihood of falling. used widely in acute care settings both in hispital and long term care inpatient settings. It consists of six variables. |
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6 morse Fall scale indicators |
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Definition
1 History of falling within three months
2 secondary diagnosis
3 ambulatory aid
4 IV/Saline lock
5 Gait/transferring
6 Mental status |
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Definition
History of falls
mobility impairment
use of assisrive devices and muscle weakness
cognitive impairment and depression
visual deficits
dizziness/lightheadness, postural hyportension
agitation
urinary frequence
arthritis
age >65 |
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raise head of bed and dangle |
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Definition
to reduce fall with those who have postural hypotension |
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Great risk of fall can happen if one takes more than ____ types of medication |
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psychotropics, aticonvulsants, antiarrhythmic, antihypertensive, and diuretics |
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Medications that are associated with increased risk of falls are |
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moving the patient near the RN station
orient to environent, keep belonging in reach and keep call light in reach
bed low in locked position
adquate lighting
non-slip footwear, glasses, and hearing device on
safest rail position
toileting
bed alarms
sitter
patient and client education
ALWAYS DOCUMENT
FALL MUST BE DOCUMENTED
INTERVENTIONS MUST BE DOCUMENTED
INCIDENT REPORTS MUCH BE COMPLETED AFTER EACH FALL
after a FALL always DOCUMENT THE PATIENTS RESPONSE TO THE FALL, EVIDENCE AT INJYR, NOTIFY THE PHYSICIAN and MEDICAL AND NURSIGN INTERVENTIONS MUST BE IMPLEMENTED!!
Communicate the fall to all shifts
Monitor the patient carefull after the fall |
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should only be used after less restrictive intervention have been ineffective |
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address fall risk factors, reduce noise, have light, surveillence, adaptive equipment, answer call lights within 3 minutes and rounding |
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Definition
strategies to minimize restraints |
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Definition
physical restraints that result in injury may lead to |
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self, others, injury, falls, and prevent therapy disruption |
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we use restraints to reduce risk to |
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physician's order; face-to face |
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restraints needs a ____and requires a ______assesment of the client |
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once restraint is ordered it needs to be |
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orders for restraints are good for |
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PRN orders as needed or stanging order |
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with restraints there are no |
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1-2 hours or more frequently |
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always assess restraint for about |
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always tie the restraint to the ______ and use the quick release |
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allow room for _______between restraint and clients limb |
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check client and reorient every |
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always provide regular ____ and regular food and fluid |
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assessing the client _______ and comfort is important |
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Documentation of Restraints |
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Always document behavior that led the restraints
documment restraint alternative attempts
document ongoign assessing and releases
document behaviors after the application of restraints
document CMs assessment and oxygenations
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Physiologic hazards associated with restraints |
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Definition
suffocation from entrapment
impaired circulation
altered skin integrity->pressure ulcers
diminshed msucle and bone mass
joint contractures
fractures
altered nutrtion and hydration
aspiration and breathing difficulties
new onset continence |
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these are considered a restraint, since they restrict the client's freedom voluntary movement in and out of bed |
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event of such magnitude that it requires the response of people outside the community in which it is occuring |
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floods, hurricanes, tornadoes, earthquakes |
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toxic spills, wars, terrorist events |
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nurses must be prepared to treate and hospitals much have a disaster plan that is well practiced before hand for |
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question whether they may have been exposed to a biological agent |
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Definition
if there is an unusual number of people suddenly experiecing similar signs and symptoms always |
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