Lesson 1-Safety NURS 116: Foundations of Nursing
Practice
Identify Safety Risk With-In Healthcare Setting
Different factors that influence patient safety




Developmental Stages: Children, Adolescents, Adults, Older Adults
Lifestyle: Smoking, Eating, and Occupation
Immobility: Physically challenged
Sensory & Communication Impairments: Dementia or Visual
Impairment
 Lack of Safety Awareness: Not aware of their surroundings
Environmental Risk
 Home Hazards:
 Nutrition:
 Pathogen transmission: Proper handwashing techniques
What are infants are at risk for:




Falls
Chocking
Poison
Drowning
What are adults at risk for:
 Lifestyle habits (eating, smoking)
 Hazard’s work (Occupation)
What are Older adults at risk for
 Numerous medication
 Falls
Safety: Freedom from accidental injuries
 Types of Hazards
o Car Accidents
 Don’t drink a drive
 Don’t text and drive
 Obey safety laws
o Poison
 Teach patient about poison control
o Fire
 Smoking in bed
 Candles
 Electric heater
 Oxygen is flammable
 Educate on fires and fire extinguishers
o Disasters
 Prepare and train for disasters
o Pollution
 Inhaling
o Pathogen Transmission
 Wash hands
o Falls
 Objects blocking aisle
National Patient Safety Goals (PG 385)







Identifying patient correctly (Name & Date of Birth)
Improve staff communication
Use medication safety
Use alarm safety
Prevent infection
Identify patient safety risks
Prevent mistakes in surgery
Documentation/Electronic Record & Communication (PG 371 Table 26.2 &
26.3)
 S: Situation:
2
 B: Background:
o The diagnosis
o Any allergies
 A: Assessment:
o Abnormal finding
o Vital signs
o Wounds
o Tubes
 R: Recommendation:
o Concerns related to patient
o What to suggest about those concerns?
Errors
 Lack of communication
 Lack of clarity
 Be specific with documentation
Most common mistakes during documenting






Failing to document relevant information
Failing to record nursing actions
Failing to document administrating medication
Recording on the wrong chart
Transcribing orders improperly (repeat order back)
Handwriting unreadable or incomplete records
Documentation








3
Date
Time
Sign Name
Document all facts subjective and accurate
No opinions
Document for yourself
Draw line through messed up documenting with error above
Blue or black ink
 Do not erase
 No whiteout
Error Reporting/Analysis Systems
 Over worked or fatigued
o Take breaks when needed
 Diagnostic Errors
o
 Treatment Errors
o Occurs during performing operations or procedures
 Preventative Error
o Failure to provide prophylactic or inadequate monitoring or
preventive treatment
 Communication
o Miss communication
Where errors can occur
 Active or Latent
 Active Errors are at the sharp end of care (direct patient care)
 Latent Errors occur as a fault in the system
Adverse Events Levels of Errors
 Near Miss: Can cause harm but harm didn’t not occur
o Example: Patient allergy to medication nurse noticed before
administrating
 Sentinel Event: Unexpected event that can result in death or serious
injury
o Example: Patient fall
 Adverse event: Unintentional or accidental harm
o Example: Something that happens to the patient by accident
 Act Commission: Doing the wrong thing
 Example: Elevating patient wrong when needed
 Act of Omission: No action
 Example: Not walking patient when needed
4
Medication Administration
 Hospital setting is the most common for errors
o Distractions
 Ways to prevent medication errors
o Barcode on medication
o Two patient identifiers
o Patient allergic
Diagnostic Workup
 Educating patient of side effects of medication
o Drink lots of fluids to flush your system out
Diagnostic Errors (PG 235)




Failure of treatment delays
Failure to active or monitor test results
Failure to perform indicating test
Errors in data collection
Fall Prevention/Risk Assessment
 Falls are a major concern in safely environments
When to




Change in condition
After a patient fall
When a patient is transferred
Admission
Risk Factor (PG 394)
 Gate or balance problems
 Weakness in lower extremities
 Taking medication
Implementation
 Hourly or purposeful rounding
 Yellow wristbands
5
 Safety equipment (Gait belt)
 Assessment of environmental hazards
o Moving object out of aisle
o Avoid area rugs
o Carpeting secure throughout home
o Electronic safety device (Life Alert)
Exit ticket Email:
 Relevant Assessment Data (Five items/data that you see in this
scenarios)
 Three evident based practiced interventions with rationales
Restraints
 Restrains should be used as last resort
 Restrains also require an order
o Type of restraint
o Where it should be applied
o How long for
 Prevents interruptions during treatment or procedures
 Prevent them from harming them self
 Chemical restraints
o Medication
 Quick release restraint incases need to perform CPR
 Check every hour to prevent skin tearing
Restraint Alternative (PG 406)
 Our patients to the environment
 Frequent observation (patient that are confused)
6