SAFETY
RNSG 1171
Professional Nursing Concepts I
Concept – SAFETY
Concept Definition
Protection from harm or injury for patients and providers through both system effectiveness
and individual performance.
Exemplars
National Patient Safety Goals
Standard Precautions
Skills course: environmental safety and medication administration
Objectives
1. Explain the health care system concept of safety. (Including definition, antecedents,
and attributes).
2. Analyze conditions which place a patient at risk for injury.
3. Analyze conditions which place the nurse at risk for harm or injury.
4. Identify when safety is being compromised or is developing and include the concept
of missed nursing care.
5. Discuss exemplars of common safety practices such as standard precautions,
national patient safety goals, environmental safety, and medication administration.
Concept Analysis Diagram
Note: Diagram is on separate page
Explanation of Safety Diagram:
The definition of safety is the protection from harm or injury for patients and providers
through both system effectiveness and individual performance. The sub-concepts listed in the
diagram are merely components of safety.
For safety to occur there must be knowledge of risks and a culture of safety. These are
considered the antecedents as they must be present for safety to be assured. For effective
safety to be measured the desired attributes include being injury free as defined by TJC (The
Joint Commission), OCSHA (Occupational Safety and Health Administration), and QSEN (Quality
and Safety Education for Nurses) Standards.
If the attributes are met then positive consequences occur such as culture of
transparency, uneventful discharge, and no harm. If the attributes are not met then negative
consequences result such as extended hospitalization, injury, death, increased cost, and liability
charges. Interrelated concepts either impact safety in a positive or negative manner thus
impacting the type of consequences that occur and safety may impact the interrelated concept
in like manner.
Nursing care is implemented either proactively or in response to negative consequences
and is focused on improving the antecedents. If the nursing care is successful the result will be
the measurement of optimal attributes which will indicate safety exists.
N:ADNsyllabus\CBC Curriculum\Level I Fall 2014
Reviewed 06/14
SAFETY
Assignments
Prior to class:
1. Review definitions of inter-rated concepts on concept analysis diagram.
2. Review concept analysis diagram.
3. Required assigned reading:
*Page numbers, assignments, and other lecture information will be posted on
blackboard.
 Berman, A. & Snyder, S. (2012). Kozier & Erb’s Fundamentals of Nursing.
Boston: Pearson.
 Chapter 31: Standard Precautions
 Chapter 32: Safety
 Giddens, J.F. (2013). Concepts for nursing practice. St. Louis, Missouri:
Mobsy Elsevier.
 Chapter 43: Safety
4. Videos to review:
 National Patient Safety Goals 2012
http://mcom.alexanderstreet.com/view/1772727
 Patient Safety: Your First Concern
http://mcom.alexanderstreet.com/view/1665642
 Risk Assessment (Part 1) in Fall Prevention
http://mcom.alexanderstreet.com/view/1665612
 Preventative Strategies and Products (Part 2) in Fall Prevention
http://mcom.alexanderstreet.com/view/1665613
 Preventing Transmission, Protecting Yourself
http://mcom.alexanderstreet.com/view/2063517
 Standard Precautions
http://mcom.alexanderstreet.com/Series/29
 Transmission of infection
http://mcom.alexanderstreet.com/view/1665479
5. Note the following Nursing Diagnoses:
 Risk for injury
 Risk for falls
 Knowledge Deficit: personal safety or health maintenance or treatment
regimen
 Acute confusion
N:ADNsyllabus\CBC Curriculum\Level I Fall 2014
Reviewed 06/14
SAFETY
Concept content outline:
Concept:
Safety
Sub Concepts: National Patient Safety Goals
Sentinel Events
Near miss/Adverse event
Antecedents: Knowledge of risk
Culture of safety
Risk Factors: Lack of knowledge
Fear of harm to patient or nurse
Assessment: Fall risk
Braden scale
Examination of environment
Need for restraints to maintain safety
Positive Outcomes:
Culture of transparency
Uneventful discharge and no harm
Negative Outcomes:
Extended hospitalization
Injury and or death
Increase cost and liability of the health care facility and provider
Clinical Management:
Nursing interventions
Collaborative interventions
Exemplars:
National Patient Safety Goals
Standard Precautions
Skills course: environmental safety and medication administration
N:ADNsyllabus\CBC Curriculum\Level I Fall 2014
Reviewed 06/14
SAFETY
CONCEPT ANALYSIS DIAGRAM (TEXAS) – SAFETY
Nursing Care
 Directed toward what contributes to a normal concept and is thereby related to all factors
involved in or with the concept. Not always needed to have a normal outcome.
Attributes
 Defining characteristics of the concept
 What must occur for the concept to exist
Antecedents
 What precedes the concept for it to exist
 Events or incidents that must happen before the concept
Consequences
 Untoward events or outcomes that occur due to malfunction within the concept
 Positive events or outcomes that occur due to proper functioning within the concept
Interrelated Concept
 Concepts which can affect change in the other
 Concepts which work together to ensure a normal process
 Concepts which if depleted or impaired can cause a negative consequence in the other
Sub- Concept
 Critical components of major concept
Patient
Education
Attributes
Injury Free as defined by:
TJC
OSHA
QSEN Standards
Nursing Care
Interrelated
Concepts
Patient-Centered Care
Quality
Improvement
Health Policy
Evidence-Based
Practice
Clinical
Judgment
Safety
Antecedents
Protection from harm or
injury for patients and
providers through both
system effectiveness
and individual
performance.
Knowledge of Risk
Culture of Safety
Consequences
(Outcomes)
Extended
Hospitalization
Injury
Negative
Culture of
Safety
Culture of
Transparency
Sentinel Events
National
Safety Goals
Death
Sub -Concepts
Near Miss/Adverse Events
N:ADNsyllabus\CBC Curriculum\Level I Fall 2014
Positive
Cost
Uneventful
Discharge
No
Harm
Liability
Reviewed 06/14