what is healthcare excellence Canada?
organization that shares innovations to improve patient safety and quality of care
collaborates with pt/families/caregivers, healthcare, organization, first nations, governments
patient safety is a key _ _ and an essential component of _ _
professional value
daily practice
what is the 3rd leading cause of death after cancer and heart disease?
avoidable medical incidents
what are the 4 categories of harmful events?
health care + meds (I.e., bed sores, wrongs meds...)
infections
procedure related (I.e., bleeding out)
patient accidents (I.e., falls)
what is the 2020 safety competencies framework?
framework that identifies competencies that can be adopted and adapted by diverse healthcare programs to design curricula to teach safety + quality for any sector or healthcare program
what are the 6 domains of safety competencies?
patient safety culture
teamwork
communication
safety, risk,and quality improvement
optimize human and system factors
recognize, respond to and disclose patient safety incidents
explain patient safety culture
- individuals that are committed to minimize pt harm during delivery of care
- feel comfortable speaking apt unsafe practices
- understanding one's role in enhancing a safety culture
- recognizing the importance of ongoing collaboration and commitment to advocate for change
- healthcare leaders must set clear expectations for positive safety culture and balance a "no blame system" with individual accountability
explain teamwork
- collaboration among team members
- effective conflict resolution among team members
- value role of each member
- pt centered care
explain communication
- effective communication is beneficial to pt, builds trust, and is precondition of obtaining consent
- effective verbal + nonverbal
explain safety, risk, and quality improvement
- must collect and monitor performance data to assess risk + improve outcomes
- detects + report pt safety threats
- implements evidence informed practice
- evaluate quality improvement interventions
explain optimize human and system factors
- optimize those that support the achievement of best human performance
- policies/procedures
- resource allocation/workload
- well being of healthcare workers
explain recognize respond to and disclose patient safety issues
- open, honest and empathetic disclosure + appropriate apologies benefit pt, providers, organizations
- recognize/report pt safety incidents
- prevent reoccurrences
- support pt
- engage in reflection
- provide support to team members
what is difference between accident + incident?
incident: events that did not reach the pt but could have cause harm
accident: event that reached the pt whether causing harm or not
what is the primary purpose of reporting incidents/accidents?
first its LEGAL obligation
primary purpose is reducing risk of occurrence of pt safety incidents in future - analyzed by institutions
what is identified when the incidents/accidents are reviewed ?
identify potential factors that contributed
identify potential interventions to prevent recurrence
in what circumstances should you complete an incident/accident report?
when occurred in course of providing care and services to a user, I.e. any undesirable situation that has or could have harmed the users' health must be reported by means of this form
when should you complete an incident/accident report?
as soon as possible after recognizing/discovering event
who should you complete an incident/accident report?
any employee of institution who witnesses/discovers/directly involved in incident/accident - includes nursing students
what are examples of circumstances to complete a incident/accident report?
administers wrong meds
pt allergies known, given allergen
meds found in pt bed
meds not administered by another nurse
narcotic med missing
pt falls
near fall
pt found on floor
pt injured during application of restraints
what is disclosure?
process by which a pt is informed of an accident that has occurred - by physician
verbal communication
documentation in pt's chart
where do you report in Quebec?
MSSS
- rapport de declaration des incidents/accidents
- rapport d'analyse des incidents/accidents
- rapport de divulgation d'accident
what are 3 ways to provide safe care + health services?
report
disclose
be involved
how do nurses communicate to other professionals the pt's clinical situation and required follow up?
nursing documentation
- a professional responsibility
- helps ensure protection of public
what are the 4 OIIQ principles of nursing documentation?
relevant
concise
complete
organized
what does the nursing documentation involve?
observations + assessmments
nursing analysis - health problems + goals
interventions
outcomes
required follow up
what is a patient's chart?
legal doc that is used to record the comprehensive assessment and care a pt receives within health care system
official means of communication among health professionals to ensure safety + continuity of care
what are progress notes?
focus on nurse's clinical decisions, provides clinical justification in reference to clients evolving condition
what are the 3 reserved activities in Nurses Act?
assessing physical + mental condition of symptomatic person
providing clinical monitoring of condition of pt whose state of health is problematic, including monitoring + adjusting the therapeutic nursing plan
providing nursing follow up for persons with complex health problems
why was the therapeutic nursing plan created? what is it?
to document nurses clinical decisions which are based in nurses assessment, which are crucial to pt follow up, tracks
separate documentation tool, part of chart, contains only priority health problems and needs that affect clinical follow up + nursing directives
who does not need a TNP?
one time client interventions
what is client already has TNP?
nurse must consult it to determine if any elements of previous TNP are relevant to new care episode
when should you adjust TNP?
changes in clients condition - must explain the adjustments in progress notes
what is a priority problem or need? (nursing analysis CRC)
- requires particular clinical follow up
- will affect clinical follow up
- presents a significant change on clinical follow up
(I.e., new problem, deterioration of previous problem)
determined after nurses assessment
what is the nursing directive?
contains crucial indications to ensure that clinical monitoring, nursing care, Tx and other interventions the pt requires are carried out
ex: priority problem: R knee surgery
nursing directive: apply clinical pathway for R knee surgery
what is delegation?
nurse ensure that plans are carried out by assigning tasks to team members after verifying they have the legal authority, knowledge and skills required to perform activities
work with LPNs and PABs, nursing assistants