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SAFETY http://www.youtube.com/watch?v=kg2kEzWIOI&feature=fvwrel Quote for the Day: It is improper to consider personal danger when the public welfare is at stake." (Maimonides, "Iggeret Teman") PATIENT SAFETY ADVOCATE Developed by D. Ann Currie, RN,MSN PATIENT SAFETY ADVOCATE Patient Safety Advocate: A licensed nurse who promotes safety in the patient and family environment by: following scope and standards of nursing practice; practicing within the parameters of individual knowledge, skills, and abilities; identifying and reporting actual and potential unsafe practices; and implementing measures to prevent harm. . RNSG 2308 COURSE OBJECTIVES Unit IV: Patient Safety Advocate 1. Examine the Texas Nursing Practice Act and the Texas Board of Nursing Rules that emphasis safety as well as the federal, state, and local government and accreditation organizations safety requirements and standards in regard to the maternal, newborn, women’s health care patients. (SLO #4, & 5) 2. Identify measures that promote quality patient-centered care and a safe supportive, protective environment for childbearing families, women selected health issues, the nurse, and other health care team members.(SLO #4 & 5) 3. Examine the nurse’s role in local health facilities and community regarding disaster planning and bioterrorism as it relates to childbearing families and women with selected health issues. (SLO #5 & 6) RNSG 2308 UNIT IV OBJECTIVES 1. Discuss the Texas Nursing Practice Act and the Texas Board of Nursing Rules in regard to safety in the caring of the maternal, newborn, and/or women’s health patients. 2. Compare and contrast the federal, state, and local government and accreditation organizations’ safety requirements and standards in the patient-centered nursing care of the maternal, newborn and women’s health patients. 3. Examine the policies and procedures of area facilities as they pertain to the delivery of safe patient-centered nursing care for the childbearing family and women health care patients. 4. Discuss National Standards for safe Nursing Practices as they apply to the maternal, newborn, and/or women’s health care patients. CONT. UNIT OBJECTIVES 5. Discuss the principles of quality improvement and outcome measurement in health care organizations in regard to the maternal, newborn, and/or women health patients. 6. Identify potential risk for maternal, newborn, and/or women’s health patient harm related to accidents. 7. Discuss measures to prevent risk to the maternal, newborn, and/or women’s health patient resulting from errors and preventable occurrences. 8. Summarize national and state standards and guidelines and procedures for infection control in the maternal, newborn, and/or women’s health care areas. CONT. UNIT OBJECTIVES 9. Discuss the importance of correctly identifying and matching the mother and infant couplet on the mother baby or postpartum unit. 10. Explore the role and responsibilities of the nurse in regard to baby abduction. 11. Discuss the nurse’s role in local facilities and community regarding disaster planning and preparedness for childbearing families. 12. Examine the nurse’s role and responsibilities internal and external disasters in the maternal, neonatal and women’s health care areas of the hospital. CONT. UNIT OBJECTIVES 13. Explain the specific bioterrorism agents (effects of biological, chemical, and nuclear agents) on reproduction, pregnancy outcomes, fetus, and neonate. 14. Compare how the interventions for biological agents differ in pregnant patients. 15. Discuss how the nurse can utilize evidence based nursing practices to improve the quality and safety of the patient-centered nursing care for childbearing patients, women with selected health issues and their families. 16. Explore the how the use of technology and informatics can assist in the nurse in delivering safe patient-centered nursing care for childbearing patients, women with selected health issues and their families. PATIENT SAFETY –IT CAN GO WRONG http://www.youtube.com/watch?v=BFd54Yzgvo&feature=autoplay&list=PLCBDB95498F3E4649&playnex t=2 TEXAS NURSING PRACTICE ACT AND TEXAS BOARD OF NURSING (BON)RULES THAT EMPHASIZE SAFETY http://www.bne.state.tx.us/ TEXAS DEC’S Patient Safety Advocate: A. Demonstrate knowledge of the Texas Nursing Practice Act and the Texas Board of Nursing Rules that emphasize safety, as well as all federal, state, and local government and accreditation organization safety requirements and standards. B. Implement measures to promote quality and a safe environment for patients, self, and others. C. Formulate goals and outcomes using evidence-based data to reduce patient risks. D. Obtain instruction, supervision, or training as needed when implementing nursing procedures or practices. E. Comply with mandatory reporting requirements of the Texas Nursing Practice Act. F. Accept and make assignments and delegate tasks that take into consideration patient safety and organizational policy. NPA 217.1&2 (B) Implement measures to promote a safe environment for clients and others; (C)Know the rationale for and the effects of medications and treatments and shall correctly administer the same; (N) Clarify any order or treatment regimen that the nurse has reason to believe is inaccurate, non- efficacious or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when the nurse makes the decision not to administer the medication or treatment; (O) Implement measures to prevent exposure to infectious pathogens and communicable conditions; (S) Make assignments to others that take into consideration client safety and that are commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made; (T) Accept only those nursing assignments that take into consideration client safety and that are commensurate with the nurse's educational preparation, experience, knowledge, and physical and emotional ability; THE JOINT COMMISSION The National Patient Safety Goals www.jointcommission.org http://www.jointcommission.org/standards_in formation/npsgs.aspx http://www.youtube.com/watch?v=X6nBd9Nv qrk&feature=related NATIONAL PATIENT SAFETY GOALS -JAN. 1,2012 Identify patients correctly Improve staff communication Use medicines safety Prevent infections Identify patient safety risks Prevent mistakes in surgery IDENTIFY PATIENTS CORRECTLY Use at least two ways to identify patients. For example, use the patient’s name and date of birth. This is done to make sure that each patient gets the correct medicine and treatment. Correctly Indentify mother /baby couplet. Make sure that the correct patient gets the correct blood when they get a blood transfusion. IMPROVE STAFF COMMUNICATION Communication • Verbal • • • • • • Handoffs Reports Nurse to Nurse Nurse to Doctors Other Nurse to other Health Care Team Members Documentation Get important test results to the right staff person on time. What is SBAR and What is SBAR Communication? A Communication Technique for Today's Healthcare Professional Situation Background Assessment Recommendation (SBAR) is a standardized way of communicating. It promotes patient safety because it helps individuals communicate with each other with a shared set of expectations. Staff and physicians can use SBAR to share patient information in a concise and structured format. It improves efficiency and accuracy. SBAR stands for: Situation Background Assessment Recommendation Communication with physician. “Dr. ________________, This is [state your name], one of the nurses in [state your department]. We have a new patient, [patient’s name], a [age] year-old, [race], [gender]. He came in with complaints of________________________ _____________________________, which started at [time of onset]. His vital signs are [HR], [RR], [BP], [T], and [pulse ox, amount of O2 and type of delivery]. He has a history of ___________________________________________. On assessment, we found______________________________________. So far, we have [tell what interventions you have done so far]. I think he may have ________________________________________. I think he needs some________________________________________. What else you would like for us to do?” Restate what needs to be done, including reading back the orders. Confirm when the health care provider will arrive to assess the patient. PLEASE USE CUS WORDS BUT ONLY WHEN APPROPRIATE! USE MEDICINES SAFELY Before a procedure, label medicines that are not labeled. For example, medicines in syringes, cups and basins. Do this in the area where medicines and supplies are set up. Take extra care with patients who take medicines to anticoagulants. Record and pass along correct information about a patient’s medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Make sure the patient knows which medicines to take when they are at home. Tell the patient it is important to bring their up-to-date list of medicines every time they visit a doctor. Improve the safety of using medications. • Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used by the organization, and take action to prevent errors involving the interchange of these drugs. • Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and off the sterile field. • Reduce the likelihood of patient harm associated with the use of anticoagulation therapy. LOOK ALIKE MEDICATIONS http://www.usp.org/images/patientSafety/prn1162004-04-30h.jpg http://www.uspharmacist.com/publish/images/8_1307_3.jpg MEDICATION ERRORS http://www.youtube.com/watch?v=uQ-Vns6XFc&feature=related PREVENT INFECTION Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Set goals for improving hand cleaning. Use the goals to improve hand cleaning. Use proven guidelines to prevent infections that are difficult to treat. Use proven guidelines to prevent infection of the blood from central lines. Use proven guidelines to prevent infection after surgery. Use proven guidelines to prevent infections of the urinary tract that are caused by catheters. INFECTION CONTROL STARTS WITH HANDWASHING HIP HIP HOORAY DR SEMMELWEISS IDENTIFY PATIENT SAFETY RISKS Find out which patients are most likely to try to commit suicide. Falls DVT Infant abduction PREVENT MISTAKES IN SURGERY Make sure that the correct surgery is done on the correct patient and at the correct place on the patient’s body. Mark the correct place on the patient’s body where the surgery is to be done. Pause before the surgery to make sure that a mistake is not being made. SURGERICAL TIME OUT PROCEDURE Even for an emergency C-Section or a BLT http://www.youtube.com/watch?v=w7GE_YvPVh4 http://www.youtube.com/watch?v=lEzwBvByIiE STANDARDS OF CARE AWHONN • http://www.awhonn.org/awhonn/ Nann • http://www.nann.org/ ANA • http://www.nursingworld.org/ AACRNA • http://www.aana.com/Pages/default.aspx INSTITUTE OF MEDICINE (IOM) http://www.iom.edu/Global/Topics/Quality-PatientSafety.aspx AGENCY FOR HEALTHCARE RESEARCH AND QUALITY www.ahrg.gov PATIENT SAFETY QUALITY HEALTHCARE www.psqh.com INSTITUTE FOR IMPROVEMENT www.ihi.org/ihi INSTITUTEFOR SAFE MEDICATION PRACTICES www.ismp.org NCLEX Client needs Safe and Effective Care Environment Safety and Infection Control www.ncsbn.org . Safety and Infection Control – protecting clients and health care personnel from health and environmental hazards. Related content includes, but is not limited to: ..Accident/Injury Prevention ..Emergency Response Plan ..Ergonomic Principles ..Error Prevention ..Handling Hazardous and Infectious Materials ..Home Safety ..Reporting of Incident/Event/Irregular Occurrence/Variance ..Safe Use of Equipment ..Security Plan ..Standard Precautions/Transmission-Based Precautions/Surgical Asepsis ..Use of Restraints/Safety Devices WHAT ARE SAFETY ISSUES WITH THE MATERNAL/NEWBORN AND WOMEN’S HEALTH CARE PATIENTS? ARE YOU PREPARED TO PROVIDE SAFE CARE? Read Tx Bon Rules on Safe Nursing Care and NPA Read the National Safety Goals by the Joint Commission Read Standards of Care by AWHONN or NANN Read Hospital Policies and Procedures Read your Textbooks Read Evidences-Based Practice Nursing Journal Articles REMEMBER Keep your Patient Alive http://www.youtube.com/watch?v=7wTPvl_QP34 Keep your Patient SAFE http://www.youtube.com/watch?v=IEGDLJinzDE&feature=fvsr Keep your Patient HAPPY http://www.youtube.com/watch?v=WIM3GHvBQjY Communication/Document correctly and in a timely manner. http://www.youtube.com/watch?v=1PENZkWqqUk http://www.youtube.com/watch?v=1ym11J8NbMg QUESTIONS YOUR TURN Can You answer the following questions? QUESTIONS 1. SBAR stands for: S ________________________________ B________________________________ A________________________________ R________________________________ SBAR S Situation Describe the situation WHAT IS GOING ON NOW B Background Deliver a concise history WHAT HAS HAPPENED A Assessment Use your best Judgment WHAT DO YOU THINK IS WRONG R Recommendations What needs to happen? WHAT WOULD YOU SUGGEST HAPPEN ? According to the Joint Commission for the Accreditation of Hospitals, what was the root cause of nearly 80% of all sentinel events between 1995 and 2005? a. Communication errors b. Inappropriate staff mix c. Insufficient orientation of new RN’s d. Leadership failure Communication errors Describe one communication tool that the RN can use to increase patient safety. http://www.youtube.com/watch?v=RwUG SYDKUxU&feature=fvwrel SAFETY DANCE http://www.youtube.com/watch?v=B64vsqn8oiY&playne xt=1&list=PL6073914211EA7949&feature=results_main
