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Chapter 13
Promotion of Safety
© 2009 Delmar, Cengage Learning
Oxygen
• Oxygen is necessary for life
• Some diseases and conditions cause the
patient to be unable to take in enough oxygen
• Doctors will usually order additional oxygen
to be given by an oxygen delivery system
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Oxygen
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Oyxgen is:
a colorless, odorless gas
a medication prescribed by a doctor
highly flammable and feeds a fire, which can
turn a small spark into a big flame
• used by many people in healthcare facilities
and in the community
• represented by the chemical symbol of O 2.
© 2009 Delmar, Cengage Learning
Oxygen
• Types of oxygen equipment (display pictures of equipment
as each is explained
• O 2 tank - holds limited amount of O 2, gauge shows how
much is left
• Wall Outlet -O 2 is piped into each patients unit.
• O 2 concentrator - machine removes O2 from the air, power
source is needed
• Nasal Cannula - prongs are inserted into nostrils, tubing
goes over ears and under chin to keep in place.
• Simple Facemask - nose and mouth are covered. Carbon
Dioxide CO 2 escapes from small holes in the sides.
• Endotracheal tube and ventilator which supports breathing
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Types of Oxygen
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Oxygen Administration
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O2 Precautions
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O2 in use sign on patient door
No smoking sign
O2 tanks should always be in a carrier
Be mindful of oxygen extension tubing
Cotton clothing only
– Avoid static electricity
• No open flames
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Regulatory Agencies
• The Joint Commission
• OSHA- Occupational Safety and Health
Administration
• WHO- World Health Organization
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The Joint Commission (TJC)
• The Joint Commission (TJC), formerly
the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO)
• An independent, not-for-profit
organization
• Certifies more than 20,000 health care
organizations
• Certification is recognized nationwide
as a symbol of quality that reflects an
organization’s commitment to meeting
certain performance standards.
© 2009 Delmar, Cengage Learning
The Joint Commission
• Annual National Patient Safety Goals- to improve patient safety in
identified problematic areas
– Patient falls
– Patient identification
– Improve communication
– Medication safety
– Health care associated infections
– Reconcile medications
– Reduce flu and pneumococcal disease
– Surgical fires
– Pressure ulcers
– Risk assessment
– Changes in patient condition
– Universal/standard precautions
© 2009 Delmar, Cengage Learning
13:2 Preventing Accidents and Injuries
• Occupational Safety and Health
Administration (OSHA)
– Division of the Department of Labor
– Establishes and enforces safety standards
in the workplace
– Two main standards that affect health care:
• The Occupational Exposure to Hazardous Chemicals Standard
• The Bloodborne Pathogen Standard
(continues)
© 2009 Delmar, Cengage Learning
1. Occupational Exposure to
Hazardous Chemicals
• The Standard requires employers to
inform employees of all chemicals and
hazards in workplace
• All manufacturers must provide
Material Safety Data Sheet (MSDS)
with any hazardous product they sell
• Specific information has to be provided
on the MSDS
• See MSDS on page 337 on DHO
• Training for employees
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Preventing Accidents and Injuries
(continued)
• Two standards that affect health care
workers:
1. The Occupational Exposure to Hazardous
Chemicals Standard
2. The Bloodborne Pathogen Standard
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Bloodborne Pathogen Standard
• Contains mandates to protect health care
providers from diseases caused by exposure
to body fluids
• Diseases that can be contracted by exposure
to body fluids include hepatitis B, hepatitis
C, and HIV/AIDS
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Ergonomics
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Ergonomics
• Applied science to promote the safety
and well-being of a person by adapting
the environment and using techniques
to prevent injuries
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Components of Ergonomics
• Correct placement of
furniture and
equipment
• Training in muscle
movements
• Efforts to avoid
repetitive motions
• An awareness of the
environment to
prevent injuries
(continues)
© 2009 Delmar, Cengage Learning
Components of Ergonomics
(continued)
• Prevention of accident and injury
• Centers around people and the
immediate environment
• Health care worker must follow
safety regulations
• Remember, health care workers have a legal
responsibility to protect the patient from
harm and injury
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Equipment and Solutions Regulations
• Do not operate or use any
equipment until you have been
trained on how to use it
• Read and follow operating
instructions
• Report any damaged or
malfunctioning equipment
immediately
• Do not use frayed or damaged
electrical cords
(continues)
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Equipment and Solutions Regulations
(continued)
• Observe all safety rules
• Read MSDSs
• Never use solutions that are
from
unlabeled bottles
• Read labels at least three times
• Do not mix solutions together
unless instructed to do so
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Patient/Resident Safety Regulations
• Do not perform any procedures on patients
unless instructed and properly authorized
• Provide privacy for all patients
• Identify your patient
• Explain the procedure
(continues)
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Personal Safety Regulations
• Responsible to protect yourself and others
from injury
• Use correct body mechanics
• Wear the required uniform
• Walk; do not run
• Report any injury or accident
• Unsafe situations need to be reported
(continues)
© 2009 Delmar, Cengage Learning
Personal Safety Regulations
(continued)
• Keep all areas neat and clean
• Wash hands frequently
• Dry hands thoroughly before handling
electrical equipment
• Wear safety glasses when appropriate
• Observe all safety precautions
(continues)
© 2009 Delmar, Cengage Learning
Personal Safety Regulations
(continued)
• If any solution comes in
contact with skin
or eyes, flush immediately
with cool water and report
• If particle gets in eyes, report
immediately,
do not try to remove or rub
eye
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Occurrence/ Incident Reports
• Records details of an accident or unusual
event of patient, visitor or employee within
24 hours of event
• This report documents exact details of the
occurrence
• Useful when dealing with possible liability
issues in the future
• It never becomes a part of the patient medical
record
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Hospital Safety Informational Video
• Hospital Workers Safety Video
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Summary
• Health care workers are legally
responsible for familiarizing themselves
with disaster policies
• Preventing fires is everyone’s concern
• Be alert to causes of fires and take measures
to prevent them
• Know policies to follow in case of fire
© 2009 Delmar, Cengage Learning
© 2009 Delmar, Cengage Learning
Sentinel Event
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Sentinel Event
• A sentinel event is an unexpected
occurrence involving death or
serious physical or psychological
injury, or the risk thereof. Serious
injury specifically includes loss of
limb or function.
© 2009 Delmar, Cengage Learning
Top Sentinel Events Reviewed by TJC
in 2013 as compared to 2014
1.
2.
3.
4.
Unintended retention of a foreign body — 56/112
Fall — 48/91
Suicide-82
Other unanticipated event (includes unexpected additional
care/extended care, and psychological impact) — 40
5. Delay in treatment — 56/73
6. Wrong-patient, wrong-site, wrong-procedure — 60/67
7. Op/Post op complications- 52
8. Criminal Event- 47
9. Perinatal death or injury -32
10. Infection related deaths-12
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National Patient Safety Goals
• Refer to handout
• NPSG’s
• You are expected to know all 7
NPSG’s
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Groups
• In your groups–
–Research specific examples of
interventions ( at least 2) which
currently exist to help improve
patient safety as outlined by the
NPSG’s
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What is your reaction?
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Statistic
• ***It is estimated that between 44,000 and
98,000 patients die each year as a result of
medical errors in the USA
• That is the equivalent of at least 4 jet liners
crash landing every week for one year
without any survivors!!
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New Statistic
• Now comes a study in the current issue of the
Journal of Patient Safety that says the
numbers may be much higher — between
210,000 and 440,000 patients each year who
go to the hospital for care suffer some type of
preventable harm that contributes to their
death
© 2009 Delmar, Cengage Learning
Leading Causes of Death in the USA 2012
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Number of deaths for leading causes of death
Heart disease: 597,689
Cancer: 574,743
Chronic lower respiratory diseases: 138,080
Stroke (cerebrovascular diseases): 129,476
Accidents (unintentional injuries): 120,859
Alzheimer's disease: 83,494
Diabetes: 69,071
Nephritis, nephrotic syndrome, and nephrosis: 50,476
Influenza and Pneumonia: 50,097
Intentional self-harm (suicide): 38,364
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The Josie King Story
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Josie King Story
•Josie King
© 2009 Delmar, Cengage Learning
Josie King
Journal about the what happened in this real life event
•What factors contributed to Josie King’s death?
•How could this have been prevented?
•How does a break down in communication affect patient
care?
•Think about a time when you or a loved one felt worried
about the quality of care being provided. Did you feel
empowered to express your concerns? What did your
provider do (or what could he/she have done) to make you
feel more comfortable speaking up?
•In the case of Josie King, how could the hospital and its
providers have given Sorrel King more power over how
Josie was treated?
© 2009 Delmar, Cengage Learning