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Flashcards in Midterm Deck (106):
1

what is a sentinel event?

an acutal adverse event

2

what is a potential adverse event?

something that was caught before it happened

3

what is an active error?

an error caused by an individual (e.g. falls as result of PTs action)

4

what is a latent error?

an error caused by a third party (e.g. an improperly installed lift)

5

what does HIPPA stand for

Health insurance portability and accountability act

6

what is the purpose of HIPPA

set the standards to protect an individual's healthcare information

7

what does PHI stand for?

protected health information

8

guidelines for communicating with people with disabilities

position yourself at eye level, avoid leaning on assistive devices, interact with them as if they didn't have a disability

9

how many identifiers are required to confirm patient?

2

10

what is a Material Safety Data Sheets (MSDS)

a document that contains information on potential hazards (chemicals in the room, etc.)

11

how often should hand hygiene be performed?

before and after treatments

12

what are safety recommendations when moving a patient?

maintain sufficient space and perform transfers in unobstructed areas

13

what can be done to improve safety in regards to equipment?

implement a maintenance program for equipment and materials

14

what is an interprofessional collaboration?

collab between different fields (ex. collab between PT & speech)

15

what is a professional collaboration?

collab within the profession (ex. PT & PTA)

16

what does the joint commission do?

deals with organizational quality of care issues and the safety of the environment

17

what does HAI stand for?

healthcare associated infections

18

HAIs infect what percentage of patients?

1 in 20 patients

19

what is the 4th leading cause of death in the US?

Healthcare associated infections (HAI)

20

what is the correct order of the cycle of infection? (6)

1. infectious agent
2. reservoir
3. exit
4. method of transmission
5. entry
6. susceptible host

21

what is a reservoir and what are some examples?

where an infection can grow; humid, warm environments, humans, insects, animals

22

what is an exit and what are some examples?

a means to leave the host or reservoir; mouth, blood, feces, sex, sneeze, etc.

23

what is transmission and what are some examples?

how the disease is transferred from host to human; direct (touching) and indirect (airborne and sneezing)

24

what is an infection and what are some entry portals??

virus, bacterial, fungal; abrasion, cut, mouth, sexual contact, etc.

25

what is susception and what are conditions that make a person susceptible?

people liable to contact disease; immunocompromised individuals

26

what is MRSA? how many people contract it per year? how many people die as a result?

a form of staff infection; infects over 80,000 people per year and kills about 11,000 per year

27

what are ways to sterilize objects?

steam, gas, ultraviolet rays, and dry heat

28

what does PPE stand for?

personal protective equipment

29

what are standard precautions?

group of infection prevention practices that apply to ALL patients

30

what are the standard precautions?

-frequent hand washing
-use of PPE

31

what are transmission based precautions?

designed to protect caregivers from highly transmissible pathogens

32

what are contact precautions?

-patient in private room
-gloves and gown required if within 6 feet of patient

33

what are droplet precautions?

-patient in private room
-mask required if within 3 feet of patient
-gown and gloves required if skin lesions are present

34

what are airborne precautions?

-patient in private room
-negative airflow
-N-95 respirator mask

35

when is hand washing required?

when hands are visibly soiled and when working with a patient who has C.Diff

36

which is more effective, hand washing or hand rubbing?

hand rubbing, and it's quicker

37

what diseases with contact precautions require a mask?

Zika requires mask; EVD (ebola) requires face shield

38

what diseases fall under droplet precautions?

mumps (rubella), meningitidis, Strep A

39

what diseases fall under airborne precautions?

measles & tuberculosis

40

what is required for airborne plus contact precautions?

-patient in private room
-negative airflow
-N-95 respirator mask, gloves & gown

41

what diseases fall under airborne plus contact precautions?

chickenpox, smallpox, disseminated herpes

42

what are the vital signs? (5)

(1) body temperature
(2) HR
(3) BP
(4) RR
(5) Pain Level

43

when should vitals be assessed? (4)

(1) at rest prior to treatment
(2) immediately following exercise
(3) five minutes post exercise
(4) with a change in patient's status

44

general factors that affect vital signs

level of activity, temperature, age, emotional status, physiological status (medication, illness, etc)

45

what is normal range for temperature?

96.8 - 99.3
Average: 98.6

46

normal range for pulse in adults

60 - 100bmp

47

normal range for pulse in newborn

100 - 130bpm

48

normal range for pulse in child (age 1-7)

80 - 120bpm

49

what is tachycardia?

more than 100 beats per minute

50

what is bradycardia?

less than 60 beats per minute

51

normal blood oxygen saturation levels

95-100%

52

hypoxemia

below 90% O2 saturation

53

what factors decrease effectiveness of pulse-ox?

fingernail polish, artificial nails, Raynaud's syndrome, poor circulation

54

orthostatic hypotension

drop in BP from change in position
drop in systolic BP >20
drop in diastolic BP >10

55

when do you notify a doctor about patient's blood pressure?

> 160/90

56

when does a patient need immediate care?

> 180/100

57

when is occlusion point?

when inflating a BP cuff, th point at which a pulse is no longer palpable

58

normal values for breaths per minute in adults

12 to 18

59

normal values for breaths per minute in infants

30 to 50

60

visual analog scale

a line with either numbers or level of pain and have patient mark where they fall on the scale

61

numerical pain rating scale (NRPS)

have patient select an exact number off the scale. (pick 3 numbers; current pain, best pain, worst pain of past 24 hours and average)

62

faces pain scale

often used for children; patient points to face of how they feel

63

what is the single most common cause of painful soft
tissue syndromes affecting the body?

posture

64

where is the center of gravity on a human body?

around S2

65

how do you reduce torque on a person when carrying an object?

position object's center of gravity close to person's center of gravity

66

where is the vertical line of gravity for a human?

along sagittal plane, between two legs

67

what movement should be avoided when picking up an object?

simultaneous flexion & twisting

68

events that change a person's COG (4)

(1) adding ambulation aids
(2) standing on one foot
(3) reaching for an object
(4) adjusting BOS

69

what is back school?

written instructions for posture for the patient’s lifestyle

70

what is proper posture for sitting?

1. head in neutral (chin tucked)
2. knees, hips & elbows at 90 degrees
3. feet flat
4. lumbar lordosis (use lumbar roll)
5. wrists neutral

71

what life is used for smaller individuals and people with weak upper body strength?

the half-kneeling lift

72

purpose of changing positions (3)

1. prevent contracture
2. relieve pressure off skin, subcutaneous tissue, organ systems & body structures
3. prevent decreased function

73

reasons for draping (4)

1. provide modesty
2. maintain comfortable body temperature
3. provides access to required areas while protecting others
4. protects skin & clothing

74

what is the max amount of time a patient should be in one position with normal circulatory capacity?

2 hours

75

cautions for transfemoral amputation (5)

-avoid prolonged hip flexion
-avoid elevation of residual limb for more than a few minutes
-limit sitting to 40 minutes per hour
-avoid hip abduction
-maintain RL in extension

76

cautions for transtibial amputation (4)

-avoid prolonged hip ER and flexion & knee flexion
-avoid elevation of residual limb for more than a few minutes
-limit sitting to 40 minutes per hour
-maintain RL in extension

77

cautions for hemiplegia (upper & lower)

-avoid shoulder adduction, IR, elbow flexion, forearm pro- or supination, flexion & abduction of fingers
-avoid hip, knee flexion; hip ER; ankle plantarflexion & inversion

78

cautions for RA (3)

-avoid immobilization of affected joints
-protect bony prominences
-perform gentle exercises several times per day

79

cautions for burns/grafted areas (3)

-avoid prolonged positions for affected joints
-avoid positions of comfort
-perform gentle frequent exercises

80

cautions for total hip replacement (3)

-avoid hip adduction
-avoid hip IR
-avoid hip flexion over 90 degrees

81

cautions for TKR (2)

-keep knee in extension
-put hip in extension (prone or supine w/neutral hip)

82

what is minimal assistance

patient perform 75% or more of activity

83

what is moderate assistance

the patient performs 50-74& of activity

84

what is maximal assistance

the patient performs 25-49% of the activity

85

what is dependent considered?

the patient requires total physical assistance from one or more persons

86

required documentation for transfers (5)

-amount/type of assistance required
-amount of time to complete
-level of safety demonstrated
-level of consistency of performance
-equipment used

87

if hands touch the patient at all, it's considered at minimum what type of assistance?

minimal assistance

88

what is required for somebody who is modified independent?

an assistive device

89

standby assistance

patient requires verbal cues, but no touching

90

contact guard

patient requires minimal touching, such as hand on patient or gaitbelt

91

who enforces HIPPA?

Office of Civil Rights

92

who do you report HIPPA violations to?

Office of Civil Rights

93

when was HIPPA enacted?

1996

94

rights under HIPPA (4)

o Right to request privacy protection
o Right to access your own protected health information
o Right to amend medical history
o Right to request any account of when medical info was shared (ex. for research)

95

fines for violating HIPPA

-$250,000 or 10 years in prison
-$100 charge per person, per violation

96

2 bed rails up is considered what?

a constraint

97

what are 3 types of restraints?

chemical, physical, environmental

98

what does OSHA stand for?

Occupation of Safety & Health Administration

99

what organization is in place to minimize workplace violence?

OSHA

100

how frequently must restraints be renewed?

-4 hours for adults
-2 hours for children 9-17
-1 hour for children under 9

101

what is the max amount of time a patient can be restrained?

24 hours

102

what does FIM stand for?

functional independence measure

103

FIM scale numbers

7 - independent
6 - modified independent
5 - contact guard
4 - minimal assistance
3 - moderate assistance
2 - maximal assistance
1 - dependent
0 - unmovable

104

what is a transfer?

safe movement of a person from one surface, location or position to another

105

4 parameters for determining which type of transfer

-evaluate patient's physical, mental & emotional ability
-information from patient & family
-goals of treatment
-medical records

106

purpose of transfers

-prevent skin problems, weakness & contractures
-acts as stepping stone to independent living
-promotes function