Safety

Question 1

Sentinel event

Answer 1

Unexpected occurrence/risk of:
Death or serious physical/psychological injury.

Question 2

Never events

Answer 2

Surgery on wrong person/body part.
Leaving a foreign body (scissors/gauze) inside after a surgery.
D/c infant to wrong parents.

Question 3

RCA + when to do it for falls

Answer 3

Asking many “why”s to discover where improvements can be made.

Used after a fall that causes injury/death.

Question 4

Restraint characteristics

Answer 4

Chemical or physical devices that can’t be easily removed.
Must be ordered from provider.
Must keep patient or others from harm.
NOT interfere w/physiological function (must check extremity often for skin injury or circulation).
LAST RESORT

Question 5

Restraint examples

Answer 5

Side rails.
Geriatric chairs with attached trays.
Appliances tied at wrist/ankle/waist.
Infant mummy restraint.

Question 6

Risks of restraints

Answer 6

Falls (w/injury)
Skin breakdown
Contractures (shortening/hardening of tissues)
Incontinence
Depression, delirium, anxiety
Aspiration & resp difficulties
Death (sentinel event)

Question 7

Initial & ongoing restraint documentation

Answer 7

I: date/time, type of restraint, tried alternatives & their results, notification of family and provider.

O: freq of assessment (every 1-2hrs) & findings, release intervals, interventions like offered hydration/toileting/ROM

Question 8

What is the 1st thing to assess right after a patient falls?

Answer 8

Any loss of consciousness

Question 9

Falls: some modifiable risk factors

Answer 9

Wet floor, long chords, rug, bad lighting

Question 10

Are incident reports mentioned in EHR chart?

Answer 10

Never

Question 11

What is documented with falls?

Answer 11

History of falls
Use of assissted devices/lift equipment
Modifiable risk factors
Fall risk tool
Precautions used to prevent falls
Injury?

Question 12

Fall precautions

Answer 12

Fall bundle: yellow non-skid socks, door sign, (armband/bed alarm)

Bed/chair alarms.
Fall contract.
Signs/posters.
Tools: gait belt, walker, wheelchair

Question 13

PPE & examples for contact transmission

Answer 13

Gloves
Gown

C-diff, MRSA, infected wound

Question 14

PPE & examples for droplet transmission

Answer 14

Mask

Meningitis, Influenza (anything else w/ a cough)

Question 15

PPE & examples for airborne transmission

Answer 15

N95 mask
Negative pressure room

MTV: measles, TB, varicella

Question 16

Standard precautions

Answer 16

Hand hygiene
For risk of bodily fluids: gloves, gown, face (mask and eye protection)

Question 17

When to use sterile technique?

Answer 17

Surgical procedures
Catheterizations
Dressing changes

Question 18

Individual risk factors for falls

Answer 18

Atherosclerosis (muscle weakness).
Orthostatic or regular hypotension.
Dehydration causing hypotension. Vitamin D deficiency.
Use of meds (ex hypertension meds).
Visual impairment.
Osteoporosis.
Hypovolemia.
Cormobidities.
Problems w/gait, balance, feet, strength.
Home hazards.