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Module 2.0
Hospital / Patient Safety
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*Key areas of potential risk common topatients and practitioners in the hospital
*Fire Hazards
*Electrical Hazards
*Patient Movement and Ambulation
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* Fire Safety
* Fire Safety Education
* Plan
* RACE
* ABC
* PASS
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* Fire Safety
* PLAN
* Know your hospital’s fire safety plan
* Know where the fire alarm pull stations are
* Know where the fire extinguishers are
* Know the fire evacuation routes
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* Fire Safety
* R.A.C.E
* R - Rescue/Remove patients from the immediate fire scene
* A - Alert personnel by activating the nearest fire alarm pullstation
* C - Confine the fire/smoke by closing all doors in the area
* E - Evacuate/Extinguish – extinguish a small fire, evacuatefrom a large one
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* Fire Safety
* Fire Triangle
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* Fire Safety
* Classification of Fuels
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* Fire Safety
* Classification of Fuels
* Class A - Wood, paper, cloth, trash, plastics
* Class B - Flammable liquids: gasoline, oil, grease, acetone
* Class C - Electrical: energized electrical equipment
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* Fire Safety
* Types of Fire Extinguishers
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* Types of Fire Extinguishers* APW (Air Pressurized Water)
* Class A - Wood, paper, cloth, trash, plastics
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* Types of Fire Extinguishers* CO2 (Carbon Dioxide)
Class B - Flammable liquids: gasoline, oil, grease, acetone
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* Types of Fire Extinguishers* ABC (Dry Chemical Extinguisher)
* Class C - Electrical: energized electrical equipment
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* Fire Safety
* P.A.S.S.
* P – Pull the pin. Hold the extinguisher with the nozzle
pointing away from you, and release the locking mechanism
* A – Aim low. Point the extinguisher at the base of the fire
* S – Squeeze the lever slowly and evenly
* S – Sweep the nozzle from side to side
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* Fire Safety
* P.A.S.S.
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*Electrical Safety
* Because respiratory care often
involves electrical equipment,RT’s must understand the
fundamentals of electrical safety
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*Physiological Effects of Electrical Current
* Pain
* Burns
*Exhaustion
* Fainting
* Respiratory paralysis
*Damage to vital organs
* Ventricular fibrillation
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*Physiological Effects of Electrical Current
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*Electrical Shock
* Shock occurs when electrical current passes through the body
* Skin offers high resistance to electrical current, except when itis wet or bypassed by:
* Pacemakers wires
* Saline filled intravascular catheters
* Urinary catheters
* Body fluid drainage catheters
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*Hazard Created By A Broken Ground Wire
* Equipment to practitioner
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*Hazard Created By A Broken Ground Wire
* Equipment to patient
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*Hazard Created By A Broken Ground Wire
* Practitioner to patient
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*Preventing Shock Hazards
* Electrical safety training for practitioners
* Equipment used for patient care should be connected togrounded outlets with three-wire cords
* Equipment must be regularly inspected for electrical safety
* Performed by qualified electrical experts
* Dated safety inspection stickers visible
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*Preventing Shock Hazards
* Report faulty equipment, frayed wiring, or damaged receptacles
* Remove from service
* Label “Broken – Do Not Use”
* Report to supervisor
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*Healthcare industry workerssustain 4.5 times moreoverexertion injuries than anyother type of worker. (U.S.Department of Labor, Bureau ofLabor Statistics, 2000.)
*According to national statistics,six of the top 10 professions atgreatest risk for back injuryare:* nurse's aides
* licensed practical nurses
* registered nurses* health aides
* radiology technicians
* physical therapists
*Greater than 1/3 of backinjuries among health careprofessionals are attributed
to the frequency withwhich they are required tomanually move patients.
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*Patient Movement and Ambulation
* Basic Body Mechanics
* Lifting
Good posture is needed toreduce the risk of injury
Back straight, Knees bent
Poor posture may place stress onbones, muscles, and organs
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*Patient Movement and Ambulation
* Basic Body Mechanics
* Lifting
Good posture andbody mechanics asthey apply to liftingand moving apatient
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*Patient Movement and Ambulation
* Basic Body Mechanics
* Moving the Patient in Bed
Lateral movement of a bed-bound patient
Moving a patient up in be with patient assistance
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*Hippocrates (460 – 377 BC) – The father of medicine
“Do no harm”
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*A 1999 report by the Institute of Medicine, themedical branch of the National Academy of Sciences,estimated that 44,000 to 98,000 Americans die each
year because of medical errors, the equivalent of ajumbo jet filled with passengers crashing every day
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*RT’s share general responsibilities for providingsafe and effective patient care with the othermembers of the healthcare team* Administrators
* Physicians
* Nurses
* Nursing Aides
* Physical therapists
*Radiology Techs
* Medical Technologists
* Etc., Etc., Etc.
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* Founded in 1951
* An independent, not-for-profit organization,
* accredits and certifies more than 19,000 health care organizations &programs in the US
* Joint Commission accreditation and certification is recognizednationwide as a symbol of quality that reflects an organization’s
commitment to meeting certain performance standards.* organization must undergo an on-site survey by a Joint Commission
survey team at least every three years
* Mission: To continuously improve health care for the public, incollaboration with other stakeholders, by evaluating health careorganizations and inspiring them to excel in providing safe and
effective care of the highest quality and value.
* Vision Statement: All people always experience the safest, highestquality, best-value health care across all settings.
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*The Joint Commission’s National Patient
Safety Goals
*The purpose of the Joint Commission’s National
Patient Safety Goals are to promote specificimprovements in patient safety. The Goalshighlight problematic areas in health care anddescribe evidence and expert-based solutions tothese problems
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*Improve the accuracy of patient identification*Use at least two patient identifiers when providing
care, treatment, and services
*Acceptable identifiers
* Name* Medical record number
*Room number or location is not an identifier
*Procedure:
*First, identify the individual as the person for
whom the service or treatment is intended -involve the patient when possible
*Second, match the service or treatment to thatindividual
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*Improve the effectiveness of communicationamong caregivers
*Report critical results of tests and diagnosticprocedures on a timely basis
*Telephone/Verbal orders/Critical Test Results* For verbal orders, telephone orders, or reporting of
critical test results via telephone, the individualgiving the order verifies the complete order or testresult by having the person receiving theinformation record and "read-back" the completeorder or test result.
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*Improve the effectiveness ofcommunication among caregivers
*Abbreviations
*There is a standardized list of abbreviations,acronyms, symbols, and dose designations thatare NOT to be used throughout theorganization
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*Examples of Misinterpretation ofAbbreviations
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*Accurately and completely reconcile medications across thecontinuum of care
* The organization obtains and documents an accurate list of the patient’s currentmedications and known allergies in order to safely prescribe any setting-specificmedications
* Comparing the patient’s current medications with those ordered for the patientwhile under the care of the organization
* Communicating medications to the next provider
* Providing the patient with a current and reconciled list of medications upondischarge
*
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*Improve the safety of usingmedications
*Label all medications
*Label all medications, medication
containers (for example, syringes,medicine cups, basins), or othersolutions on and off the sterile field
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*Reduce the risk of Healthcare-Associated Infections(HAI)
*Comply with current World Health Organization (WHO) handhygiene guidelines or Centers for Disease Control andPrevention (CDC) hand hygiene guidelines
*HAI: Infections that patients acquire during the course of receiving treatment for other conditions or that
healthcare workers (HCWs) acquire while performingtheir duties within a healthcare setting
* HAIs account for an estimated 2 million infections, 90,000deaths, and $4.5 billion in excess health care costs annually
* The most common route for transmission of nosocomialinfection is hand contact
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*Reduce the risk of patient harm resultingfrom falls
*The organization implements a fall reductionprogram that includes an evaluation of theeffectiveness of the program
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*Encourage the active involvement ofpatients and their families in the patient'scare as a patient safety strategy
*Define and communicate the means for patients
to report concerns about safety and encouragethem to do so
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*The organization identifies safety risksinherent in its patient population
*The organization identifies risks associated withhome oxygen therapy such as home fires
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*Changes in Patient Condition
*The organization selects a suitable method thatenables health care staff members to directlyrequest additional assistance from a specially
trained individual(s) when the patient’s conditionappears to be worsening
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*Improve the effectiveness of clinical alarmsystems
* Implemented in 2004
*Preventive maintenance/testing
*Activated with appropriate settings
* Staff education
*Audible with respect to distance and competing
noises
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