JC Basics
Patient Safety
Work Place
Documentation
Potpourri
100
During the JC survey, the surveyors will talk primarily to: A. The Hospital Administrators B. The doctors, nurses and staff C. The patients D. The Houston Chronicle
B. YOU! That's why you are playing this game, right?
100
Name one of the 2015 National Safety Patient Goals
(1) Improve accuracy of patient identification (2) Improve effectiveness of communication among caregivers (3) Improve safety of using medications (4) Reduce risk of health-care associated infections (5) Use Alarms Safely - ensure alarms are heard and responded to on time (6) Identify safety risks inherent to population - suicide (7) Prevent mistakes in Surgery
100
They are responsible for operating oxygen shutoff valves in case of a fire
Who is Charge Nurse, Supervisor, or Lead Tech on duty
100
This is done immediately prior to a procedure and requires patient, physician, and staff interaction.
What is Time Out procedure?
100
What quality performance data are collected in your area and how are you involved?
IR - Reducing Delays in Procedure Start Times
200
Surveyors analyze a hospital's systems by following individual patients through their hospitalization, evaluating multiple care units, departments, and services rendered to the patient.
What is "tracer methodology"?
200
Name one way you reduce the risk of health-care associated infections in your department.
Handwashing with soap and water before and after each patient contact: Even if you used gloves wash vigorously for 15 seconds. Alcohol-based hand rubs may be used if there is no visible soiling and C. Diff is not suspected. LATHER UP!
200
This is the number you call to report concerning behavior, perceived threats or acts of hostility...
What is Extension 21111
200
This is done to medicine cups, syringes, and basins (once drawn from original container).
What is pre-procedure labeling?
200
Kevin is working in the Main Radiology Area on a hot summer day in July. It is a cooler temperature in the hallway, so Kevin uses a door stop to prop open the door to Main Radiology work area...Is this OK?
NO, NO, and NO. Doors may not be propped open. (This is a fire safety issue)
300
What is HIPPA? Name one way protected health information is kept private in your department.
No! Not Hippo HIPPA: Health Insurance Portability and Accountability ACT. States the PHI may only be used for purposes of treatment, payment, healthcare operations. (1) don't discuss patient information in the hallway or elevators, (2) keep door to exam room closed, (3) close computer screens.
300
Name, Date of Birth, and Social Security are three methods that can be used...
What is patient identifiers?
300
What common mnemonic is used when there is a fire? R - Rescue patients and others, A- Alarm, C- Contain the fire (close doors), E- Extinguish the fire when it is safe to do so, E - Evacuate
What is RACEE?
300
This is completed every day if you have refridgerated medications.
What is medication temperature Log?
300
How do you know a piece of equipment (e.g. defibrillator, ultrasound) is okay to use?
Check on the equipment for a green dated sticker that the equipment has been serviced by CES (24040).
400
What does JCAHO stand for? Hint: It's not "Julia comes and hangs out"
Joint Commission on Accreditation of Healthcare Organizations
400
UTMB collects data on these four "Core Measures"
(1) HF - Heart Failure (2) AMI - Acute Myocardial Infarction (3) SCIP = Surgical Care Improvement Project (4) PN - Pneumonia
400
Isolate the spill, notify supervisor immediately, seek medical attention (if needed); Notify Health and Saftey Services @ 21781 or operator if after hours @ "0" Obtain MSDS, stand by to advise Health Safety Services
What should you do in the event of a hazardous material spill?
400
True or false Can a minor sibling translate for a parent if the minor is 13 years old, clearly fluent in both languages and both the minor and the parent consent to using the minor as the interpreter.
So VERY, VERY False! (You must use an approved hospital translator)
400
What four cards should you have in your badge?
(1.) Mission, Vision and Values (2.) In Case of Fire (3.) Infant Abduction and Response (4.) Flu Shot Delaration Badge (During Flu Season)
500
We conduct them quarterly at the hospital and off-campus clinics
How often are fire drills conducted?
500
ICU Patient is having an MRI Brain exam and has a cardiac arrest during the exam. The nurse calls the code team to the location. The anesthesia resident trys to enter the room but is halted by the MRI Technologist...why did they stop them from entering room?
What is Zone 4? The resident had not been "screened" by MRI personnel to ensure that they could safely enter the MRI exam room. The magnet is always "ON" so there is a potiental for injury if a person enters with metal in their clothing or some indwelling metal prothesis/aneurysm clip.
500
Items must be this distance from the ceiling (or sprinkler head)
What is 18 inches?
500
This is the location where you document a patient fall, adverse reaction, or near miss incidents.
PSN - Found on UTMB Website
500
What Performance Improvement Projects are going on in your area.
In General Radiology, Dr. Garcia is evaluating extremity images for quality, postioning, and hanging protocols.
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