Safety 1st
These are things we do every day to prevent Healthcare Acquired Infections (HAI)
Depending on unit:
•Hand hygiene
•Clean equipment
•Patient/Family education
•PICC / CL maintenance per policy
•Central Line checklist
•Surveillance & performance improvement activities
•Foley insertion & maintenance per policy
•Surgical prep per protocol
These three elements are required for all entries in the patient medical record.
What are signature, date, and time?
These are things we do every day to prevent Healthcare Acquired Infections (HAI)
Depending on unit:
•Hand hygiene
•Clean rooms and equipment per policy and guidelines
•Patient/Family education (HH, transmission, precautions, etc)
•PICC / CL maintenance per policy
•Central Line checklist
•Infection Surveillance & performance improvement activities
•Foley insertion & maintenance per policy
•Surgical prep per protocol
The following items must be kept locked or under constant observation at all times.
What are medications?
This must be documented both at the time of administering pain medication, AND within one after after administering pain medication.
What is pain level using pain scale appropriate for the patient.
These are the steps to follow during a fire.
What is RACE?
1. Rescue- remove patients from fire proximity
2. Alarm - pull file alarm AND dial 444 (inpatient)
3. Confine the fire- close doors
4. Extinguish the fire or Evacuate the area
This is the term used to define specimen testing done outside of the lab. May include blood glucose testing, urine pregnancy testing, or rapid strep testing.
What is Point of Care Testing or Waived Testing?
This safety precaution must be taken with pill splitters to prevent medication contamination/allergic reaction between patients.
What is label pill splitter with patient label to ensure single patient use. Dispose of any used pill splitter that is not labeled.
This is the correct procedure for labelling blood, urine, and other collected samples or specimens.
1. Confirm patient full name and DOB against wristband and patient label.
2. Collect specimen
3. Apply patient label to container immediately, while remaining with patient
4. Write your initials and date, time collected.
This category of orders should be used only during emergencies or surgeries/procedures, and should be repeated back to the provider to confirm accuracy.
What are verbal orders?
1. Doors to soiled utility rooms must be kept in THIS position to maintain required negative pressure, preventing microbes from contaminating clean areas.
2. And this is what to do if you happen to see it in the wrong position
1. What is CLOSED?
2. Close it!
This is an unexpected occurrence involving death, serious physical or psychological injury, or risk thereof.
What is Sentinel Event?
These are the:
1. Definition of critical value and
2. Required response to critical value.
1. definition: values and interpretations where delays in reporting may result in serious adverse outcomes for the patient
2. process: must be reported as soon as possible to patient provider so that timely intervention can occurr. Nursing reports to covering provider within 30 minutes. Other depts have dept specific policies and timeframes. Reporting must be documented in the patient medical record.
This is a two part question:
1. These are two examples of prohibited or Do Not Use abbreviations
2. This is the reason they are prohibited.
QD, QOD, IU, U, MS, MSO4, and MgSO4
These are prohibited because they can be misread or easily confused with similar looking abbreviations.
This system is found on the AnnaOnline home page. Provides detailed information on the chemical makeup and how to treat an exposure to each hazardous material we have on site. Cleaning solutions are a common item.
What are Safety Data Sheets? (SDS)
These are 3 requirements when caring for a patient at risk for suicide.
What are (any 3 of following?)
1. Risk assessment screening
2. Room safety checklist
3. Patient activity documented Q15m by watcher
4. Patient behavior/condition documented Q4H by RN
5. Reassessment at change of shift or change of staff
6. Others items include: assistance with hygiene, supervised toileting, safe meals, continuous observation by 1:1 or 2:1 depending on risk score
This is the required process for documenting telephone orders.
1. Telephone orders are utilized when the ordering provider is not physically present.
2. The order should be "read back" to the provider to confirm accuracy.
3. All alerts/warnings/pop up screens must be read to the provider at the time they appear on the screen during the ordering process.
This is the method of continuous study and improvement of processes with the goal of improved patient outcomes and satisfaction.
What is Process Improvement?
These are:
1. The required elements of a complete medication order and
2. The action that must be taken if any part is missing.
What is: To be considered complete, all medication orders must include:
1. name of the drug
2. dosage
3. strength
4. quantity or duration
5. route of administration
6. frequency of administration
7. indication if PRN
8. time and date or order with provider signature (automatic with CPOE)
Action if not present: Incomplete orders must be clarified with the prescribing practitioner before administration.
*NOTE- titration orders have additional required elements:
a. intent of the order. (i.e. “titrate medication to achieve blood pressure of ___/___”),
b. initial rate of infusion and
c. how often rate/dose can change
d. max & min dose/rate
e. titration increments clearly defined so staff know how frequently and how much to increase or decrease the rate or dose