Quality and Safety #1
Quality and Safety #2
Quality and Safety #3
Continuum of Care
100
True or False: It is okay to leave a foley catheter bag laying on the ground as long as there's a towel placed underneath it.
False - a foley bag should never touch the ground.
100
Describe the difference between phlebitis, infiltration, and extravasation
A. Phlebitis is inflammation of a vein; may be accompanied by pain/tenderness, erythema, edema, purulence, and/or a palpable venous cord.
B. Infiltration is an inadvertent administration of non-vesicant solution or medication into surrounding tissue.
C. Extravasation: is the inadvertent leakage or escape of a vesicant drug or solution from a vein or unintentional injection into surrounding healthy tissues.
Policy: HS-NA0426
100
True or False: Air mattresses replace manual turning and repositioning
False: you must continue to turn and reposition your patient Q2 hours even with an air mattress
100
How long do you have to document a dual skin exam on admission?
4 hours
200
True or False: Apply a brief to a bedbound patient is okay only if they're incontinent
False: Briefs should never be applied to bedbound patients
200
You receive a patient from the ED with a newly placed central line. The dressing is clean, dry, and intact, but a BioPatch is missing. Does the dressing need changed?
No. Since the dressing is CDI, do not change the dressing just to put a BioPatch on.
200
True or False: A central line placed (or accessed) at an outside hospital need the blue caps changed upon admission.
True: all outside hospital caps needs changed, even if they look like ours.
200
How often should a cardiac rhythm strip be interpreted on your monitored patient?
Admission
Once a shift
Any rhythm changes
After the patient comes back from testing*
300
True or False: All bedbound patients require a foley catheter.
False, being bed bound is not an indication for a foley catheter.
300
Your patient has a chronic foley catheter. When should a foley Cather be exchanged?
Every 30 days per policy
300
Name strategies to prevent Hospital-Acquired Pressure Injuries (HAPIs)
Q2 hour/Q1 hour turn and repositioning
floating heels
4 eyes in 4 hours
utilizing specialty mattresses
optimize nutrition
ensure skin is clean, dry, and intact
be mindful of personal and medical devices such as glasses or tubing
300
What is the bedside nurse's primary role during a rapid response?
Communication in an SBAR format to the responding teams.
400
True or False: If a patient is admitted with a Pressure Injury, and it becomes worse (ex. Stage 1 to stage IV), it is still considered a hospital-acquired pressure injury (HAPI)
True
400
When should a central line dressing be changed? Who changes them?
They should be changed Q7 days or PRN. Transfers from outside facilities with intact central line dressing do not automatically need a dressing change - use nursing judgment.
Check with your UBE on which central access devices you can change vs IV team.
400
Your patient has been on tube feeds for the past 4 days. The patient suddenly develops a tonic-clonic seizure and begins to desaturate. What is the best action regarding tube feed management?
Immediately pause the tube feeds. Flush 10cc of water into the feeding tube to prevent it from clogging.
400
What is the timeframe for calling CORE when a patient expires?
You must call CORE within 1 hour of all hospital deaths.
500
What is the Present on Admission (POA) window for C.Diff infections?
the window is hospital days 1-3. A positive c. diff sample sent to the lab after day 3 of admission is reported as an HAI, regardless of symptom onset
500
Your patient falls on your shift. What are the appropriate next steps.
Ensure the patient is okay. Ask them if they hit their head.
Notify the provider, unit leadership, and AOD
Complete a post fall form (most likely located in your unit's nurses' station)
Complete a risk master
Document a Morse Fall Assessment
500
Describe the difference between Constand Observation and Special Constant Observation for psychiatric sitters.
CO: the patient considered at risk for suicide, homicide, or self-injurious behaviors or one that may jeopardize their safety or the safety of others. Ensure the patient’s hands are always visible and the patient is always within view of the care attendant – including while patient is in bathroom or off the unit.
SCO: the patient considered to be at immediate risk for suicide, homicide, or self-injurious behaviors or one that may immediately jeopardize their safety or the safety of others. The care attendant must ensure the patient’s hands are always visible and the patient is always within arm’s reach of the care attendant – including while patient is in bathroom or off the unit.
500
You suspect your patient is experiencing an acute stroke. What is the stroke alert process here?
Call a rapid response. The responding CCM will decide whether to upgrade to a stroke alert.