Chapter 13 Promotion of Safety 2009 Delmar Cengage

Chapter 13 Promotion of Safety © 2009 Delmar, Cengage Learning

Oxygen • Oxygen is necessary for life • Some diseases and conditions cause the patient to be unable to take in enough oxygen • Doctors will usually order additional oxygen to be given by an oxygen delivery system © 2009 Delmar, Cengage Learning

Oxygen • • Oyxgen is: a colorless, odorless gas a medication prescribed by a doctor highly flammable and feeds a fire, which can turn a small spark into a big flame • used by many people in healthcare facilities and in the community • represented by the chemical symbol of O 2. © 2009 Delmar, Cengage Learning

Oxygen • Types of oxygen equipment (display pictures of equipment as each is explained • O 2 tank - holds limited amount of O 2, gauge shows how much is left • Wall Outlet -O 2 is piped into each patients unit. • O 2 concentrator - machine removes O 2 from the air, power source is needed • Nasal Cannula - prongs are inserted into nostrils, tubing goes over ears and under chin to keep in place. • Simple Facemask - nose and mouth are covered. Carbon Dioxide CO 2 escapes from small holes in the sides. • Endotracheal tube and ventilator which supports breathing © 2009 Delmar, Cengage Learning

Types of Oxygen © 2009 Delmar, Cengage Learning

Oxygen Administration © 2009 Delmar, Cengage Learning

O 2 Precautions • • • O 2 in use sign on patient door No smoking sign O 2 tanks should always be in a carrier Be mindful of oxygen extension tubing Cotton clothing only – Avoid static electricity • No open flames © 2009 Delmar, Cengage Learning

Regulatory Agencies • The Joint Commission • OSHA- Occupational Safety and Health Administration • WHO- World Health Organization © 2009 Delmar, Cengage Learning

The Joint Commission (TJC) • The Joint Commission (TJC), formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) • An independent, not-for-profit organization • Certifies more than 20, 000 health care organizations • Certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. © 2009 Delmar, Cengage Learning

The Joint Commission • Annual National Patient Safety Goals- to improve patient safety in identified problematic areas – Patient falls – Patient identification – Improve communication – Medication safety – Health care associated infections – Reconcile medications – Reduce flu and pneumococcal disease – Surgical fires – Pressure ulcers – Risk assessment – Changes in patient condition – Universal/standard precautions © 2009 Delmar, Cengage Learning

13: 2 Preventing Accidents and Injuries • Occupational Safety and Health Administration (OSHA) – Division of the Department of Labor – Establishes and enforces safety standards in the workplace – Two main standards that affect health care: • The Occupational Exposure to Hazardous Chemicals Standard • The Bloodborne Pathogen Standard (continues) © 2009 Delmar, Cengage Learning

1. Occupational Exposure to Hazardous Chemicals • The Standard requires employers to inform employees of all chemicals and hazards in workplace • All manufacturers must provide Material Safety Data Sheet (MSDS) with any hazardous product they sell • Specific information has to be provided on the MSDS • See MSDS on page 337 on DHO • Training for employees © 2009 Delmar, Cengage Learning

Preventing Accidents and Injuries (continued) • Two standards that affect health care workers: 1. The Occupational Exposure to Hazardous Chemicals Standard 2. The Bloodborne Pathogen Standard © 2009 Delmar, Cengage Learning

Bloodborne Pathogen Standard • Contains mandates to protect health care providers from diseases caused by exposure to body fluids • Diseases that can be contracted by exposure to body fluids include hepatitis B, hepatitis C, and HIV/AIDS © 2009 Delmar, Cengage Learning

Ergonomics © 2009 Delmar, Cengage Learning

Ergonomics • Applied science to promote the safety and well-being of a person by adapting the environment and using techniques to prevent injuries © 2009 Delmar, Cengage Learning

Components of Ergonomics • Correct placement of furniture and equipment • Training in muscle movements • Efforts to avoid repetitive motions • An awareness of the environment to prevent injuries (continues) © 2009 Delmar, Cengage Learning

Components of Ergonomics (continued) • Prevention of accident and injury • Centers around people and the immediate environment • Health care worker must follow safety regulations • Remember, health care workers have a legal responsibility to protect the patient from harm and injury © 2009 Delmar, Cengage Learning

Equipment and Solutions Regulations • Do not operate or use any equipment until you have been trained on how to use it • Read and follow operating instructions • Report any damaged or malfunctioning equipment immediately • Do not use frayed or damaged electrical cords (continues) © 2009 Delmar, Cengage Learning

Equipment and Solutions Regulations (continued) • Observe all safety rules • Read MSDSs • Never use solutions that are from unlabeled bottles • Read labels at least three times • Do not mix solutions together unless instructed to do so © 2009 Delmar, Cengage Learning

Patient/Resident Safety Regulations • Do not perform any procedures on patients unless instructed and properly authorized • Provide privacy for all patients • Identify your patient • Explain the procedure (continues) © 2009 Delmar, Cengage Learning

Personal Safety Regulations • Responsible to protect yourself and others from injury • Use correct body mechanics • Wear the required uniform • Walk; do not run • Report any injury or accident • Unsafe situations need to be reported (continues) © 2009 Delmar, Cengage Learning

Personal Safety Regulations (continued) • Keep all areas neat and clean • Wash hands frequently • Dry hands thoroughly before handling electrical equipment • Wear safety glasses when appropriate • Observe all safety precautions (continues) © 2009 Delmar, Cengage Learning

Personal Safety Regulations (continued) • If any solution comes in contact with skin or eyes, flush immediately with cool water and report • If particle gets in eyes, report immediately, do not try to remove or rub eye © 2009 Delmar, Cengage Learning

Occurrence/ Incident Reports • Records details of an accident or unusual event of patient, visitor or employee within 24 hours of event • This report documents exact details of the occurrence • Useful when dealing with possible liability issues in the future • It never becomes a part of the patient medical record © 2009 Delmar, Cengage Learning

Hospital Safety Informational Video • Hospital Workers Safety Video © 2009 Delmar, Cengage Learning

Summary • Health care workers are legally responsible for familiarizing themselves with disaster policies • Preventing fires is everyone’s concern • Be alert to causes of fires and take measures to prevent them • Know policies to follow in case of fire © 2009 Delmar, Cengage Learning

© 2009 Delmar, Cengage Learning

Sentinel Event © 2009 Delmar, Cengage Learning

Sentinel Event • A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. © 2009 Delmar, Cengage Learning

Top Sentinel Events Reviewed by TJC in 2013 as compared to 2014 1. 2. 3. 4. Unintended retention of a foreign body — 56/112 Fall — 48/91 Suicide-82 Other unanticipated event (includes unexpected additional care/extended care, and psychological impact) — 40 5. Delay in treatment — 56/73 6. Wrong-patient, wrong-site, wrong-procedure — 60/67 7. Op/Post op complications- 52 8. Criminal Event- 47 9. Perinatal death or injury -32 10. Infection related deaths-12 © 2009 Delmar, Cengage Learning

National Patient Safety Goals • Refer to handout • NPSG’s • You are expected to know all 7 NPSG’s © 2009 Delmar, Cengage Learning

Groups • In your groups– – Research specific examples of interventions ( at least 2) which currently exist to help improve patient safety as outlined by the NPSG’s © 2009 Delmar, Cengage Learning

What is your reaction? © 2009 Delmar, Cengage Learning

Statistic • ***It is estimated that between 44, 000 and 98, 000 patients die each year as a result of medical errors in the USA • That is the equivalent of at least 4 jet liners crash landing every week for one year without any survivors!! © 2009 Delmar, Cengage Learning

New Statistic • Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210, 000 and 440, 000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death © 2009 Delmar, Cengage Learning

Leading Causes of Death in the USA 2012 • • • Number of deaths for leading causes of death Heart disease: 597, 689 Cancer: 574, 743 Chronic lower respiratory diseases: 138, 080 Stroke (cerebrovascular diseases): 129, 476 Accidents (unintentional injuries): 120, 859 Alzheimer's disease: 83, 494 Diabetes: 69, 071 Nephritis, nephrotic syndrome, and nephrosis: 50, 476 Influenza and Pneumonia: 50, 097 Intentional self-harm (suicide): 38, 364 © 2009 Delmar, Cengage Learning

The Josie King Story © 2009 Delmar, Cengage Learning

Josie King Story • Josie King © 2009 Delmar, Cengage Learning

Josie King Journal about the what happened in this real life event • What factors contributed to Josie King’s death? • How could this have been prevented? • How does a break down in communication affect patient care? • Think about a time when you or a loved one felt worried about the quality of care being provided. Did you feel empowered to express your concerns? What did your provider do (or what could he/she have done) to make you feel more comfortable speaking up? • In the case of Josie King, how could the hospital and its providers have given Sorrel King more power over how Josie was treated? © 2009 Delmar, Cengage Learning