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83 Cards in this Set
- Front
- Back
Safety
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the prevention of health care errors and the elimination or mitigation of patient injury caused by health care errors
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National patient safety goals
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established in 2002 to help accredited organizations address specific areas of concern in regards to patient safety
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unsafe acts
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an error or a violation committed in the presence of a potential hazard
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violations
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A deliberate deviation from an opening procedure, standard, or rules
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Errors
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failure to carry out a planned action as intended ot application of an incorrect plan
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Mistake
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An error in decision making, incorrect planning
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Lapse
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An unobservable, or mental, error of execution
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Slip
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An unobservable error of execution
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Adverse event
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unintended harm by an act of commission or omission rather than as a result of disease process
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Near miss
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error of commission or omission that could have harmed a patient, but harm did not occur as a result of chance
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Sentinel event
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unexpected occurrence involving death or serious injury
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categories of errors
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diagnostic, treatment, preventive, communication
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scope of errors
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latent, active
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concept attributes of safety
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knowledge, skills, attitudes
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swiss cheese model
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shows how errors occur when situational factors align, despite multiple layers of safeguards for the prevention of errors
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Crew resource management :6 critical components
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situational awareness, problem identification, decision making, appropriate workload distribution, time management, conflict resolution
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Just culture
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seeks to find a balance between the need to learn from mistakes and the need for disciplinary action against employees
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just culture
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a health care system's value is in reporting errors without punishment
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critical behaviors to improve safety
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follow safety protocols, speak up when you have concerns, communicate effectively, take care of yourself
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Categories of communication
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linguistics, paralinguistics, metacommunication
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Linguistics
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the verbal exchange of messages through spoken words and written symbols
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Forms of linguistics
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conversing face to face, reading newspapers, reading books, cell phone texting
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Paralinguistics
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nonverbal exchange on symbols, less recognizable but important means of transmitting messages
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forms of paralinguistics
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gestures, touch, eye contact, facial expressions
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paralinguistics
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necessary for a complete understanding of the message sent because nonverbal gestures and facial expressions provide important cues about emotions, moods, and/or psychologic states
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metacommunication
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factors that affect how messages are recieved and interpreted would include internal personal states, environmental stimuli related to the setting of the communication, and contextual variables
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metacommunication
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all of the nonverbal cues (tone of voice, body language, gestures, facial expressions
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communication
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the use of symbols to convey meanjng through an interactive process
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communication
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sender encodes message -> message transmitted -> receiver decodes and interprets message
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relationships
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develop self awarness to focus on being helpful to patients
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non therapeutic communication responses
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stereotyping, agreeing and disagreeing, being defensive, challenging, probing, testing, rejecting, changing topic, unwanted reassurance, giving common advice
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Excellent clinical skills can compensate for poor interpersonal skills?
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False, all the clinical skills in the world cannont compensate for poor interpersonal skills
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Phases of communication
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Orientation, working, termination
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orientation phase
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indentify role, introductions, identify patient needs
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working phase
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assessment, identity of plan of care, timing, environment, implementing care, teamwork, ongoing evaluation
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termination phase
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evaluation, skills obtained, avoid continuing the relationship past the clinical needs
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Most people have the innate capacity to recognize their own emotional needs, biases, and blind spots, as well as the impact of these on others
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False
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Nurse characteristics
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Professional, Authentic, and Non - judgemental
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Professional Characteristics
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avoid personal attachment, boundaries (physical, verbal, emotional )
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Authentic Characteristics
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be true to yourself
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Non - judgemental characteristics
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accepting of other cultural belief systems/values
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when does communication begin?
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When people become aware of each other's presence
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written communication
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if error is made in written statement on chart then place single, straight line through error and initial and write the correct entry below
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Electronic medical records
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disadvantage = confidentiality
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delegation
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all decisions related to delegation of nursing activities must be based upon the fundamental principle of public protection
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delegation
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licensed nurses have ultimate accountability for the management and provision of nursing care, including all delegation decisions
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delegation
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effective delegation is based on one's state nurse practice act and an understanding of the concepts of responsibility, authority, and accountability
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delegation
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the delegator is responsible for the delegation process. the delegatee is responsible for the care that the delegatee provides or the performance
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5 rights for effective delegation
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right task, right circumstance, right person, right directions, right supervision
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RN needs to know in order to effectively delegate
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the practice/organization, yourself (barriers/benefits), what needs to be done, the delegate (competency/motivation ), communication, collaboration, feedback/evaluation
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SBAR
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Situation, background, assessment, recommendation
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S =Situation
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identify yourself, unit, patient name, room number, briefly state problem, 10 seconds total
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B = Background
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admitting medications, date of admission, clinical information, vital signs, allergies, IV fluids, lab results, code status
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A = Assessment
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body system involved, how severe the problem, "might be", "could be"
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R = Recommendation
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what do you need from physician, repeat back med orders, hardest step for nurses when calling the physician
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SBAR
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preparation is the key, have all information ready when call is placed
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SBAR uses
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shift reports, transfers to different units, transfers to different institutions, provider calls
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bedside report
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communication takes 2, family and significant others can be involved with the patients consent
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email communication
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greeting closing, concise, polite tone, provide several ways to be contacted in signature, recipient's first impression of sender
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health history
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effective verbal communication essential to a successful client interview
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health history
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elicit as much data about the clients health status as possible
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health history
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open ended questions, specific information, laundry list(mundane/distasteful information), rephrasing, interfering(snooping, prying), providing information
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the most prevalent HAC is
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urinary tract infection
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which two common events has the Nursing Executive Center identified as largely nursing's responsibility
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falls and pressure ulcers
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examples of HROs in exemplar hospitals include
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intensive care units and operating rooms
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compared with errors, near misses occur
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with greater frequency
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a just culture is one in which
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staff can report mistakes without punishment
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HROs use root cause analysis (RCA) to
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analyze institutional problems
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the ultimate goal of root cause analysis is to
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prevent future harm
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preventing never events requires
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teamwork and a collaborative environment
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the exercise of power in a healthcare setting can
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lead to failure to detect errors
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never events are serious medical errors or adverse events that
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should never happen to a patient
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research has demonstrated that staffung with a higher percentage of RNs results in
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fewer adverse patient events
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the nurse is walkimg in the hall and notices that someone has spilled water on the floor. what is the most appropriate action for the nurse to take to maintain a safe environment?
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wipe up the spilled water
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the nurse is caring for a 12 year old hild following an appendectomy. what intervention could unterfere witb the quality and safety of nursing care?
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following the doctors orders no matter what
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a sentinel event refers to an event that
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harms a patient by omission or comission, not an underlying disease or condition signals the need for immediate investigation and response
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the purpose of the SBAR
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a way to provide clear, concise information concerning a patients status
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the most important information the nurse should share with the patient during the orientation phase is
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name, credentials, extent of responsibility
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a child is admitted to the pediatric unit following an automobile crash, when will the nurse begin the discharge planning process
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the day the patient is admitted
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bedside report
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keeps out negativity, helps when offgoing nurse explains tubes/drains to ongoing nurse, builds patient nurse bonding
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error of commission
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doing wrong thing, (not wearing gloves)
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error of omission
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not diing the right thing (not washing hands)
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error of execution
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doing right thing but the wrong way/incorrectly
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