Health CORE

1
Health CORE

• Safety in Health Care

2
Environmental Safety

• Identify and correct potential hazards that can
  cause accidents, injuries, or errors
• Promote Organization culture of safety (JCAHO
  2006 goal)

3
Prevention

• Appropriate dress
• Safe movement
• Protection for self and others
• Awareness of possible safety hazards
• Report accidents ASAP
• Do not perform procedure if not qualified
• Know how to use equipment

4
Safety with Movement

• Do not run
• Stay to the right of hallways
• Open doors slowly
• Use handrails
• Look for hallway mirrors

5
Dressing Safely

• Wear hair tied back out of work area
• No hoop earrings
• No necklaces
• Limit rings
• Low heeled shoes
• Short fingernails

6
Protecting Everyone

• Use Standard Precautions
• Wipe up spills immediately
• Dispose of sharps in proper container immediately
• Be aware of possible safety hazards

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Safety Hazards

• Faulty equipment
• Spills on floor
• Hospital bed in high position
• Bed rails
• Water temperature
• Broken glass
• Area rugs
• Swivel chair

• Frayed cords
• Restraints
• Improper shoes
• Poor brakes on bed/wheelchair
• Loose wheels
• Poor lighting
• Clutter
• And...

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Always Report Accidents
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IOM Report

• 2000 To Err is Human
• Suggested 98,000 patients die every year from all
  types of medical errors
• Led to legislation to decrease number of medical
  errors

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Medical Errors

• Failure of a planned action to be completed as
  intended or the use of a wrong plan to achieve an
  aim.
• Medical errors can occur at any time during the
  treatment of a patient
• Can occur during preventative care
• Not all errors cause harm to patients

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Sentinel Event

• According to Joint Commission on Accreditation of
  Health Care Organization (JCAHCO) , sentinel
  event is defined as an event that resulted in an
  unanticipated death or major permanent loss of
  function, not related to the natural course of
  the patients illness.
• Sentinel must be analyzed to determine the cause
  and how it can be prevented in the future

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Sentinel event also includes the following even
if death or major permanent loss of function does
not occur

• Suicide in a facility
• Infant abduction or discharge to wrong family
• Rape
• Blood transfusion given with blood that is
  incompatible
• Surgery on wrong patient or wrong body part

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Root Cause Analysis

• Systematic analysis to determine what caused the
  problem and how to fix it
• Can be done before a sentinel event occurs
• Determines how the system can be improved to
  decrease the chance of reoccurrence

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Florida Law definition of adverse incident

• An event over which healthcare personnel could
  exercise control and which is associated in whole
  or in part with medical intervention rather than
  the condition for which such intervention
  occurred, and which also satisfies one of the
  following requirements

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• The performance of a surgical procedure on
• the wrong patient
• a wrong surgical procedure
• a wrong-site surgical procedure
• a surgical procedure otherwise unrelated to the
  patients diagnosis or medical condition

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• 2. Required the surgical repair of damage
  resulting to a patient from a planned surgical
  procedure, where the damage was not a recognized
  specific risk, as disclosed to the patient and
  documented through informed-consent process.

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• 3. Was a procedure to remove unplanned foreign
  objects remaining from a surgical procedure which
  results in one of the following injuries
• death
• brain or spinal damage
• permanent disfigurement
• fracture or dislocation of bones or joints

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• 4. A resulting limitation of neurological,
  physical, or sensory function which continues
  after discharge from the facility, any condition
  that required specialized medical attention or
  surgical intervention resulting from nonemergency
  medical intervention, other than an emergency
  medical condition, to which the patient has not
  given his or her informed consent

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• 5. Any condition that required the transfer of
  the patient, within or outside the facility, to a
  unit providing a more acute level of care due to
  the adverse incident, rather than the patients
  condition prior to the adverse incident
• Florida Statutes section 395.017 (2001)
• MUST be reported immediately

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Where do Medical Errors Occur?

• Hospital
• Clinic
• Nursing home
• Doctors office
• Pharmacy
• Patient home

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What would be possible medical errors in your
health occupation?

• Medicine errors
• Surgical errors
• Diagnostic errors
• Equipment errors
• Lab errors
• Procedural errors?

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Medical Error Examples

• Regular diet given to diabetic pt
• Wrong medicine given to pt
• Not washing hands and spread of MRSA
• Elderly patient falling due to nurse not telling
  next shift about his unsteadiness and need for
  assist with ambulation
• Injury due to safety hazards

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Incident Report

• An incident report must be completed if a medical
  error occurs
• Know the procedure in your facility for reporting
  medical errors

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Prevention of Medical Errors

• Pay attention!
• Follow procedure for giving medications (6
  rights)
• Accurate documentation
• Communicate
• Involve the patient, they are responsible, too

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Patients Need to Know

• Patient should ask questions and get
  clarification if they do not understand
• Patient should keep a current list of all
  medications including OTC
• Patient should be familiar with medications and
  possible side effects
• Patients should get results of any test or
  procedure

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Patients Need to Know

• Patient should talk with doctor and research
  which facility has the best care for their
  specific needs
• Patient has the right to choose where he/she
  wants to receive care
• Patient should find out about surgical procedures
  to be performed, what, how long, postop,
  recovery, etc.

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Patients with Special Needs

• Elderly
• Infant/child
• Adolescence
• Disabled

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Identifying Your Patient

• Always check patients ID band
• Call patient by name
• Caution with patients with same name

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Reporting Safety Hazards

• If a safety hazard is identified report ASAP
• If equipment is broken, label it and inform the
  proper person or department
• If an accident occurs report ASAP
• If you are unsure whether to report it, do it!

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Be Responsible

• Know your scope of practice
• Get help if you do not understand
• Do not assume anything
• Keep good habits to decrease chance of errors
• Be on the lookout for safety hazards!
• Inform supervisor of ways you think will decrease
  errors

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Patient Safety

• Always check patient identification band
• Address patient by name
• Prevent falls
• leave bed in lowest position
• check for obstacles
• provide adequate lighting
• proper shoes
• know patients abilities before transfers

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Patient Safety

• Prevent Nosocomial Infections
• Intervene for patients at risk for skin breakdown