Patient Safety Final Assessment Questions and
Answers Final Exam Review
Safety (9/5)
⟶ Defines as the state of being free from harm or danger
⟶ Multiple healthcare settings have different safety concerns
⟶ Nurse must assess the patient, their equipment, and the environment and plan to maintain
safety
⟶ Perform a risk assessment
o Falls o Malnutrition o Bed sores
Risk Assessment Screening Tools
⟶ Braden Scale for Bed Sore Risk
o 0-23 o 23: Low risk o <9:
High risk
⟶ Hendrich II Fall Risk
o >5: High risk
⟶ Glasgow Coma Scale: Consciousness
o 15: Fully alert
⟶ MMSE: Cognition o 30:
Max o 27: Average o
<24: No cognition
Factors Affecting Safety
⟶ Musculoskeletal: Arthritis
⟶ Neurological & Sensory: Seizures, confusion
⟶ Cardiovascular & Respiratory: Shortness of breath, heart failure, blood pressure
⟶ Immune: Autoimmune disorders or immunocompromised patients
⟶ Integumentary: Open wounds, risk for bed sores
Risk Assessment
⟶ Unsteady gait
⟶ Medications o Pain medication o
Blood pressure medication
⟶ Blood pressure changes
⟶ Altered mental
status o
Dementia o
Confusion
⟶ Sensory impairment o Sight, smell, taste,
touch, hearing
⟶ Prolonged bed rest
pg. 1
, Leads to depression, atrophy, contractures, bed sores, respiratory impairment ⟶
Incontinence/lack of toileting schedule
⟶ Environment
o Hospital
Factors Affecting Safety
⟶ Environmental
o Workplace
▪ HAI’s
o Other
▪ Fire
▪ Pollution
▪ Radiation
▪ Terrorism
⟶ Equipment o
Call bell
o Oxygen o IV
o Monitors
o Urinary catheters o Tubes
Mechanisms for Quality & Safety Improvement
1. Mistake-proofing
2. Checklists
3. Redundancy
4. Communication
Tools for Quality & Safety Improvement
⟶ TeamSTEPPS: Strategies and Tools to Enhance Performance and Patient Safety
⟶ SBAR (Change in status)
o Situation o
Background o
Assessment
o Recommendation
⟶ IPASS the BATON (Change in shift) o
Identify self
o Patient identification o Assessment o Situation o
Safety o Background o Action o Timing o
Ownership o Next steps
⟶ Huddles (Pre-conference)
⟶ Debriefing (Post-conference or post-event)
pg. 2
,Alternative to Restraints
⟶ Education
⟶ Comfort measures ⟶
Toileting schedule
⟶ Re-orienting
⟶ Pain Relief
⟶ Relaxation techniques
⟶ Decreased sensory overload
⟶ Activity/Exercise
⟶ Sleep hygiene
⟶ One-to-one
*Restraints need to be re-ordered every 24 hours
*Non-violent restraints to have a face-to-face assessment every 24 hours and violent restraints
need to have a face-to-face assessment every 4 hours
Infection Control (9/5)
⟶ Sepsis: Infection in tissue
⟶ Septicemia: Infection in blood
⟶ Infection disease: Transmissible
Chain of Infection
⟶ Infectious agent
o Bacteria o
Fungi o
Virus o
Parasite o
Prion
⟶ Source
o Humans o Animals
o Inanimate objects
⟶ Portal of exit
o Sputum o Blood o Stool
o Emesis
⟶ Mode of transmission
o Contact o
Droplet o
Airborne
⟶ Portal of entry
o Mucous membranes o Nonintact skin o GI tract
o GU tract
o Respiratory tract
⟶ Susceptible host o
Immunocompromised patients o
Elderly patients o Chronically ill
patients o Trauma patients o
Surgical patients
Isolation Systems
pg. 3
, ⟶ Standard precautions
⟶ Transmission based precautions (negative pressure)
o Airborne (Measles, TB) o Droplet (Flu) o
Contact (MRSA, C. diff)
⟶ Protective isolation (positive pressure)
o Immunosuppressed patients
Communication: Nurse-Patient Relationship (9/12)
Types of Communication
⟶ Written
⟶ Verbal
⟶ Non-verbal
⟶ Metacommunication
Communication Relationships
⟶ Congruent
⟶ Incongruent
Communication Process
⟶ Sender
⟶ Encoding ⟶
Decoding
⟶ Receiver
⟶ Feedback
Nurse-Patient Relationship
⟶ Phases o
Orientation o
Working o
Termination
⟶ Contract setting
⟶ Advocacy
⟶ Circle of confidentiality
Definitions
⟶ Fidelity: Fulfill promises
⟶ Justice: Fairness
⟶ Nonmaleficence: Do no harm
⟶ Beneficence: Do good without self-interest
⟶ Veracity: Honesty
Techniques to Facilitate Communication/Help Patients Get Started
⟶ Open ended questions
⟶ Opening remarks
⟶ Active listening
⟶ Restatement
⟶ Reflection
pg. 4
Answers Final Exam Review
Safety (9/5)
⟶ Defines as the state of being free from harm or danger
⟶ Multiple healthcare settings have different safety concerns
⟶ Nurse must assess the patient, their equipment, and the environment and plan to maintain
safety
⟶ Perform a risk assessment
o Falls o Malnutrition o Bed sores
Risk Assessment Screening Tools
⟶ Braden Scale for Bed Sore Risk
o 0-23 o 23: Low risk o <9:
High risk
⟶ Hendrich II Fall Risk
o >5: High risk
⟶ Glasgow Coma Scale: Consciousness
o 15: Fully alert
⟶ MMSE: Cognition o 30:
Max o 27: Average o
<24: No cognition
Factors Affecting Safety
⟶ Musculoskeletal: Arthritis
⟶ Neurological & Sensory: Seizures, confusion
⟶ Cardiovascular & Respiratory: Shortness of breath, heart failure, blood pressure
⟶ Immune: Autoimmune disorders or immunocompromised patients
⟶ Integumentary: Open wounds, risk for bed sores
Risk Assessment
⟶ Unsteady gait
⟶ Medications o Pain medication o
Blood pressure medication
⟶ Blood pressure changes
⟶ Altered mental
status o
Dementia o
Confusion
⟶ Sensory impairment o Sight, smell, taste,
touch, hearing
⟶ Prolonged bed rest
pg. 1
, Leads to depression, atrophy, contractures, bed sores, respiratory impairment ⟶
Incontinence/lack of toileting schedule
⟶ Environment
o Hospital
Factors Affecting Safety
⟶ Environmental
o Workplace
▪ HAI’s
o Other
▪ Fire
▪ Pollution
▪ Radiation
▪ Terrorism
⟶ Equipment o
Call bell
o Oxygen o IV
o Monitors
o Urinary catheters o Tubes
Mechanisms for Quality & Safety Improvement
1. Mistake-proofing
2. Checklists
3. Redundancy
4. Communication
Tools for Quality & Safety Improvement
⟶ TeamSTEPPS: Strategies and Tools to Enhance Performance and Patient Safety
⟶ SBAR (Change in status)
o Situation o
Background o
Assessment
o Recommendation
⟶ IPASS the BATON (Change in shift) o
Identify self
o Patient identification o Assessment o Situation o
Safety o Background o Action o Timing o
Ownership o Next steps
⟶ Huddles (Pre-conference)
⟶ Debriefing (Post-conference or post-event)
pg. 2
,Alternative to Restraints
⟶ Education
⟶ Comfort measures ⟶
Toileting schedule
⟶ Re-orienting
⟶ Pain Relief
⟶ Relaxation techniques
⟶ Decreased sensory overload
⟶ Activity/Exercise
⟶ Sleep hygiene
⟶ One-to-one
*Restraints need to be re-ordered every 24 hours
*Non-violent restraints to have a face-to-face assessment every 24 hours and violent restraints
need to have a face-to-face assessment every 4 hours
Infection Control (9/5)
⟶ Sepsis: Infection in tissue
⟶ Septicemia: Infection in blood
⟶ Infection disease: Transmissible
Chain of Infection
⟶ Infectious agent
o Bacteria o
Fungi o
Virus o
Parasite o
Prion
⟶ Source
o Humans o Animals
o Inanimate objects
⟶ Portal of exit
o Sputum o Blood o Stool
o Emesis
⟶ Mode of transmission
o Contact o
Droplet o
Airborne
⟶ Portal of entry
o Mucous membranes o Nonintact skin o GI tract
o GU tract
o Respiratory tract
⟶ Susceptible host o
Immunocompromised patients o
Elderly patients o Chronically ill
patients o Trauma patients o
Surgical patients
Isolation Systems
pg. 3
, ⟶ Standard precautions
⟶ Transmission based precautions (negative pressure)
o Airborne (Measles, TB) o Droplet (Flu) o
Contact (MRSA, C. diff)
⟶ Protective isolation (positive pressure)
o Immunosuppressed patients
Communication: Nurse-Patient Relationship (9/12)
Types of Communication
⟶ Written
⟶ Verbal
⟶ Non-verbal
⟶ Metacommunication
Communication Relationships
⟶ Congruent
⟶ Incongruent
Communication Process
⟶ Sender
⟶ Encoding ⟶
Decoding
⟶ Receiver
⟶ Feedback
Nurse-Patient Relationship
⟶ Phases o
Orientation o
Working o
Termination
⟶ Contract setting
⟶ Advocacy
⟶ Circle of confidentiality
Definitions
⟶ Fidelity: Fulfill promises
⟶ Justice: Fairness
⟶ Nonmaleficence: Do no harm
⟶ Beneficence: Do good without self-interest
⟶ Veracity: Honesty
Techniques to Facilitate Communication/Help Patients Get Started
⟶ Open ended questions
⟶ Opening remarks
⟶ Active listening
⟶ Restatement
⟶ Reflection
pg. 4
