NSE 111/ NSE111 Final Exam (New 2026/ 2027 Update) Questions and Answers | Grade A| 100% Correct (Verified Answers)

…. DLDD NSE 111/ NSE111 Final Exam (New 2026/ 2027 Update) Questions and Answers | Grade A| 100% Correct (Verified Answers) Q. what are the three specific guidelines for healthy eating? ANSWERS - nutritious foods are the foundation - processed / prepared foods should not be consumed regularly - foods skills (food literacy) is needed Q. what is the nutritional requirement for an infant 6 months? ANSWERS breastmilk & formula Q. what is the nutritional requirement for an infant 6 months? ANSWERS - introduction to solid foods - begin with pureed smoothed foods - detect & control allergic reactions Q. what is the nutritional requirement for a toddler (1-3)? ANSWERS - increased protein & calcium Q. what is the nutritional requirement for a preschooler (3-5)? ANSWERS - nutrient density more important than quantity Q. what is the nutritional requirement for a school-aged child (6-12)? ANSWERS - concerns about obesity - diets tend to be high in fat, sugar, salt & low in produce Q. what is the nutritional requirement for an adolescent? ANSWERS - need to meet metabolic demands for growth - diet influenced by many factors; onset of eating disorders Q. what is the nutritional requirement for an adult (young to middle-aged)? ANSWERS - nutrients reduced as the growth period ends - now food is required for energy, maintenance & repair - possibility of obesity Q. what is the nutritional requirement for a pregnant woman? ANSWERS - nutrition more important than weight gain - influences birth weight & chance of infant survival - omega-3 fats, folic acid, calcium important Q. what is the nutritional requirement for a woman who is lactating? ANSWERS - increased caloric intake required - should avoid caffeine, alcohol, drugs Q. what is the nutritional requirement for an older adult? ANSWERS - metabolic rate slows - calcium/vitamin D crucial (bone health) Q. what factors may influence nutritional intake? ANSWERS - food security/income - health status (therapeutic diets?) - knowledge - culture - social determinants Q. what is the purpose of a dietary history? ANSWERS to collect information about food consumption patterns & nutritional needs Q. what are the nine components of a dietary history assessment? ANSWERS - food practices - allergies - symptoms - 24 hour recall - chewing & swallowing - hunger (appetite & satiety) - elimination patterns - chemical substances - knowledge Q. How do you promote appetite in a hospitalized client? ANSWERS - normalize the setting/experience - maintaining patient comfort - eliminating unpleasant odours Q. How do you maintain patient comfort during a meal? ANSWERS - reduce distractions - keep table settings simple - allow plenty of time to eat - food temperature, preferences Q. What are two examples of alternative food patterns? ANSWERS religion, vegetarian Q. What are the ten therapeutic diets:? ANSWERS clear liquid thickened liquid full liquid pureed mechanical soft soft or low residue high fibre low cholesterol low sodium diabetic Q. What is a mechanical soft diet? ANSWERS semi-solid foods that are easily digested Q. What is a low residue/soft diet? ANSWERS low fiber, easily digested Q. What is a pureed diet? ANSWERS blended; semi-solid consistencies and liquid Q. What is a clear liquid diet? ANSWERS anything clear or see through Q. What is dysphasia? ANSWERS difficulty swallowing Q. What are some warning signs of dysphagia? ANSWERS - coughing during - eating - change in voice - abnormal movements - change in speech - delayed swallowing - pocketing of food Q. What are prevention measures for dysphagia? ANSWERS - thickeners - small amounts of food on unaffected side of mouth - observation - suction airway - don't rush feeding - inspect for food pocketing - patient sits upright 30 mins after meal Q. What are risk factors of dysphagia? ANSWERS - increased risk of aspiration, pneumonia - choking - malnutrition Q. How can you help a patient with vision deficits eat? ANSWERS - clock method - read aloud menu items - ask if they would like assistance removing packaging from items Q. What should you do before feeding a patient? ANSWERS - assess for aspiration risk - ensure assistive devices are in place - protect bedding / clothing with napkins Q. What is an incident report? ANSWERS confidential document that describes any patient accident while the person is on the premises of a health care agency Q. What is the purpose of incident reports? ANSWERS allows organization to identify trends of incidents & improve, promoting safety Q. What are the three categories of risks to client safety? ANSWERS falls, procedure-related accidents, equipment-related accidents Q. 90% of all reported incidents in hospitals are: ANSWERS falls Q. What are some risk factors for falling? ANSWERS - age - previous history - gait disturbance - balance, mobility problems - medications - etc What are some possible interventions to prevents falls? - assess & communicate patient risks - signage - nurse toilet & comfort rounds - involving patient & family - etc What are procedure-related accidents? examples? - occur during therapy - e.g. medication errors, improper application of external devices, improper performance of procedures What are some possible interventions to prevent procedure-related accidents? - signs in medication rooms - easier to read labels - correct use of safe patient handling techniques - nurses staying up to date on medications what are equipment-related accidents? malfunction, disrepair or misuse of equipment what are some interventions to prevent equipment-related accidents? - nurses should not operate equipment without training - faulty equipment should be tagged & reported what are some risks to safety for an individual? - impaired mobility - sensory or communication impairment - lack of safety awareness what are some safety risks for infants & children? they trust the environment, leading to poisoning, drowning, etc what are some safety risks for children aged 5-14? risk is reflective of others' actions (e.g. not wearing a helmet while biking due to others doing the same) what are some safety risks for adolescents? stressors from peers may result in impulsive decisions & risk taking what are some safety risks for adults? related to life style habits (e.g. smokers = risk of pulmonary diseases) what are some safety risks for older adults? - psychological changes - changes in hearing, vision, mobility, reflexes, circulation - falls what should be assessed to maintain a safe environment for clients? their health history home environment risk for falls risk for medical errors their expectations how do you maintain a safe environment for a patient? - health promotion - developmental interventions (for children) - environmental interventions - limit specific risks what are examples of environmental interventions? preventing fires, physical hazards, transmission of pathogens how can you ensure a patient's home environment is safe? walk through it with them, focussing on key areas such as the bathroom, kitchen, stairs what are examples of developmental interventions? promoting safe practices / rules for parents and child (e.g. ensuring poisons are away from the child's reach) what are passive health promotion strategies? example? implemented by public health (e.g. clean water laws) what are active health promotion strategies? example? individual is involved (e.g. wearing a seatbelt) what does WHMIS stand for? Workplace Hazardous Materials Information System what does WHMIS do? sets standards for control of hazardous substances in workplaces what are the three main elements of WHMIS? - worker education programs - cautionary labelling of products - provision of material safety data sheets what does MSDS stand for? Material Safety Data Sheet what do material safety data sheets do? provide information about a substance, its hazards, and precautions / actions to take what is a restraint? a measure used to control physical or behavioural activity of a person or part of their body what should be considered/done before using a restraint? - assessment - patient involvement - alternatives - documentation what is the least-restraint approach? all alternative interventions should be attempted before the use of restraints; it is a LAST RESORT what are some examples of alternatives to restraints? - providing companionship & supervision - offering distractions - using deescalation - etc restraint use should be done based on the needs of the _________, not the ________ patient, staff what are physical restraints? examples? - limits a patient's movement - can be attached to their body or a barrier - e.g. bed rails, wrist restraints what are the three types of restraints? physical, chemical, environmental what are chemical restraints? examples? "any form of psychoactive medication used not to treat illness but to inhibit a behaviour/movement" - e.g. sedatives, tranquilizers what are environmental restraints? example? modifications of an individual's surroundings that control their mobility - e.g. a locked unit what are the objectives of restraints? - protect from injury - protect others from injury - maintain treatment what are some potential complications of restraints? - increased risk of falls - pressure injuries - contractures - psychological impacts - etc what are the three nursing responsibilities when using restraints? - assessment should be ongoing - proper documentation - should actively involve patient, family, & healthcare team what should be assessed prior to planning client's elimination needs? - health history (usual patterns, symptoms, etc) - physical assessment (skin integrity? organ related to voiding's condition?) what factors can affect urinary elimination? - psychological - sociocultural - fluid balance - surgical procedures - pathological conditions - medications what factors can affect bowel elimination? - age-related changes - infectious disease (e.g. norovirus) - IBS or IBD - diabetes - pain - pelvic floor trauma - acute illnesses, medications what age-related changes affect bowel elimination? older persons are at a higher risk of incontinence, constipation due to changes in muscle tone & slowing of nerve impulses what is urination? other names? the process of emptying the bladder; also known as micturition, voiding what is urinary incontinence? why does it occur? "an involuntary loss of urine" due to pelvic lack of muscle strength, control of the bladder and structural damage what is urinary retention? inability to empty the bladder what are signs of urinary retention? - absence of urinary output - bladder distention - pain, discomfort what is defecation? elimination of wastes & undigested foods in the form of feces from the rectum what is bowel incontinence? involuntary passage of feces and gas from the anus what are contributing factors to bowel incontinence? - diet - fluid intake - alcohol - nicotine risks for bowel incontinence? - lack of cognitive awareness - conditions that result in frequent large loose stools what is flatulence? accumulation of gas in the intestines causing the walls to stretch, resulting in gas passing through the anus what are signs of constipation? - Infrequent bowel movements (less than 3 per week) - Hard, dry stools that are difficult to pass - abdominal pain, fullness what is diarrhea? an increase in the number of stools and the passage of liquid, unformed feces how can you measure urine output? from drainage bag or urine hats how can you measure urine input? measuring what fluids enter the body during meals or through IV abnormal urine output? - less than 30ml per hour for 2 hours - daily what are normal and abnormal urine colours? normal = range from pale straw to amber abnormal = red, orange, dark amber what are normal and abnormal urine clarity levels? normal = transparent at voiding, can become cloudy if left standing abnormal = cloudy/foamy, thick what are abnormal urine smells? sweet = diabetes or starvation ammonia = stagnant urine what are interventions to promote normal micturition? - patient education - promote regular urinary habits (i.e. try not to void too frequently) - promote complete bladder emptying - using positions or stimulating the micturition reflex what are interventions to promote normal bowel elimination? - positioning - ensuring comfort & safety - address factors that can impact defecation - ensure adequate fluid intake - promote physical activity - medications how do you collect a urine sample midstream? clean the perineal area before beginning to void, after stream has been initiated then collect sample how do you collect a stool sample? feces cannot be mixed with urine or water, should defecate into a clean dry bedpan or special container what factors can influence personal hygiene practices? - social practices/influences - personal preferences - body image - socioeconomic status - health beliefs / motivation - culture - physical condition what considerations should be assessed when planning client hygiene needs? - patients ability to perform self-care - usual hygiene practices - preferences - physical condition & abilities what are risks to oral hygiene? - mobility issues - dehydration, PTO - medications - diabetes - surgery / trauma - etc what are risks to skin related hygiene? - immobilization - reduced sensation - limited nutrition / hydration - external devices - etc what is a risk for foot hygiene? inability to bend over / see clearly what is a risk for eye care? reduced dexterity / hand coordination what is a complete bed bath? bath administered to totally dependent patient in bed what is a partial bed bath? only bathes body parts that would cause discomfort or odour if not cleaned what is a tub bath/shower? helps promote independence & raises safety concerns what is a bag bath? 10 washcloths in a bag w/ water/cleanser added - no rinsing required what is perineal care? cleansing the genitalia and rectum what are the benefits of back rubs? promotes relaxation, relieves muscle tension, stimulates circulation, improves sleep what patients may require more frequent shampooing? those who stay in bed, perspirating excessively, are undergoing treatments (blood on scalp) how often should oral hygiene be completed? 4 times a day - brushing once a day - flossing What does ADPIE stand for in the nursing process? Assessment Diagnosis Planning Implementation Evaluation what are the steps of the clinical judgement model? Recognize cues Analyze cues Prioritize hypothesis Generate solutions Take action Evaluate outcomes what does DIPPS stand for? Dignity Independence Preferences Privacy Safety what is dignity? (DIPPS) the state of feeling worthy, valued, respected what is independence? (DIPPS) encourage patients to do what they can themselves, even if they may struggle what is preferences? (DIPPS) allow patients to make choices on how they would like things done what is privacy? (DIPPS) ensure to provide privacy during care (also can refer to information) what is safety? (DIPPS) patients need to be in an environment that will keep them safe from harm what is the role of the college of nurses of ontario? - expressing/promoting standards - quality assurance - enforcing standards of practice/conduct - establishing practice requirements what are the CNO standards of practice? Accountability Continuing competence Ethics Knowledge Knowledge application Leadership Relationships what are the two types of relationships in the CNO standards? - therapeutic nurse-client - professional what is client centered care? care that focuses on the patient, who is an active participant in decisions; a partner in their own care what is personhood? being recognized and seen as a unique person what is the reassurance position? non threatening position used to pause treatment/care & diffuse situations what are the steps of verbal redirection validate & join into the persons reality, distract, redirect what is PIECES? guides assessment to identify triggers & behaviours what does PIECES stand for? - physical - intellectual - emotional - capabilities - enviornment - social and cultural what are the steps in the chain of transmission? infectious agent reservoir portal of exit modes of transmission portals of entry susceptible host what is an infectious agent? (chain of transmission) a pathogen that causes disease in the host - can be a bacteria, virus, parasite and fungus what is a reservoir? (chain of transmission) the place where the infectious agent lives, survives & grows/multiplies - can be a living organism or inanimate object what is a portal of exit? (chain of transmission) how the infectious agent leaves the reservoir / host what is a mode of transmission? (chain of transmission) how the infectious agent travels & spreads from one person to another (directly or indirectly) what are the types of modes of transmission? - contact - droplet - airborne - vehicle - vector what is contact transmission? Transfer of an infectious agent to a susceptible host through direct or indirect contact what are some contact precautions? gown and gloves what is droplet transmission? transmission via airborne droplets up to 2 meters what are some droplet precautions? mask & eye protection what is airborne transmission? small nuclei remain in the air for long periods of time and are moved by air currents over long distances (over 2 metres) what are some airborne precautions? negative pressure room, N95 respirator what is a negative pressure room? Air flow is into the room, not out what is vehicle transmission? occurs through vehicles such as water, food, etc what is vector transmission? occurs through living organisms that can transmit the infectious agent what is a portal of entry? (chain of transmission) how the pathogen enters another person's body or new host what is a susceptible host? (chain of transmission) anyone who is at risk of spreading the infectious agent how does the body protect itself from infection? inflammatory response, body systems defences, normal flora what is normal flora? microorganisms that live outside/inside the body, do not cause disease and can protect from pathogens what is the inflammatory response? response to injury/infection, an accumulation of white blood cells what does HAI stand for? hospital acquired infection what is a HAI? infection a client acquires after admission to a health care facility that is not present at time of transmission what does ARO stand for? antibiotic resistant organism what is an antimicrobial-resistant organism? occurs when bacteria, virus, fungi, etc change over time and no longer respond to medicines, making the condition difficult to treat and increasing risk of complications what is medical asepsis? measures used to reduce and prevent the spread of pathogens what are some examples of medical asepsis? hand hygiene, disposable gloves, cleaning the environment etc what is surgical asepsis? used to eliminate all microorganisms including pathogens & spores what are examples of surgical asepsis? surgery, dressing changes, etc what is another name for medical asepsis? clean technique what is another name for surgical asepsis? sterile technique what is cleaning? physical removal of foreign material including microbes using water and soap what is disinfection? elimination of all pathogens except bacteria spores how is disinfection done? UV lights, chemicals what is sterilization? destruction of ALL microorganisms INCLUDING spores how is sterilization done? moist heat (steam), chemicals, gas, boiling water what are additional precautions for contact? private room or cohort, gloves, gown what are additional precautions for airborne? private room, negative pressure airflow, N95 masks how do you break the link at the infectious agent? - clean, disinfect, sterilize the environment - treat the client how do we break the link at the reservoir? - clean, disinfect, and sterilize high touch surfaces, medical equipment, etc - use proper food handling & storage - assist client with personal hygiene - educate client about respiratory etiquette, hand hygiene, etc how do we break the link at the portal of exit? - perform hand hygiene, and follow routine practices - teach clients about respiratory etiquette - cover wounds - dispose of contaminated linens how do we break the link at the mode of transmission? - perform hand hygiene, and follow routine practices - clean, disinfect, and sterilize - ensure appropriate space between clients - educate clients how do we break the link at the portal of entry? - perform hand hygiene, follow routine practices - follow policies - teach cleanest from dirtiest how do we break the link at the susceptible host? - identify high risk individuals & protect the client's body defences from infectious - a healthy lifestyle, vaccinations what are the psychological effects of isolation precautions? - loneliness - body image altered how can we help those in isolation precautions? provide sensory stimulation what is a risk assessment? should be done before working with a client to determine what precautions need to be taken what is comfort? absence of discomfort, distress, and pain what does comfort depend on? - age - severity of illness - level of daily activities what environmental factors may prevent comfort? - noise - odours - lights what are noxious stimuli? factors outside the body that can cause stress what is high fowler's position? what is it used for? sitting upright 60-90 degrees, usually done for procedures what is semi fowlers position? what is it used for? 30-45 degrees, comfort position or for eating what is supported supine psoition? lying horizontally face up what is body alignment? relationship of one body part to another along a vertical line what is correct body alignment? positioning in a way that there is no excessive strain placed on any joints, tendons, ligaments, muscles how is body balance achieved? achieved by low center of gravity; enhanced by posture what is friction? what risk does it pose to the patient? A force that opposes motion - can cause skin & tissue damage what factors influence activity? - behaviour - environmental issues - culture / ethnic influences - family & social support what are some changes associated with immobility? - depression - behavioural changes - sleep-wake changes - changes in coping what body systems contribute to movement? skeletal, skeletal muscle, & nervous system what is activity tolerance? type and amount of exercise or work that a person is able to perform what is deconditioning? loss of functional use, specifically the musculoskeletal system what is functional decline? decrease in physical / cognitive functioning How does the CJM relate to the implementation of foundational skills? provides a basis for critical thinking for nurses when it comes to assessing patients through a step-by-step format Identify the approach to clients using Dignity, Independence, Preference, Privacy, Safety (DIPPS) acronym.*** *** examples of each D-- addressing by preferred name I-- letting client comb hair if they have ability P-- nurse asking patient meal options preferred P-- closing curtains S-- call bell in reach, objects causing tripping are removed Describe what person/client-centered care is. Patient as partner in care who actively participates (i.e. patient is the focus of care & DIPPS) Identify who the College of Nurses of Ontario (CNO) and describe their purpose. - government body for nurses -purpose-- to protect the public's interest by ensuring nurses provide quality care Examine the CNO Entry-to-Practice Competencies for Registered Nurses**. Give an example of each ** there are 9 1.Clinician-- prepping client for procedure 2.Professional 3.Communicator 4.Collaborator 5.Coordinator-- coordinating point of care health services with client & healthcare team 6.Leader 7.Advocate-- supports client's voices by speaking/ standing up for their rights 8.Educator-- clients, students, co-workers etc. 9.Scholar-- engaging in critical inquiry & application of evidence for practice What does CNO stand for? College of Nurses of Ontario What does CJM stand for? Clinical Judgement Model What is the difference between subjective and objective data? subjective-- info that's shared such as symptoms and signs objective-- info that's observed such as cuts, wounds, skin perspiration Define what a controlled act is activities that are considered harmful if performed by someone who is unqualified Define clinical deterioration worsening clinical state related to physiological decompensation What is the purpose of Maslow's Hierarchy of needs? developed to consider basic human needs & motivations of healthy individuals What are the ABC's of a primary surveys? A-- airway B-- breathing C-- circulation Define a contraindicated intervention intervention that has the potential to cause harm to the client What is the purpose of health promotions? to implement range of social/environmental interventions that enable people and communities to increase control in their health What are the 3 goals of nursing? 1. Restore 2. Maintain 3. Advance health of clients, groups and communities Describe why nursing is both a science and an art Science-- application of nursing knowledge & technical aspects Art-- establishment of caring relationship through which knowledge, skills and judgment are applied What is in the nursing process in the CJM?*** *** 5 objectives 1. Assessment 2. Analysis 3. Planning 4.Implementation 5. Evaluation **refer to diagram in slides What are the 6 steps in the CJM? Provide examples for each step. 1. Recognizing cues -- patient feels lightheaded 2. Analyze data/cues (make sense of data)-- the patient has type 1 diabetes so you may link to that 3. Prioritize Hypothesis (evaluating/ranking hypotheses according to priority)-- i.e. urgency, likelihood, risk, time etc; 4. Generate Solutions (identify the expected outcomes)-- e.g. pain relief meds for headache 5. Take Action (TREATMENT)-- may administer blood glucose test for patient with type 1 diabetes who feels lightheaded 6. Evaluated Outcomes-- observe effectiveness of intervention What are the 4 types of health assessments? Describe each. 1. Primary survey-- checking ABCs, circulation, exposure (i.e. temp, dressings, wounds) 2. Focused assessment-- assessment that is specific to a health concern 3. Head-to-toe assessment-- assesses several body systems provides overview of clients current health status 4. Complete health assessment-- involves subjective & objective assessment of all body systems What are the 5 levels of needs according to Maslow's Hierarchy of Needs?*** ***greatest to least priority 1. Physiological 2. Safety 3. Love 4. Esteem 5. Self actualization What are the 3 types of health promotion? Describe each. 1.Behavioural health promotion: focuses on lifestyle & behaviours @ individual level 2. Relational health promotion: @ relational level (i.e. relationships between people, environments & events) 3. Structural health promotion: focuses on structural aspects of health & wellbeing (i.e. addresses polices/practices that affect health at a broader community level like systemic discrimination What does it mean to be a self-regulating profession? Why? Profession that protects public's interest by setting standards of competency (CNO) in order for nurses to provide safe & competent care Nurses cannot give a __________.*** *** starts with d diagnosis When should be a primary survey be done? Start of all health assessments CJM is key to preventing _________ _______________. clinical deterioration actors influencing hygiene practices 7 Social Groups Personal preference Body image Socio/economic status Health beliefs/motivations Cultural beliefs Physical condition Risks for unmet hygiene needs Tracheostomies, drains, dressings, skin integrity, chewing and swallowing difficulties, range of motion, diminished vision, hand inflammation, reduced physical energy, language deficit, worsened ability to walk/weight bear, poor fitting shoes, so many Safety in providing hygiene (7) 1. Infection control 2. body mechanics 3. rails and bed safety 4. client ability + risks 5. water temp and product use 6. skin integrity 7. energy requirements (nurse and patient) Strategies for bathing clients with dementia or impaired cognitive skills (4) 1. distraction/negotiation 2. unpleasant noise reduction 3. quietly play client's fave music 4. prioritize which body parts need cleaning What is a complete bed bath nurse washes entire body what is a self-help bath client bathes themselves, nurse assists with washing the back what is a partial bed bath washing face, hands, armpits, perineal, and back what is a bag bath 8-10 washcloths in a bag w/ water/cleanser added. no rinsing required. what is a tub bath A body cleansing by being immersed in water sensitive areas of care (4) PEETO eyes, ears, perineal, teeth/oral area Which area do you clean first in perineal care? Meatus (the hole) Which side to dress first: unaffected or affected? DAF; dress affected side first Which side to undress first; unaffected or affected? undress unaffected side first Factors influencing hygiene practices 1. Social groups 2. personal preference 3. body image 4. socio-economic status 5. health beliefes + motivation 6. cultural beliefs 7. physical condition Risks for unmet hygiene needs tracheostomies, drains, dressings, skin integrity, chewing and swallowing difficulty, language deficits, reduced physical energy, range of motion, diminished vision, hands inflammation, decreased dexterity, worsened ability to walk/weight bear, poor fitting shoes, environment-bathing obstacles Safety in providing hygiene infection control body mechanics rails and bed safety client ability and risks energy requirements (nurse + client) water temp + product use skin integrity Strategies when cleaning people with cognitive impairment or dementia use distraction + negotiation minimize external noise or softly play patients fav music prioritize which body parts need to be bathed and which ones can wait Sensitive areas of care eyes, ears, perineal/genital area, teeth and oral area Which side to dress first, affected or unaffected DAF Dress the affected side first what to avoid (oral hygiene) lemon/glycerin swabs, sweet/spicy foods, toothpaste/mouthwash with alcohol, caffeine, tobacco, sugar, sodium lauryl sulphate, starchy carbohydrates (unless able to rinse) Positioning clients with swallowing problems Supine OR lying on their side with towel placed on pillow Position for unconscious oral care Sims, head turned towards nurse The solution used for unconscious oral hygiene care chlorhexidine What is the purpose of building a "culture of safety"? -providing safety for all A culture of safety includes addressing _________ and ________ of the institution. structure and process __________ safety is at the core when building a culture of safety. patient Who's input is included when building a culture of safety? All individuals including patients, healthcare providers, management etc. What is a patient safety incident? Provide an example. an unexpected event that could have/did result in unnecessary harm to patient e.g. patient fell or nurse administered wrong meds Describe the role of the organization in building a culture of safety identifying trends and patterns of safety incidents to improve "weak" areas What is the role of the nurse in reporting client safety incidents? nurses must report incident report What is a safety incident report? confidential report focusing on event rather than individuals involved A safety incident report is also known as.... a occurrence report What are the three categories of risks to client safety? 1. Patient/provider factors 2. Task factors 3. Technology factors What are patient/provider factors involved in risks? Give an example. Characteristics of individuals such as health, age, knowledge and experience, cultural background etc. Some patient/provider factors vary depending on the situation. Give three examples. mood, fatigue, and stress Describe task factors involved in risks to patient safety. Give an example -characteristics of the tasks health care providers perform -e.g. workflow, time pressure, and workload Describe technology factors involved in patient risks. Give examples. technologies and their quantities/qualities available E.g. 1. Quantity-- number, types, availability, and location 2. Quality-- design factors including integration with other tech., propensity to breakdown, responsiveness etc. What are risks are unique to adolescents? risk taking behaviors causing increased potential for accidents What are risks are unique to adults? lifestyle habits such as smoking, stress, being sedentary etc. What are risks are unique to older adults? physiological changes due to aging process e.g. vision, mobility etc. What are the 5 environmental risks for safety in a healthcare setting? 1. Chemicals 2. Lighting 3. Noise 4. Physical space and layout 5. Physical hazards Provide 3 examples of chemical risks in healthcare 1. Anaesthetic gases 2. Cleaning solutions 3. Disinfectants What are examples of physical hazards in healthcare? broken wheelchair or walker What are the 4 risks to patient safety? 1. Falls 2. Procedure related accidents 3. Equipment related accidents 4. Infection How do you decrease the risk of falls? Using fall risk assessment tools (e.g. Morse Falls Scale) to identify if client is high/moderate/low risk to initiate appropriate nursing interventions What is done to decrease the risk of infection? hand hygiene and PPE to reduce transmission of infection to patients Provide an example of a procedure related accident nurse administering wrong medications/dose or usage of wrong delivery system** **e.g. injecting instead of inhalation Provide an example of an equipment related accident malfunction of equipment e.g. mechanical lift or broken walker What is the purpose of WHMIS? provides standards for control of hazardous substances in workplaces What does WHMIS stand for? Workplace Hazardous Materials Information System What are the 3 main elements of WHMIS? 1. Worker education program 2. Cautionary labelling of products 3. Provision of Material Safety Data Sheets (MSDS) What do the labels on a chemical provide? labels display safety and first aid measures that need to be taken Draw the symbol for Flammable & Combustible material and provide a description.** **WHMIS product may catch fire when exposed to heat, sparks, or flame Draw the symbol for Oxidizing material and provide a description.** **WHMIS product may cause a fire or explosion if exposed to combustible material Draw the symbol for a compressed gas and provide a description.** **WHMIS product is under high pressure. may explode or burst when heated, dropped, or damaged. Draw the symbol for corrosive material and provide a description.** **WHMIS product can cause burns to eyes, skin, or respiratory system Draw the symbol for Dangerously Reactive material and provide a description.** **WHMIS product may react with light, heat, extreme temps. or vibration causing explosion, fire or release of poisonous gases. Draw the symbol for Poisonous and Infectious material (immediate & serious effects) and provide a description.** **WHMIS product may be fatal or cause serious/permanent damage if exposed to even once Draw the symbol for Poisonous and Infectious material (other toxic effects) and provide a description.** **WHMIS product may cause cancer, birth defects, or other permanent damage if exposed to repeatedly Draw the symbol for Poisonous and Infectious material (Biohazardous) and provide a description.** **WHMIS product may cause disease, serious illness, or death What is a restraint? physical, chemical, or environmental means of controlling an individual's behavior or actions Restraints should be used for a _________ period of time. short What approach is recommended with restraints? least restraint approach What does a least restraint approach entail? -restraints as the last option -least restrictive device to be used - only applied after discussion with health care team & family What are alternatives to restraints? 1. Provide companionship and supervision 2. Provide diversionary activities 3. Promote relaxation techniques & normal sleep patterns 4. Attend to needs for toileting, food, and liquid Give an example of a physical restraint bedrail, being tied down or mitten restraint etc. Give an example of an environmental restraint locked unit Give an example of a chemical restraint tranquilizers and sedatives (i.e. meds) What are the four objectives for the use of restraints? 1. Following guidelines when using/applying restraints 2. Used for a variety of reasons 3. Short period of time 4. Least-restraint approach What are the six potential complications of physical restraints? 1. Respiratory-- pneumonia 2. Skin integrity-- increased skin breakdown 3. ROM-- contractures 4. Genitourinary-- incontinence 5. Psychological-- emotional distress 6. Circulation-- impaired circulation What are the nursing responsibilities with restraints? -knowing agency policy -assessment of client -documentation -support for client/family What are the five common things noted in documentation with restraints? 1. Discussion with client, family, sub. decision-maker, healthcare team 2. Attempts at alternatives 3. Decision to restraint 4. Ongoing assessments 5. Patient response You are providing care for a correctional facility patient who is wearing handcuffs accompanied by officers. What should you do? -if handcuffs pose no interference w/care, proceed as normal. Patient is under correctional facility's custody/care -if handcuffs pose interference w/care, collaborate to create care plan