NUR 2243 Extensive Safety in Healthcare Questions and Approved Answers 2023/2024

NUR 2243 Extensive Safety in Healthcare Questions and Approved Answers 2023/2024 IOM Comprehensive approach to healthcare quality and safety improvement created a model which includes - Answer a) Domains of Quality b) External Drivers (need to be balanced The domains of quality are - Answer a) Safety/Safe care processes- freedom from accidental injury b) Practice consistent with current medical knowledge (evidence based practice) c) Customization (patient centered) 4) Issues that effect safety in healthcare: - Answer a) Misuse (most common)- avoidable complication b) Overuse c) Underuse 5) The external drivers that influence quality improvement - Answer a) Regulatory and Legislative b) Economics and other incentives 6) Definition of healthcare quality (quality and safety always go together CANNOT separate) - Answer a) Processes and outcomes that meet or exceed the needs and desires of the population 7) State of healthcare 1999 - Answer a) Medical errors 8th leading cause of death, estimated as much as 98K deaths annual An error is defined as the failure of a planned action to be completed as intended (i.e., error of execution) or the use of a wrong plan to achieve an aim (i.e., error of planning). They are a systems issue. - Answer a) Class of errors i) Diagnostic ii) Treatment iii) Preventative failure (e.g. monitoring or follow-up) iv) Other failure (e.g. equipment) b) Types of errors/Unsafe acts i) Error in execution (1) Slip-observable (wrote wrong drug) (2) Lapse- non observable (not remembering something) (3) Violation is unsafe act and deliberate although may feel justified ii) Error in Planning 1 (1) Mistake, rule based or knowledge based- planned action was wrong, e.g. lack of knowledge or assessed incorrectly iii) Active error-felt immediate, at front line, frontline operator iv) Latent error-removed from direct control, in system, *pose greatest threat- e.g. poor design instillation, management structure c) Most common medical error is medication error 9) Why do errors happen-Systems Approach – Answer a) Multiple contributing factors b) Complex systems- System-set of independent elements, both human and nonhuman, interacting to achieve a common goal c) Any element in system may belong to other systems d) System failure- due to multiple failures that occur in an unanticipated interaction create chain of events in which faults grow and evolve e) Accident- event that involves damage to defined system that disrupts ongoing or future output of that system, an unintentional incident Adverse event is an injury caused by medical management rather than the underlying condition of the patient. An adverse event attributable to error is a "preventable adverse event." - Answer a) Preventable - attributed to error b) Negligent - legal criteria c) "Near" miss events