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L230 Concept 6

QuestionAnswer
personal commitment to error prevention includes supporting the vision of a safe place for our patients
personal commitment to error prevention includes practicing...and encouraging... low risk behaviors...your co workers to practice them too
everyone plays a critical role in healthcare safety
...the way model
inspire a shared vision
challenge the process
enable others to act
encourage the heart
...+...+...=exceptional care safety, quality, satisfaction
it is imp to frame safety with ...that make up... respect to the other elements...exceptional pt care
exceptional care from the pt's perspective includes safety, quality, patient satisfaction, efficiency
orgs that hold safety as their core value believe that safety cannot be compromised
being in the hospital is on what side of the chart unsafe side
culture is the...of the ... shared values and beliefs...individuals in the organization
culture drives how we behave
behaviors drive the outcomes
HROs are organization in...that consistently... high risk/high complexity environments...manage unexpected events in order to avoid catastrophic fialures
hros are exceptionally consistent in ...and despite... accomplishing their goals...unexpected events, the system remains stable
HROs function as a system
HROs recognize that...but the system is able to... errors/unexpected events will occur...detect the errors and correct or contain them before harm occurs
human errors is really a...and not the... symptom...cause of failure
the swiss cheese effect is a model that explains how human error results in events of harm
in most everything we do, there are...to help catch errors and prevent them, which is called checks and barriers...defense in depth
the slices of swiss cheese represent defense in depth
good defences can include technology, processes, other people
there are two ways to reduce event rate including reducing human error rate and finding/fixing the holes in the cheese
human error rate is proportional to the event rate
the majority of root causes resulting in serious safety events SSEs are associated with the process or system, not the individual
SSEs occur bec of high risk situation plus high risk behavior
ex of high risk situations new equipment, untrained staff, high workload, distractions, fatigue, multiple physicians for a single patient, look alike/sound alike drugs
ex of high risk behaviors failure to use repeat/ read-back methods proceeding in the face of uncertainty bypassing safety devices taking shortcuts acting overconfident
SSEs occur when we...and cause... deviate from generally accepted performance standards...significant patient harm
near miss safety events ...and the error is... do not reach patients...caught by a detection barrier or by chance
precursor safety event ...and results in ... reaches the pt...minimal harm or no detectable harm
serious safety events...and results in... reaches the patient...moderate harm to severe harm/death
behavior based expectations are the ...that are considred to be... manner of conducting oneself...reasonable, necessary, bound in duty or obligated
error prevention techniques are...or uses... specific actions/methods and individual completes...to accomplish or satisfy a desired behavior=based expectation
ARCC stands for ask a question, request a change, voice a concern, invoke chain of command
SBAR stands for situation, background, assessment, recommendation
STAR stands for stop, think, act, review
ARCC helps us ..in a... assert a concern...non threatening way to avoid coming on too strong
coaching involves giving 5 positives to one negative
SBAR is used to ensure clear communicataion
other prevention tools besides SBAR for clear communication include structured hand offs, 3 way repeat backs, 3 way read backs
safe handoffs are...with.. interactive..direct communications between care providers/team members
safe handoffs involve a...specificed by the... standardized process...department/servidce
safe handoffs must occur prior to a change in a care provider or servide
safe handoffs may be for an entire shift or portion of a shift
structured handoff includes the five p
five p's of structured hand off include patient/project, plan, purpose, problems, precautions
repeat back 3 steps are sender, receiver acknowledgment, and sender acknowledgement
read back is the same as repeat back except the receiver writes down the info, request, or order and reads it back
a questioning attitude is about...and using our... questioning the answers, not asking questions...critical thinking skills to make sure that our actions are the best ones for the situation
having a questioning attitude is intended to help...due to... prevent errors...a failure to use critical thinking skills
asking 1-2 clarifying questions reduces the chance of making an error by 2.5 times
types of clarifying questions include phonetic, numeric, general
phonetic is happybirthday
numeric 15, that's one five
general asking specific question
QV&V stands for qualify, validate and verify
QVV is a technique for ...into.. raw info...fact
qualifying the...means asking... source...do I trust this source
validate does it make sense to me
verify check it with an independent, expert source
QVV is a tool for...much like STAR is a tool for... questioning attitude...self checking
STAR decreases chance of error by more than 10 times
the majority of the delivery of nursing care will not be in acute care
our roles will change with settings
RNs will assume more leadership roles
APRNS will provide more and different care
IOM report helps us to seek significant improvement in public and institutional policies at all levels
IOM recommendations include to remove scope of practice barriers
IOM recommendations include expanding...and... opportunities for nurses to lead...diffuse collaborative improvement efforts
IOM recommendations are to implement nurse residency programs
IOM recommendations are to increase proportion of nurses with BSN degree to 80% by 2020
IOM recommendations include doubling the number of nurses w/ doctorate
IOM recommendations include ensuring that nurses engage in lifelong learning
IOM recommendations include preparing/enabling nurses to lead change to advance health
IOM recommendations include building an infrastructure to collect and analyze interprofessional workforce data
removing scope of practice barriers means that nurses must be able to practice to full extent of their edu and training
removing scope of practice involves...or... transformation...expanind medicare/insurers to include APRN coverage and care for the continuum
removing scope of practice includes standardizing national scope of practice regulations
expanding opportunities for nurses to lead and diffuse collaborative improvement efforts involves cms expansion, support innovation, engaging in design/development/purchase/implementation/eval of health, medical and health technology products
expanding opportunities for nurses to lead and diffuse collaborative improvement efforts includes providing... entrepreneurial professional development for program/business development-improve health and health care
ACA: comparative effectiveness research involves establishing a nonprofit pt cent
implementing nurse residency will redirect funding from diploma nurse programs to rural and critical access areas
we expect ACA to increase..and... workforce development grants...supply of health care workforce
we expect aca to create more...and more... student loan forgiveness...geriatric fellowships for faculty and students
we expect aca to strengthen primary care
we expect aca to improve access to health care services
ensure accredited nursing schools have 10% baccalaureate graduates enrolled in grad programs w/I 5 years post grad
regularly eval and update programs for evidence based, flexible, positive clinical outcomes to ensure that nurses engage in lifelong learning
Build an Infrastructure for the collection and analysis of interprofessional health care workforce data by standardizing minimum data sets across states and professions
Created by: handrzej
 

 



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