RET 1024 Introduction to Respiratory Therapy Module 2.0 Hospital / Patient Safety.

RET 1024RET 1024Introduction to Respiratory Introduction to Respiratory TherapyTherapy

Module 2.0Module 2.0

Hospital / Patient SafetyHospital / Patient Safety

Hospital / Patient SafetyHospital / Patient Safety

Key areas of potential risk common to patients and Key areas of potential risk common to patients and practitioners in the hospitalpractitioners in the hospital

Fire HazardsFire Hazards

Electrical HazardsElectrical Hazards

Patient Movement and AmbulationPatient Movement and Ambulation

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety Fire Safety EducationFire Safety Education

PlanPlan

RACERACE

ABCABC

PASSPASS

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety PLANPLAN

Know your hospital’s fire safety planKnow your hospital’s fire safety plan

Know where the fire alarm pull stations areKnow where the fire alarm pull stations are

Know where the fire extinguishers areKnow where the fire extinguishers are

Know the fire evacuation routesKnow the fire evacuation routes

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety R.A.C.ER.A.C.E

RR - - Rescue/Remove patients from the immediate Rescue/Remove patients from the immediate fire scenefire scene

AA - - Alert personnel by activating the nearest fire Alert personnel by activating the nearest fire alarm pull stationalarm pull station

CC - - Confine the fire/smoke by closing all doors in Confine the fire/smoke by closing all doors in the areathe area

EE - - Evacuate/Extinguish – extinguish a small fire, Evacuate/Extinguish – extinguish a small fire, evacuate from a large oneevacuate from a large one

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety Fire Triangle Fire Triangle

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety Classification of FuelsClassification of Fuels

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety Classification of FuelsClassification of Fuels

Class A Class A - Wood, paper, cloth, trash, plastics- Wood, paper, cloth, trash, plastics

Class BClass B - Flammable liquids: gasoline, oil, - Flammable liquids: gasoline, oil, grease, acetone grease, acetone

Class CClass C - Electrical: energized electrical - Electrical: energized electrical equipmentequipment

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety Types of Fire ExtinguishersTypes of Fire Extinguishers

Hospital / Patient SafetyHospital / Patient Safety

Types of Fire ExtinguishersTypes of Fire Extinguishers APWAPW (Air Pressurized Water) (Air Pressurized Water)

Class A - Wood, paper, cloth, trash, plasticsClass A - Wood, paper, cloth, trash, plastics

Hospital / Patient SafetyHospital / Patient Safety

Types of Fire ExtinguishersTypes of Fire Extinguishers CO2CO2 (Carbon Dioxide) (Carbon Dioxide)

Class B - Flammable liquids: gasoline, oil, grease, Class B - Flammable liquids: gasoline, oil, grease, acetone acetone

Hospital / Patient SafetyHospital / Patient Safety

Types of Fire ExtinguishersTypes of Fire Extinguishers ABC ABC (Dry Chemical Extinguisher)(Dry Chemical Extinguisher)

Class C - Electrical: energized electrical equipmentClass C - Electrical: energized electrical equipment

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety P.A.S.S.P.A.S.S.

PP – – Pull the pin. Hold the extinguisher with the Pull the pin. Hold the extinguisher with the nozzle pointing away from you, and release the nozzle pointing away from you, and release the locking mechanismlocking mechanism

AA – – Aim low. Point the extinguisher at the base of Aim low. Point the extinguisher at the base of the firethe fire

SS – – Squeeze the lever slowly and evenlySqueeze the lever slowly and evenly

SS – – Sweep the nozzle from side to sideSweep the nozzle from side to side

Hospital / Patient SafetyHospital / Patient Safety

Fire SafetyFire Safety P.A.S.S.P.A.S.S.

Hospital / Patient SafetyHospital / Patient Safety

““Is this right Professor Slocum?”Is this right Professor Slocum?”

Hospital / Patient SafetyHospital / Patient Safety

Electrical SafetyElectrical Safety

Because respiratory Because respiratory care often involves care often involves electrical equipment, electrical equipment, RT’s must understand RT’s must understand the fundamentals of the fundamentals of electrical safetyelectrical safety

Hospital / Patient SafetyHospital / Patient Safety

Physiological Effects of Electrical CurrentPhysiological Effects of Electrical Current PainPain BurnsBurns ExhaustionExhaustion FaintingFainting Respiratory paralysisRespiratory paralysis Damage to vital organsDamage to vital organs Ventricular fibrillationVentricular fibrillation

Hospital / Patient SafetyHospital / Patient Safety

Physiological Effects of Electrical CurrentPhysiological Effects of Electrical Current

Hospital / Patient SafetyHospital / Patient Safety

Electrical ShockElectrical Shock Shock occurs when electrical current passes Shock occurs when electrical current passes

through the bodythrough the body Skin offers high resistance to electrical current, Skin offers high resistance to electrical current,

except when it is wetexcept when it is wet Electrical current can easily flow into the body Electrical current can easily flow into the body

when skin is bypassed by:when skin is bypassed by: Pacemakers wiresPacemakers wires Saline filled intravascular cathetersSaline filled intravascular catheters Urinary cathetersUrinary catheters Body fluid drainage cathetersBody fluid drainage catheters

Hospital / Patient SafetyHospital / Patient Safety

Hazard Created By A Broken Ground WireHazard Created By A Broken Ground Wire Equipment to practitionerEquipment to practitioner

Hospital / Patient SafetyHospital / Patient Safety

Hazard Created By A Broken Ground WireHazard Created By A Broken Ground Wire Equipment to patientEquipment to patient

Hospital / Patient SafetyHospital / Patient Safety

Hazard Created By A Broken Ground WireHazard Created By A Broken Ground Wire Practitioner to patientPractitioner to patient

Hospital / Patient SafetyHospital / Patient Safety

Preventing Shock HazardsPreventing Shock Hazards Electrical safety training for practitionersElectrical safety training for practitioners Equipment used for patient care should be Equipment used for patient care should be

connected to grounded outlets with three-wire connected to grounded outlets with three-wire cordscords

Equipment must be regularly inspected for Equipment must be regularly inspected for electrical safetyelectrical safety

Performed by qualified electrical expertsPerformed by qualified electrical experts Dated safety inspection stickers visibleDated safety inspection stickers visible

Hospital / Patient SafetyHospital / Patient Safety

Preventing Shock HazardsPreventing Shock Hazards Report faulty equipment, frayed wiring, or Report faulty equipment, frayed wiring, or

damaged receptacles damaged receptacles Remove from serviceRemove from service Label “Broken – Do Not Use”Label “Broken – Do Not Use” Report to supervisorReport to supervisor

Hospital / Patient SafetyHospital / Patient Safety

Patient Movement and AmbulationPatient Movement and Ambulation Basic Body MechanicsBasic Body Mechanics

LiftingLifting

Good posture is needed to reduce the risk of injury

Poor posture may place stress on bones, muscles, and organs

Hospital / Patient SafetyHospital / Patient Safety

Patient Movement and AmbulationPatient Movement and Ambulation Basic Body MechanicsBasic Body Mechanics

LiftingLifting

Good posture and body mechanics as they apply to lifting and moving a patient

Hospital / Patient SafetyHospital / Patient Safety

Patient Movement and AmbulationPatient Movement and Ambulation Basic Body MechanicsBasic Body Mechanics

Moving the Patient in BedMoving the Patient in Bed

Lateral movement of a bed-bound patient

Moving a patient up in be with patient assistance

Hospital / Patient SafetyHospital / Patient Safety

Hippocrates (460 – 377 BC) – The father of medicineHippocrates (460 – 377 BC) – The father of medicine

““Do no harmDo no harm””

Hospital / Patient SafetyHospital / Patient Safety

A 1999 report by the Institute of Medicine, the A 1999 report by the Institute of Medicine, the medical branch of the National Academy of Sciences, medical branch of the National Academy of Sciences, estimated that 44,000 to 98,000 Americans die each estimated that 44,000 to 98,000 Americans die each year because of medical errors, the equivalent of a year because of medical errors, the equivalent of a jumbo jet filled with passengers crashing every dayjumbo jet filled with passengers crashing every day

Hospital / Patient SafetyHospital / Patient Safety

RT’s share general responsibilities for providing safe RT’s share general responsibilities for providing safe and effective patient care with the other members of and effective patient care with the other members of the healthcare teamthe healthcare team AdministratorsAdministrators PhysiciansPhysicians NursesNurses Nursing AidesNursing Aides Physical therapistsPhysical therapists Radiology TechsRadiology Techs Medical TechnologistsMedical Technologists Etc., Etc., Etc.Etc., Etc., Etc.

Hospital / Patient SafetyHospital / Patient Safety

The Joint Commission’s National Patient Safety GoalsThe Joint Commission’s National Patient Safety Goals The purpose of the Joint Commission’s National Patient Safety The purpose of the Joint Commission’s National Patient Safety

Goals are to promote specific improvements in patient safety. Goals are to promote specific improvements in patient safety. The Goals highlight problematic areas in health care and The Goals highlight problematic areas in health care and describe evidence and expert-based solutions to these describe evidence and expert-based solutions to these problems problems

Hospital / Patient SafetyHospital / Patient Safety

Improve the accuracy of patient identificationImprove the accuracy of patient identification Use at least Use at least two patient identifiers two patient identifiers when providing when providing

care, treatment, and servicescare, treatment, and services Acceptable identifiersAcceptable identifiers

NameName Medical record numberMedical record number

Room number or location is not an identifierRoom number or location is not an identifier ProcedureProcedure

First, identify the individual as the person for whom First, identify the individual as the person for whom the service or treatment is intended - involve the the service or treatment is intended - involve the patient when possiblepatient when possible

Second, match the service or treatment to that Second, match the service or treatment to that individualindividual

Hospital / Patient SafetyHospital / Patient Safety

Improve the effectiveness of communication among Improve the effectiveness of communication among

caregiverscaregivers

Report critical results of tests and diagnostic procedures Report critical results of tests and diagnostic procedures on a timely basison a timely basis

Telephone/Verbal orders/Critical Test ResultsTelephone/Verbal orders/Critical Test Results For verbal orders, telephone orders, or reporting of critical test For verbal orders, telephone orders, or reporting of critical test

results via telephone, the individual giving the order verifies the results via telephone, the individual giving the order verifies the complete order or test result by having the person receiving the complete order or test result by having the person receiving the information record and "read-back" the complete order or test information record and "read-back" the complete order or test result.result.

Hospital / Patient SafetyHospital / Patient Safety

Improve the effectiveness of communication among Improve the effectiveness of communication among

caregiverscaregivers AbbreviationsAbbreviations

There is a standardized list of abbreviations, acronyms, There is a standardized list of abbreviations, acronyms, symbols, and dose designations that are symbols, and dose designations that are NOTNOT to be used to be used throughout the organizationthroughout the organization

Hospital / Patient SafetyHospital / Patient Safety

Examples of Misinterpretation of AbbreviationsExamples of Misinterpretation of Abbreviations

Hospital / Patient SafetyHospital / Patient Safety

Accurately and completely reconcile medications across the Accurately and completely reconcile medications across the continuum of carecontinuum of care

The organization obtains and documents an accurate list of the patient’s The organization obtains and documents an accurate list of the patient’s current medications and known allergies in order to safely prescribe any current medications and known allergies in order to safely prescribe any setting-specific medicationssetting-specific medications

Comparing the patient’s current medications with those ordered for the Comparing the patient’s current medications with those ordered for the patient while under the care of the organizationpatient while under the care of the organization

Communicating medications to the next providerCommunicating medications to the next provider

Providing the patient with a current and reconciled list of medications upon Providing the patient with a current and reconciled list of medications upon dischargedischarge

Hospital / Patient SafetyHospital / Patient Safety

Improve the safety of using medicationsImprove the safety of using medications Label all medications Label all medications

Label all medications, medication containers (for example, Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and syringes, medicine cups, basins), or other solutions on and off the sterile fieldoff the sterile field

Hospital / Patient SafetyHospital / Patient Safety

Reduce the risk of Reduce the risk of Healthcare-Associated Infections (HAI)Healthcare-Associated Infections (HAI) Comply with current World Health Organization (WHO) hand Comply with current World Health Organization (WHO) hand

hygiene guidelines or Centers for Disease Control and Prevention hygiene guidelines or Centers for Disease Control and Prevention (CDC) hand hygiene guidelines(CDC) hand hygiene guidelines

HAI;HAI; Infections that Infections that patientspatients acquire during the course of receiving acquire during the course of receiving treatment for other conditions or that treatment for other conditions or that healthcare workershealthcare workers (HCWs) (HCWs) acquire while performing their duties within a healthcare setting acquire while performing their duties within a healthcare setting HAIs account for an estimated 2 million infections, 90,000 deaths, HAIs account for an estimated 2 million infections, 90,000 deaths,

and $4.5 billion in excess health care costs annually and $4.5 billion in excess health care costs annually

The most common route for transmission of The most common route for transmission of nosocomial nosocomial infection infection is is hand contacthand contact

Reduce the risk of patient harm resulting from falls Reduce the risk of patient harm resulting from falls The organization implements a fall reduction program that The organization implements a fall reduction program that

includes an evaluation of the effectiveness of the programincludes an evaluation of the effectiveness of the program

Hospital / Patient SafetyHospital / Patient Safety

Hospital / Patient SafetyHospital / Patient Safety

Encourage the active involvement of patients and their Encourage the active involvement of patients and their families in the patient's care as a patient safety strategyfamilies in the patient's care as a patient safety strategy Define and communicate the means for patients to report Define and communicate the means for patients to report

concerns about safety and encourage them to do soconcerns about safety and encourage them to do so

Hospital / Patient SafetyHospital / Patient Safety

The organization identifies safety risks inherent in its The organization identifies safety risks inherent in its patient populationpatient population The organization identifies risks associated with home oxygen The organization identifies risks associated with home oxygen

therapy such as home firestherapy such as home fires

Hospital / Patient SafetyHospital / Patient Safety

Changes in Patient ConditionChanges in Patient Condition The organization selects a suitable method that enables health The organization selects a suitable method that enables health

care staff members to directly request additional assistance care staff members to directly request additional assistance from a specially trained individual(s) when the patient’s from a specially trained individual(s) when the patient’s condition appears to be worseningcondition appears to be worsening

Hospital / Patient SafetyHospital / Patient Safety

Improve the effectiveness of clinical alarm systemsImprove the effectiveness of clinical alarm systems Implemented in 2004Implemented in 2004 Preventive maintenance/testingPreventive maintenance/testing Activated with appropriate settingsActivated with appropriate settings

Staff educationStaff education

Audible with respect to distance and competing noisesAudible with respect to distance and competing noises