INTERNATIONAL PATIENT SAFETY GOALS (IPSG) Jincy David Nurse Educator

IPSG 1.Identify Patients Correctly. 2. Improve Effective Communication. 3. Improve the Safety of High-Alert Medications 4. Ensure Correct-Site, Correct-Procedure, Correct Patient Surgery. 5. Reduce the Risk of Health Care-Associated Infections. 6. Reduce the Risk of Patient Harm Resulting from Falls.

IPSG.1 Identify Patients Correctly Using two patient identifiers, not including patient’s room or location Name in full Kingsway Medical Record Number Before administering any medications, blood, or blood products. Before taking blood and other specimens for clinical testing. Before providing treatments and procedures.

IPSG.2 Improve Effective Communication Telephone order Verbal order Critical result reporting ISBAR

Telephone orders:- Telephone orders are received when the physician is not in the work area. Telephone orders are only accepted by nursing when immediate or urgent patient care intervention is required. Routine orders are not accepted over the telephone.

Contd… Telephone orders must not be given and/or received for the following medications Cytotoxic Agents Parenteral nutrition Narcotics/Controlled medications

How do you accept telephone Order?? Two nurses must listen and record Read back and sign Doctor to sign within 24 hours

Verbal order:- Verbal order is received when the physician is on site but busy with emergency cases such as Code blue or involved in a sterile procedure. Verbal orders are limited to emergency situations only. Narcotic/controlled medication verbal orders from the treating physician are accepted for emergency situations only.

How do you accept verbal Order?? One nurse must listen Repeat back Doctor to sign immediately after the emergency is over

Contd… All telephone order and verbal order must be signed, timed and dated by all concerned nurses and physician.

Critical Result reporting:- Call received from the Lab for critical result Document Critical result and immediately confirm the result in the HMIS Follow the escalation process if unable to contact the oncall RMO

ISBAR:- Identify – yourself and the patient Situation – what is the problem Background –information to contextualise the problem Assessment – your clinical assessment and prediction Recommendation – what you think should happen

Contd… As a nurse, ensure that efficient, effective, timely and safe communication transpires among the team members, patients and the patient’s physician. ISBAR is using in every communication process.

IPSG. 3 Improve the Safety of High-Alert Medications High alert medications (HAM) are identified by a red label indicating “High alert” word, procuring Look alike, sound alike products (LASA), Concentrated electrolytes is stored in critical areas only, in locked cabinet separated from other medication.

LASA (Look Alike Sound Alike medications) Medication names that sound similar are identified as sound alike medications and medication names in which packaging is visually similar to another medication are identified as look alike medications.

Contd… Sound alike medications are those for which generic or trade names of the medication sound similar in the spoken or written words. Thus they have a high potential for medication error.

Sound Alike... Use Tall Man lettering to emphasize differences in medications with sound-alike names. Tall Man lettering is the practice of writing part of a medicines name in upper case letters to help distinguish sound alike from one another to avoid medication errors amloDAROnamLODIPine coUMADINcoVERSYL ValAciclovirValGANciclovir

Contd… For sound alike medications where tall man lettering is not applicable brand or generic names may be added to distinguish between the medications.

Look alike… Store LASA medications separately from their LASA pair. Whenever possible, avoid storing the products in immediate proximity to one another. Use additional warning labels for look-alike medicines. Warning labels should be uniform throughout the respective facility to facilitate identification.

IPSG.4 Ensure Correct-Site, Correct- Procedure, Correct Patient Surgery Uses an instantly recognized mark for surgical-site identification and involves the patient in the marking process. Uses a checklist or other process to verify preoperatively the correct site, correct procedure, and correct patient and that all documents and equipment needed are on hand, correct, and functional.

Contd… The full surgical team conducts and documents a time-out procedure just before starting a surgical procedure. Policies and procedures are developed that support uniform process to ensure the correct site, correct procedure, and correct patient, including medical and dental procedures done in settings other than the operating theatre.

IPSG.5 Reduce the Risk of Health Care- Associated Infections (HAI) Through implementation of effective hygiene, the health care worker can prevent infection in the unit. As per WHO, The recommended guidelines of hand hygiene is Alcohol based hand rub Hand wash with soap and water

Alcohol based hand rub:-  Apply 2-3ml of alcohol hand rub.  Perform hand hygiene for seconds.  Avoid washing hands with soap and water immediately after application of alcohol based rub agent.

Hand wash with soap and water:-  Apply 3-5ml of soap.  Perform for 60 seconds friction.  Rinse hands with water, then dry hands and forearms completely with either paper towels, hand air dryers or allow them to dry naturally.  Use a paper towel to turn off the faucet if she sink water source is not foot controlled.

Five moments of hand hygiene

IPSG.6 Reduce the Risk of Patient Harm Resulting from Falls. All admitted patients are assessed as to their risk of falling on admission, transfer, following a change in condition and/or post fall using the approved Modified Morse fall risk assessment tool.

Modified Morse fall risk assessment tool ScoreSeverity 0-24No risk 25-50Moderate risk Above 50High risk