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

Hospital / Patient Safety Key areas of potential risk common to patients and practitioners in the hospital Fire Hazards Electrical Hazards Patient Movement and Ambulation

Hospital / Patient Safety Fire Safety Fire Safety Education Plan RACE ABC PASS

Hospital / Patient Safety Fire Safety PLAN Know your hospital’s fire safety plan Know where the fire alarm pull stations are Know where the fire extinguishers are Know the fire evacuation routes

Hospital / Patient Safety Fire Safety R.A.C.E R - Rescue/Remove patients from the immediate fire scene A - Alert personnel by activating the nearest fire alarm pull station C - Confine the fire/smoke by closing all doors in the area E - Evacuate/Extinguish – extinguish a small fire, evacuate from a large one

Hospital / Patient Safety Fire Safety Fire Triangle

Hospital / Patient Safety Fire Safety Classification of Fuels

Hospital / Patient Safety Fire Safety Classification of Fuels Class A - Wood, paper, cloth, trash, plastics Class B - Flammable liquids: gasoline, oil, grease, acetone Class C - Electrical: energized electrical equipment

Hospital / Patient Safety Fire Safety Types of Fire Extinguishers

Hospital / Patient Safety Types of Fire Extinguishers APW (Air Pressurized Water) Class A - Wood, paper, cloth, trash, plastics

Hospital / Patient Safety Types of Fire Extinguishers CO2 (Carbon Dioxide) Class B - Flammable liquids: gasoline, oil, grease, acetone

Hospital / Patient Safety Types of Fire Extinguishers ABC (Dry Chemical Extinguisher) Class C - Electrical: energized electrical equipment

Hospital / Patient Safety Fire Safety P.A.S.S. P – Pull the pin. Hold the extinguisher with the nozzle pointing away from you, and release the locking mechanism A – Aim low. Point the extinguisher at the base of the fire S – Squeeze the lever slowly and evenly S – Sweep the nozzle from side to side

Hospital / Patient Safety Fire Safety P.A.S.S.

Hospital / Patient Safety “Is this right Professor Slocum?”

Hospital / Patient Safety Electrical Safety Because respiratory care often involves electrical equipment, RT’s must understand the fundamentals of electrical safety

Hospital / Patient Safety Physiological Effects of Electrical Current Pain Burns Exhaustion Fainting Respiratory paralysis Damage to vital organs Ventricular fibrillation

Hospital / Patient Safety Physiological Effects of Electrical Current

Hospital / Patient Safety Electrical Shock Shock occurs when electrical current passes through the body Skin offers high resistance to electrical current, except when it is wet Electrical current can easily flow into the body when skin is bypassed by: Pacemakers wires Saline filled intravascular catheters Urinary catheters Body fluid drainage catheters

Hospital / Patient Safety Hazard Created By A Broken Ground Wire Equipment to practitioner

Hospital / Patient Safety Hazard Created By A Broken Ground Wire Equipment to patient

Hospital / Patient Safety Hazard Created By A Broken Ground Wire Practitioner to patient

Hospital / Patient Safety Preventing Shock Hazards Electrical safety training for practitioners Equipment used for patient care should be connected to grounded outlets with three-wire cords Equipment must be regularly inspected for electrical safety Performed by qualified electrical experts Dated safety inspection stickers visible

Hospital / Patient Safety Preventing Shock Hazards Report faulty equipment, frayed wiring, or damaged receptacles Remove from service Label “Broken – Do Not Use” Report to supervisor

Hospital / Patient Safety Patient Movement and Ambulation Basic Body Mechanics Lifting Good posture is needed to reduce the risk of injury Poor posture may place stress on bones, muscles, and organs

Hospital / Patient Safety Patient Movement and Ambulation Basic Body Mechanics Lifting Good posture and body mechanics as they apply to lifting and moving a patient

Hospital / Patient Safety Patient Movement and Ambulation Basic Body Mechanics Moving the Patient in Bed Lateral movement of a bed-bound patient Moving a patient up in be with patient assistance

Hospital / Patient Safety Hippocrates (460 – 377 BC) – The father of medicine “Do no harm”

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

Hospital / Patient Safety RT’s share general responsibilities for providing safe and effective patient care with the other members of the healthcare team Administrators Physicians Nurses Nursing Aides Physical therapists Radiology Techs Medical Technologists Etc., Etc., Etc.

Hospital / Patient Safety The Joint Commission’s National Patient Safety Goals The purpose of the Joint Commission’s National Patient Safety Goals are to promote specific improvements in patient safety. The Goals highlight problematic areas in health care and describe evidence and expert-based solutions to these problems

Hospital / Patient Safety Improve the accuracy of patient identification Use at least two patient identifiers when providing care, treatment, and services Acceptable identifiers Name Medical record number Room number or location is not an identifier Procedure First, identify the individual as the person for whom the service or treatment is intended - involve the patient when possible Second, match the service or treatment to that individual

Hospital / Patient Safety Improve the effectiveness of communication among caregivers Report critical results of tests and diagnostic procedures on a timely basis Telephone/Verbal orders/Critical Test Results For verbal orders, telephone orders, or reporting of critical test results via telephone, the individual giving the order verifies the complete order or test result by having the person receiving the information record and "read-back" the complete order or test result.

Hospital / Patient Safety Improve the effectiveness of communication among caregivers Abbreviations There is a standardized list of abbreviations, acronyms, symbols, and dose designations that are NOT to be used throughout the organization

Hospital / Patient Safety Examples of Misinterpretation of Abbreviations

Hospital / Patient Safety Accurately and completely reconcile medications across the continuum of care The organization obtains and documents an accurate list of the patient’s current medications and known allergies in order to safely prescribe any setting-specific medications Comparing the patient’s current medications with those ordered for the patient while under the care of the organization Communicating medications to the next provider Providing the patient with a current and reconciled list of medications upon discharge

Hospital / Patient Safety Improve the safety of using medications Label all medications Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and off the sterile field

Hospital / Patient Safety Reduce the risk of Healthcare-Associated Infections (HAI) Comply with current World Health Organization (WHO) hand hygiene guidelines or Centers for Disease Control and Prevention (CDC) hand hygiene guidelines HAI; Infections that patients acquire during the course of receiving treatment for other conditions or that healthcare workers (HCWs) acquire while performing their duties within a healthcare setting HAIs account for an estimated 2 million infections, 90,000 deaths, and $4.5 billion in excess health care costs annually The most common route for transmission of nosocomial infection is hand contact

Hospital / Patient Safety Reduce the risk of patient harm resulting from falls The organization implements a fall reduction program that includes an evaluation of the effectiveness of the program

Hospital / Patient Safety Encourage the active involvement of patients and their families in the patient's care as a patient safety strategy Define and communicate the means for patients to report concerns about safety and encourage them to do so

Hospital / Patient Safety The organization identifies safety risks inherent in its patient population The organization identifies risks associated with home oxygen therapy such as home fires

Hospital / Patient Safety Changes in Patient Condition The organization selects a suitable method that enables health care staff members to directly request additional assistance from a specially trained individual(s) when the patient’s condition appears to be worsening

Hospital / Patient Safety Improve the effectiveness of clinical alarm systems Implemented in 2004 Preventive maintenance/testing Activated with appropriate settings Staff education Audible with respect to distance and competing noises