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Transcript of 12 13 Sogo an&Solidarios
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Quality Standards for Health
Provider Organizations:
Safe Practice and
Environment
Presented to
Dr. Betty Polido in Partial
Fulfillment of the Requirementsin the Course
N414 F
Karel S. Sogo-an
Anelen P. Solidarios
July 10, 2012
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SAFE
PRACTICE
AND
CONTROL
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OBJECTIVES
Discuss the safety measures in the healthcare
setting.
Enumerate the employers responsibilites with
health and safety.
Explain the importance of a safe environment.Describe the factors affecting the safety in
healthcare setting.
Enumerate the key components of standards
precautions.
Discuss the nursing code of ethics.
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INTRODUCTION
Maintaining a safe environment reflects a level of
compassion and vigilance for patient welfare that
is as important as any other aspect of competent
health care. The way to improve safety is to learn
about causes of error and use this knowledge todesign systems of care to make errors less
common and less harmful when they do
occur.Most important, improving the work
environment may also improve the quality andsafety of patient care.
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A. WORKPLACE HEALTH AND SAFETY
The focus is on the prevention ofinjuries and the fair and equitable
treatment of nurses who are injured at
work or develop a work- related
illness. Nurses have the right to work
in an environment that does not
threaten their health, safety or welfare.
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a. Safe Works EnvironmentMaintaining a healthy office environment
requires attention to chemical hazards,equipment and work station design, physical
environment (temperature, humidity, light, noise,
ventilation, and space), task design,
psychological factors (personal interactions,work pace, job control) and sometimes, chemical
or other environmental exposures.
As an employer, it is your responsibility to
provide a safe work environment for allemployees, free from any hazards and complying
with all state and federal laws.
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provide employees with the information,
instruction and training they need to do their
job safely and without damaging their health consult with employees about health and
safety in the workplace
monitor the work place regularly and keep a
record of what is found during the checks.
Policies should be developed in consultation with
all employees. In some instances it may be
necessary to organise support persons orinterpreters for employees with disability so that
all employees may participate in the consultation
process.
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HEALTHYWORKENVIRONMENTS
Safety measures are in place inrelation to blood borne and body fluid
pathogens to prevent contamination ofnurses and patients by adhering to the
standard precautions.
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STANDARDPRECAUTIONS Standard precautions are meant to reduce the risk
of transmission of bloodborne and other pathogens fromboth recognized and unrecognized sources. They are the
basic level of infection control precautions which are to
be used, as a minimum, in the care of all patients.
Hand hygiene is a major component of standard
precautions and one of the most effective methods to
prevent transmission of pathogens associated with health
care. In addition to hand hygiene, the use of personal
protective equipment should be guided by risk assess-
ment and the extent of contact anticipated with blood and
body fluids, or pathogens.
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In addition to practices carried out by
health workers when providing care, all
individuals (including patients and visitors)should comply with infection control
practices in health-care settings. The
control of spread of pathogens from the
source is key to avoid trans-mission.
Among source control measures,
respiratory hygiene/cough etiquette,
developed during the severe acuterespiratory syndrome (SARS) outbreak, is
now considered as part of standard
precautions.
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Worldwide escalation of the use of
standard precautions would reduce
unnecessary risks associated withhealthcare. Promotion of an institutional
safety climate helps to improve conformity
with recommended measures and thus
subsequent risk reduction. Provision of
adequate staff and supplies, together with
leadership and education of health
workers, patients, and visitors, is criticalfor an enhanced safety climate in health-
care settings.
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KEY COMPONENTS:
1. Hand hygiene
Before and after any direct patient contact andbetween patients, whether or not gloves are
worn.
Immediately after gloves are removed.
Before handling an invasive device.
After touching blood, body fluids, secretions,
excretions, non-intact skin, and
contaminated items, even if gloves are worn.During patient care, when moving from a
contaminated to a clean body site of the patient.
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2. Gloves
Wear when touching blood, body fluids,
secretions, excretions, mucousmembranes, nonintact skin.
Change between tasks and procedures
on the same patient after contact withpotentially infectious material.
Remove after use, before touching non-
contaminated items and surfaces, andbefore going to another patient. Perform
hand hygiene immediately after removal.
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3. Facial protection (eyes, nose, and mouth)
Wear a surgical or procedure mask and eye pro-
tection (eye visor, goggles) or (a face shield toprotect mucous membranes of the eyes, nose,
and mouth during activities that are likely to
generate splashes or sprays of blood, body
fluids, secretions, and excretions.4. Gown
Wear to protect skin and prevent soiling of
clothing during activities that are likely togenerate splashes or sprays of blood, body
fluids, secretions, or excretions.
Remove soiled gown as soon as possible, and
perform hand hygiene.
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5. Prevention of needle stick and injuries
from other sharp instrumentsUse care when:
Handling needles, scalpels, and other
sharp instruments or devices.Cleaning used instruments.
Disposing of used needles and other
sharp instruments.
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6. Respiratory hygiene and cough etiquette
Persons with respiratory symptoms should apply sourcecontrol measures:
Cover their nose and mouth when coughing/sneezing with tissueor mask, dispose of used tissues and masks, and perform hand
hygiene after contact with respiratory secretions.
Health-care facilities should:
Place acute febrile respiratory symptomatic patients at least 1metre (3 feet) away from others in common waiting areas, if
possible.
Post visual alerts at the entrance to health-care facilities instructing
persons with respiratory symptoms to practise respiratory
hygiene/cough etiquette.
Consider making hand hygiene resources, tissues and masks
available in common areas and areas used for the evaluation of
patients with respiratory illnesses.
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7. Environmental cleaning
Use adequate procedures for the routine
cleaning and disinfection of environmental andother frequently touched surfaces.
8. Linens
Handle, transport, and process used linen ina manner which:
Prevents skin and mucous membrane
exposures and contamination of clothing.Avoids transfer of pathogens to other patients
and or the environment.
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9. Waste disposal
Ensure safe waste management.
Treat waste contaminated with blood, body
fluids, secretions and excretions as clinical
waste, in accordance with local
regulations.Human tissues and laboratory waste that
is directly associated with specimen
processing should also be treated asclinical waste.
Discard single use items properly.
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10. Patient care equipment
Handle equipment soiled with blood,
body fluids, secretions, and excretionsin a manner that prevents skin and
mucous membrane exposures,
contamination of clothing, and transferof pathogens to other patients or the
environment.
Clean, disinfect, and reprocess reusableequipment appropriately before use with
another patient.
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SAFE PATIENT CARE
Safe Administration of Medication The administration of medication is
often a chief responsibility of the nurse.
The practice of administering medicationinvolves providing the patient with a
substance prescribed and intended for the
diagnosis, treatment, or prevention of a
medical illness or condition.
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The central action of medication administration
involves actual and complete conveyance of a
medication to the patient. However, there is awider set of practices required to achieve safe,
effective patient outcomes and to prepare for
and evaluate the outcome of medication
administration. Preparation for medication administration
begins with the order for medication, in most
circumstances written by the physician. Nurse
practitioners and physician assistants are also
often authorized to write prescriptions. State
laws vary regarding these privileges. A record
of orders
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for medication and other treatments is kept
in the medical chart. Universally accepted
safe clinical practice guidelines and statelaws govern the components of medication
orders in order to ensure consistency and
patient safety. All orders should contain the
patient's name, the date and time when the
order is written, and the signature of the
ordering clinician. Caregivers administering
medication are responsible for checking thatthese components are present and clear.
The
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name of the medication is accompanied by
the dosage, or how much of the drug
should be given; the route of administration,
or how the medication should be given (ie,
intramuscular injection); and frequency,or how often the drug is to be given.
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ADHERENCETOTHECODEOFETHICS
NURSES AND PEOPLE
The nurses primary professional
responsibility is to people requiring nursing
care. In providing care, the nurse promotes
an environment in which the human rights,values, customs and spiritual beliefs of the
individual, family and community are
respected. The nurse ensures that theindividual receives sufficient information on
which to base consent for care and related
treatment.
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NURSES AND PRACTICE
The nurse carries personal responsibility and
accountability for nursing practice, and for maintainingcompetence by continual learning.
The nurse maintains a standard of personal health such
that the
ability to provide care is not compromised. The nurseuses judgement regarding individual competence
whenaccepting and delegating responsibility.
The nurse at all times maintains standards of personal
conduct which reflect well on the profession andenhance public confidence. The nurse, in providing
care, ensures that use of technology and scientific
advances are compatible with the safety, dignity and
rights of people.
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NURSES AND THE PROFESSION
The nurse assumes the major role in
determining and implementingacceptable standards of clinical nursing
practice, management, research and
education. The nurse is active indeveloping a core of research-based
professional knowledge. The nurse, acting
through the professional organisation,participates in creating and maintaining
safe, equitable social and economic
working conditions in nursing.
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NURSES AND CO-WORKERS
The nurse sustains a co-operative
relationship with co-workers in nursing
and other fields. The nurse takes
appropriate action to safeguardindividuals, families and communities
when their health is endangered by a co-
worker or any other person.
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SAFE WORKPLACE DESIGN
Maintaining a safe workplace is
almost but not entirely totally unlike
following OSHA regulations.
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WORKPLACESAFETYTIPS
Maintain a clean work area. Not only will you removemany hazards from a work area by keeping it clean,
but you will also provide a more productive work
environment for your employees.
Use guards and engineering solutions wherever
possible instead of relying on PPE - personal
protective equipment. PPE is hard to police and
uncomfortable to wear. Find a way to prevent the
exposure in the first place. Your workers will be much
more productive if they are comfortable
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Assume your employees want to work safely
and give them that chance. Many safety
incentive programs seemed to be based on theidea that employees want to get hurt and you
have to bribe them not to stick their hand in the
machine.
Give clear work instructions. Make sure your
employees know the right way to do what you
expect of them. Don't just give them a list ofthings not to do. Include safety instructions in
every procedure you write.
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Maintain the machinery in good working order.
Many times employees get into dangerous
situations by having to compensate for a
machine defect or wear. In the case of wear,
it may have occurred so gradually that they think
it is normal. A strong preventive maintenance
program makes for a strong safety program.
Avoid unnecessary hazards. Look for new
materials or equipment that can eliminate the
hazards your workers are exposed to.
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Maintain a clean work area. See
workplace safety tip number one above.Potential exposures to hazardous material
and conditions can be dramatically
reduced simply by keeping the work areaclean. And the benefit in employee
productivity and morale is worth the effort
even without the safety incentive.
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FACTORS AFFECTING SAFETYHealthcare Setting
The healthcare environment contains manyopportunities for safety violations and hazards.
The American Nurses Associations (ANA,2004)
provided recommendations to transform the
nursing workplace environment to enhanceclients safety and quality of care.
Generally, problems with equipment, procedural
errors and impairement of clients cause falls,
fires, and adverse medication errors. Heavy use
or misuse of equipment can lead to flaws that
result in excessive leakage of electricity.
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Healthcare facilities have developed
procedures and policies for client care and
equipment operation to minimize hazards.Teams at the hospital analyze the
environment and the factors that contribute to
a sentinel event and develop solutions to
eliminate the possibility of that safety issueoccurring again.Nursing assessment of
factors that put clients at risk for injuries
should help identify safety concerns and the
precautions necessary to minimize risks.
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LESSONS LEARNED
Safety and security are basic human needs.
Safety is a paramount concern that underlies allnursing care, and it is the responsibility of
healthcare providers. The focus on safety
encompasses all healthcare facilities as well as
the time, workplace, and community. There areuniversal safety concerns common to all age
groups as wells as unique safety
considerations for each. Once a person
recognizes danger in the environment, he or
she takes measures to avoid or to prevent
those dangers and thus practices safety.
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Prevention is a keystone characteristic of safety.
Safety practices involve self-care but alsoshould provide safety for others. Safety not only
prevents harm and injury but also allows people
to feel secure in their actions. The sense of
safety reduce stress, which promotes generalhealth. Safety allows a person to meet other
basic human needs such as love, belonging,
and self-esteem and to accomplish personal
goals. A positive outlook in ife, in turn, results inbetter mental health and more effective
functioning.
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BIBLIOGRAPHY
Books
Craven, R; Hirnle, C. (2007). Fundamentals of Nursing Human
health and Function. Factors AffectingSafety.Philadelphia: LippincottCo;p.678.
Electronic Resources
http://jobaccess.gov.au/Employers/Before_you_start/Preparin
g_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspx
http://www.cdc.gov/niosh/topics/officeenvironment/
http://www.enotes.com/administration-medication-reference/administration- medication
http://www.icn.ch/about-icn/code-of-ethics-for-nurses/
http://humanresources.about.com/od/safetyworkplacesafety/Safety_Workplace_Safety _and_Employee_Safety.htm
http://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://www.cdc.gov/niosh/topics/officeenvironment/http://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://humanresources.about.com/od/safetyworkplacesafety/Safety_Workplace_Safetyhttp://humanresources.about.com/od/safetyworkplacesafety/Safety_Workplace_Safetyhttp://humanresources.about.com/od/safetyworkplacesafety/Safety_Workplace_Safetyhttp://humanresources.about.com/od/safetyworkplacesafety/Safety_Workplace_Safetyhttp://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.icn.ch/about-icn/code-of-ethics-for-nurses/http://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.enotes.com/administration-medication-reference/administration-medicationhttp://www.cdc.gov/niosh/topics/officeenvironment/http://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspxhttp://jobaccess.gov.au/Employers/Before_you_start/Preparing_and_modifying_the_workplace/pages/How_to_provide_a_safe_wor.aspx