1. Dr. Rashida Abdelfattah FACULTY OF NURSING SCIENCES University of Khartoum

2. Definition –Patient safety is a collaborative goal that requires concentrated efforts from the patient and all members of the health care team

3. Nursing and Safety Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (ANA, 2003)Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (ANA, 2003)

4. patient safety goals Eliminate transfusion errors related to patient misidentificationEliminate transfusion errors related to patient misidentification Improve the effectiveness of communication among caregiversImprove the effectiveness of communication among caregivers Improve the safety of using medicationsImprove the safety of using medications

5. patient safety goals continue Reduce the risk of health care- associated infectionsReduce the risk of health care- associated infections Reduce the risk of patient harm resulting from fallsReduce the risk of patient harm resulting from falls Prevent health care-associated pressure ulcersPrevent health care-associated pressure ulcers Identification of safety risks inherent in its patient populationIdentification of safety risks inherent in its patient population

6. Identify risks associated with hospital and home oxygen therapy such as home firesIdentify risks associated with hospital and home oxygen therapy such as home fires

7. Critical Thinking factors influence patient safety factors influence patient safety  nurse’s factors Knowledge base Knowledge base Attention Attention Barriers to care (like workplace obstacles) Barriers to care (like workplace obstacles) Missing essential information Missing essential information Behaviors not encouraging of productive thought Behaviors not encouraging of productive thought Ebright et al. (2005) Ebright et al. (2005)

8. factors influence patient safety continue factors influence patient safety continue  Complexity of nurse work  Complexity of nurse work Variety of supply locationsVariety of supply locations Locating supplies when not found in designated areas or not adequately stockedLocating supplies when not found in designated areas or not adequately stocked Repetitive travel (to patient’s rooms, nurse’s stations, supply locations, etc.)Repetitive travel (to patient’s rooms, nurse’s stations, supply locations, etc.) Unexpected situations, interruptions and distractionsUnexpected situations, interruptions and distractions

9.  Complexity of nurse work continue Pauses to wait for system services (computers or medication carts)Pauses to wait for system services (computers or medication carts) Inadequate resource access for further care and new proceduresInadequate resource access for further care and new procedures MiscommunicationMiscommunication Errors due to handwriting and labelingErrors due to handwriting and labeling

10. Errors can involve: MedicinesMedicines SurgerySurgery DiagnosisDiagnosis EquipmentEquipment Lab reportsLab reports

11.  Patient factors and safety Identified during Nursing AssessmentsIdentified during Nursing Assessments  Mobility (risk for pressure ulcers,pneumonia)  Level of awareness ( in ability to communicate)  Critical condition (closed monitoring)  Mental state (need individualized care)

12. Patient Safety Indicators  Hospital-level Patient Safety Indicators –Complications of anesthesia –Death in low mortality –Decubitus ulcer –Failure to rescue or resuscitate pt. –Foreign body left in during procedure

13. Patient Safety Indicators continue –Selected infections due to medical care –Postoperative hemorrhage or hematoma –Postoperative physiologic and metabolic mismangements –Postoperative respiratory failure –Postoperative pulmonary embolism or deep vein thrombosis

14. Patient Safety Indicators continue –Postoperative sepsis –Accidental puncture and laceration –Transfusion reaction –Birth trauma -- injury to neonate –Obstetric trauma -- vaginal delivery with instrument

15. Patient Safety Indicators continue –Obstetric trauma -- vaginal delivery without instrument –Obstetric trauma -- cesarean delivery

16. Tips to Help Prevent Medical Errors –Tips for Hospitals  Setting  Policies, protocol, guidelines –Tips for the staff

17. Tips for Hospitals tips for hospital

18. Patient Safety Tips for Hospitals –Prevent central line-associated blood stream infections –Prevent venous thromboembolism –Educate patients about using blood thinners safely –Limit shift durations for medical residents and other hospital staff if possible

19. Patient Safety Tips for Hospitals –Consider working with a Patient Safety Organization –Use good hospital design principles –Measure your hospital's patient safety culture –Build better teams and rapid response systems

20. Tip for nursing staff –Ethical consideration  Hold dignity ( age,sex, religion and ethnicity)  Autonomy (allow patient decisions about care)  Informed consent (care, research, etc)  End of life ( needs different direction from pt.)

21. Tip for nurses continue  Insuring safe medication administration  Medication errors o The rights o Reactions o tapering

22. Tip for nurses continue  Education o Keeping bed rails o Alarms o Hands washing

23. Tips for nurses  Keeping records  Rapid response  Application of nursing process  Effective communication  Infection control  O 2 saturation  injury prevention

24. Keeping records

25. Infection control

26. Rapid response

28. Effective communication

29. O 2 saturation

30. education

31. injury prevention

33. Tips for other professionals Doctors ( safe medical, surgical practice )Doctors ( safe medical, surgical practice ) DietitianDietitian PhysiotherapistsPhysiotherapists TechniciansTechnicians Ambulance staffAmbulance staff Home care providersHome care providers House-keeping personnelHouse-keeping personnel Safety staffSafety staff

34. thanks