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

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

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

4. 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

5. 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

6. Hospital / Patient Safety
Fire Safety
Fire Triangle

7. Hospital / Patient Safety
Fire Safety
Classification of Fuels

8. 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

9. Hospital / Patient Safety
Fire Safety
Types of Fire Extinguishers

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

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

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

13. 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

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

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

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

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

18. Hospital / Patient Safety
Physiological Effects of Electrical Current

19. 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

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

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

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

23. 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

24. 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

25. 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

26. 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

27. 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

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

29. 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

30. 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.

31. 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

32. 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

33. 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.

34. 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

35. Hospital / Patient Safety
Examples of Misinterpretation of Abbreviations

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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