Patient Safety and Medication Errors: Prevention and Correction Strategies, Exams of Nursing

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NUR 2206: Quality Care Assessment test

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Patient safety - Correct Answers the prevention of harm to patient medical error - Correct Answers the failure of a planned action to be completed as intended, or the use of a wrong plan to achieve an aim Six Aims for Improvement - Correct Answers Steps for Prevention - Correct Answers 1) Partnership between HCP and patient Teach patient- explain meds that they're being given

2. Use IT to reduce medication errors IT= information technology
3. Improve labeling and packaging of medications 5 Competencies - Correct Answers 1) Provide patient-centered care
4. Work in interdisciplinary teams
5. Employ evidence-based practices
6. Apply quality improvement
7. Utilize informatics Quality and Safety in Nursing Education (QSEN) - Correct Answers Designed to address gaps in nursing education related to 5 competencies for Health Professions Education identified by IOM in 2003 report; Their competencies provide framework for: nursing school curricula, transition to practice, CE programs, licensure, certification, and accreditation QSEN competencies - Correct Answers 1) Patient-Centered Care
8. Teamwork and Collaboration
9. Evidence-Based Practice
10. Quality Improvement
11. Safety
12. Informatics Safety - Correct Answers Minimize risk of harm to patients and providers through both system effectiveness and individual performance (QSEN)

Science of safety - Correct Answers human error human factors - Correct Answers Refers to the study of human behavior, abilities, limitations, and other characteristics as they affect the design and smooth operation of equipment, systems, jobs, and work environment (AHRQ) Skill-based errors - Correct Answers Performing tasks that are so routine and familiar (automatic) that one doesn't even have to think about task when performing it Strategy for Prevention:

• Avoid multitasking
• Address environmental factors that might lead to skill-based error (such as distractions) Rule-based errors - Correct Answers Recognition of a familiar situation that can be managed through a known rule;
• Rules can be miss-applied in incorrect situations
• Application of a "bad" rule
• Choosing not to comply with a rule
• Reckless behavior Strategy for Prevention:
• use checklists Knowledge-based errors - Correct Answers In a new or unfamiliar situation without a developed skill or known rule- must problem-solve to "figure out" what to do; "I don't know what to do..."
• Mistakes are likely because of lack of knowledge Strategy for Prevention:
• Recognize lack of knowledge and risk for error
• Step away from situation and problem-solve through critical thinking System-based errors - Correct Answers Caused by policies, procedures, labeling, storage, etc. within institution Adverse Event (AE) - Correct Answers any injury caused by medical care; not anticipated/expected Adverse Drug Event (ADE) - Correct Answers any undesirable occurrence related to administering or failing to administer a prescribed medication; An adverse event involving medication use

Culture of safety - Correct Answers A commitment to safety that permeates all levels of an organization from front-line personnel to executive management (Institute for Healthcare Improvement); Purpose is prevention of errors and elimination of unsafe practices; Includes:

• Acknowledgement of high-risk, error-prone nature of an organization's activities
• A blame-free environment where individuals are able to report errors or near-misses w/o fear of reprimand or punishment
• An expectation of collaboration across ranks to seek solutions
• A willingness on the part of the organization to direct resources for addressing safety concerns Work-arounds - Correct Answers a deviation from the expected pattern of work to achieve an end result by bypassing safety features; Often the result of poorly designed processes or equipment Agency for Healthcare Research and Quality (AHRQ) - Correct Answers Produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable; Works within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used
• TeamSTEPPS TeamSTEPPS - Correct Answers an AHRQ initiative designed to increase patient safety Situation monitoring - Correct Answers STEP - Correct Answers Status of the Patient Team Members Environment Progress toward Goal I'M SAFE Checklist - Correct Answers Institute for Safe Medication Practices (ISMP) - Correct Answers Goal is to advance patient safety worldwide by empowering the healthcare community, including consumers, to prevent medication errors Institute of Medicine (IOM) - Correct Answers Independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice help those in

government and the private sector make informed health decisions by providing evidence; Health arm of the National Academy of Sciences