International Patient Safety Goals (IPSG)

CHAPTER-1: International Patient Safety Goals (IPSG) 1. Name the Six International Patient Safety Goals 1. Identify patient correctly 2. Improve effective communication 3. Improve safety of high alert medications 4. Ensure Safe Surgery 5. Reduce the risk of healthcare associated Infections 6. Reduce the risk of patient harm resulting from falls 2. Which are the two identifiers used for patient identification?  All Health Care givers shall identify patient using at least two (2) identifiers:   Patient’s full name (First name, second name and/or Family name).  Unique Hospital Identification number(UHID). In case of unconscious unknown Patients:  If no information regarding patient identity is available, a temporary name using letters (UNKNOWN) with the unique hospital identification number will be assigned until identification process is completed (UNKNOWN UUHID).  For the newborn, ID bracelets placed on both ankles with the following information:  Baby of (mother’s name)  Newly generated UHID  In the event of death, the wrist ID band shall remain on the patient’s body.  For verbal communication in areas like outpatient clinics, Physiotherapy and other ambulatory areas, patient birth date will be used with the patient name to identify patients, all other situations the two identifiers must be the patient name and unique hospital identification number. 3. What are the colour codes of wrist ID Band and their indications?  Blue (All Non-Vulnerable),  Orange (All Vulnerable),  Red(Allergies)  Purple (Covid positive patients) 4. What are the Policy for Telephonic Order / verbal orders?  Telephone Order shall: (WRITE DOWN-READ BACK-CONFIRM)  Only be given in situation where the doctor is not immediately available e.g. when the patient condition needs an emergency order.  The telephonic must be authenticated by Primary Consultant within 24hours.  Telephonic orders for drugs are taken by DMOs Only.  Non-drug telephonic orders are taken by Nurses.  Verbal order is allowed only in situation when the physician cannot document the order e.g., as in emergency/urgent situation or When the ordering physician is scrubbed for a sterile procedure/surgery etc. Repeat Back-Confirm  The staff shall implement repeat back process.  The receiver repeats it back to the ordering physician.  The ordering physician confirm the order.  The receiver writes down the complete order after carrying out the order.  Verbal order must be authenticated by the ordering physician as soon as emergency is over/ before leaving the area. 5. What do you do if you take a critical result from lab? We get call from lab if any patient has critical results, we follow WRITE DOWN, READ-BACK AND CONFIRM policy while receiving the information and document in "critical results reporting form" and inform DMO and consultant WITHIN 30 MINUTES and initiate the correction as advised. 6. Is it required for doctors to do read back like nurses do? Yes, Doctors have to do read back and document the instructions/orders taken. 7. What do you if you have a “Critical Test Result” in Radiology and how do you handle them? Follow Write down- Read back- Confirm Process. When there is a critical result in the Radiology investigation, the Radiology technician /Radiologist informs the Primary consultant directly within 30 minutes and documents in the Critical Value Register. 8. If you do a glucometer /ABG test at bedside (POCT) and still receive a critical value, what should you do? You need to treat it as any other critical value, inform doctor immediately within 30minutes. The same needs to be documented and initiate treatment. 9. Do we have to document handovers? Yes 10. Who has to document handovers? Nurses, DMO’s, Consultants 11. “Patient Handoffs” require what?  Handoff is one important component of effective communication  Provide an opportunity for questions/answers between the giver and receivers  Give up-to-date information with any anticipated changes  Minimize interruptions  Repeat back or read back process  Receiver has opportunity to review the individual’s historical data, neurological status, critical labs, plan of care & any concerns. (SBAR) 12. When “HANDING OFF” Patient information, what format is used while giving or talking a handover by the Nurses?  SBAR- Situation, Background, Assessment, Recommendation  SITUATION- Current situation  BACKGROUND- History, diagnosis, tests, course of care, plan of care)  ASSESSMENT  RECOMMENDATION & Interventions for treatment 13. What happens when a patient is shifted from a ward/ICU to a temporary area in OP? (Radiology/Endoscopy/Bronchoscopy/Dialysis/Chemotherapy/Procedure area) HAND OFF TABLE: Situation Handover documented Handover in documented by Consultant/Primary physician goes on leave Doctors progress notes Consultant End of Shift-Nurses SBAR form Nurses End of Shift-Doctors DMO handover form Floor/Incharge/ICU doctors ER to ICU/Ward ER Admission Record Doctor, Nurse In house transfers, Ward-ward In-house Transfer Form Doctor and nurse of Ward-ICU, ICU-Ward, ICU-ICU sending unit Transfer to diagnostic areas or other treatment Hand off form for Doctor/Nurse from units: diagnostic the unit that sends  Ward to Radiology. procedures/Tests. the patient.  Ward to Dialysis.  ER/Ward to Chemotherapy.  Ward to ECG/ ECHO/ TMT/ EEG/ER.  Ward to Endoscopy Bronchoscopy, other procedural arears or physiotherapy.  ER/Ward to Cath lab.  ER/Ward to OT. Transfer from diagnostic areas or other Hand off for diagnostics Nurse/Technician treatment units back to origin: / Tests who  Radiology to ER/Ward receives the patient  Dialysis to ER/Ward.  Chemotherapy to ER/Ward.  ECG/ECHO/TMT to Ward Endoscopy, Bronchoscopy, Other procedural areas, Physiotherapy to ER/ Ward ER/Ward/ICU to operation Theatre Operative record Nurse from the unit that sends the patient ER/Ward/ICU to Cath lab Cath Lab to ward/ICU Hand-off form for Nurse from the unit diagnostics that tests/procedure record patient Hand off form sends the for Nurse & Doctor diagnostic tests/Procedures Operation Theatre to ward/ICU Hand –off form for Nurse & Doctor diagnostics , SBAR & In-house Transfer Form  The handovers may not be compulsorily documented in emergency situations or in situations when a doctor/Nurse or both accompany an unstable patient and is present throughout the investigation process. 14. Define High Alert Medication (HAM)? High Alert medications are the drugs that bear a heightened risk of causing significance patient harm, when they are used inappropriately.