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Zorluk: Çok zorAccident, Error, and Injury Prevention

A registered nurse is coordinating care for an older adult client with vascular dementia who is 24 hours postoperative following a right total hip arthroplasty. The client is restless, repeatedly attempts to exit the bed unassisted, and is prescribed a continuous intravenous infusion of packed red blood cells (PRBCs) for acute blood loss anemia. Which actions by the nurse prioritize accident, error, and injury prevention? (Select all that apply.)

  1. Verifying the client's two unique identifiers and the blood product details with a second registered nurse actively at the client's bedside.Cevap
  2. B
    Elevating all four bed side rails to establish a secure physical barrier while the nurse briefly exits the room to gather transfusion supplies.
  3. C
    Elevating the head of the bed to a full 90-degree angle to prevent aspiration while the client consumes oral medications and meals.
  4. Positioning a bedside commode parallel to the left side of the hospital bed to facilitate safe pivoting on the unaffected extremity.Cevap
  5. E
    Delegating the unlicensed assistive personnel (UAP) to remain at the bedside for the first 15 minutes of the transfusion to immediately report any signs of a reaction.
  6. Activating a bed-exit alarm equipped with a weight-sensitive pad that directly integrates with the unit's centralized call light system.Cevap

Cevap

The correct actions for prioritizing safety are verifying the blood product with a second nurse at the bedside, positioning the bedside commode on the unaffected left side for safe transfers, and activating a bed-exit alarm.
Verifying blood products at the bedside with a second RN is a mandatory error-mitigation standard to prevent incompatible transfusions. Positioning the commode on the left (unaffected) side ensures the client can bear weight and pivot on their strong leg, preventing falls and avoiding stress on the newly operated right hip. Activating a bed alarm is a proven restraint alternative that safely alerts staff to unassisted bed exits without confining the client.

Adım Adım Çözüm

1
Analyze the client's specific clinical risks.
The client is at high risk for falls (dementia, restlessness), hip prosthesis dislocation (recent right arthroplasty), and transfusion reactions (PRBC infusion).
Identifying the highest priority risks across multiple physiological and environmental domains dictates the necessary safety interventions.
2
Evaluate the interventions related to blood administration safety and error mitigation.
Bedside verification by two RNs is a required standard. Delegating the critical initial 15-minute observation to a UAP is an unsafe practice.
Transfusion reactions most commonly occur in the first 15 minutes and require comprehensive clinical nursing assessment, which cannot be delegated.
3
Evaluate the interventions related to fall and injury prevention.
Using a bed alarm and transferring toward the unaffected left side are safe, evidence-based practices. Conversely, using four side rails is an unauthorized physical restraint, and flexing the hip to 90 degrees creates a severe dislocation hazard.
Safety measures must mitigate existing risks without introducing new hazards, such as physical entrapment or surgical joint complications.

Anahtar Kavram

Accident, error, and injury prevention in complex clients requires synthesizing multiple safety protocols simultaneously, including strict blood administration verification, adherence to surgical positioning precautions, safe delegation practices, and utilizing restraint alternatives for confused clients.
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Konular

Accident, Error, and Injury Prevention

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