1. Identify lab and clinical policies, procedures, and safety guidelines. 2. Identify the incident reporting process. 3. Identify all requirements for clinical placement. 4. Identify the role of the respiratory care student in the lab and clinical setting. Incident reporting is a very important part of the health care system. An incident is any event not consistent with the routine operation of a health care unit or routine care of a patient. As a student, you must be aware of the steps an educational institution or a clinical site requires you to follow regarding an incident in which harm was caused, a near-miss incident, or an incident that caused no harm. Although not a part of the patient’s permanent medical record, incident reports are used by risk management and other similar departments as a source of data. They may be used to identify the source of errors and how to prevent future incidents. Examples of incident report entries can be found in Table 1-1. The following is the step-by-step process for incident reporting. TABLE 1-1 Examples of Respiratory Care Incident Entries Modified from Perry AG, Potter PA: Clinical nursing skills and techniques, ed 7, St. Louis, MO, 2010, Mosby. 2. Verify the physician’s order or the facility’s protocol for standard of care. 3. Obtain, clean, and inspect the appropriate equipment prior to entering the patient’s room. 4. Follow personal protective equipment (PPE) requirements, and observe standard precautions for any transmission-based isolation procedure. 5. Identify the patient using two patient identifiers. 6. Introduce yourself to the patient and to the family. 7. Explain the procedure to the patient and to the family, and acknowledge the patient’s understanding. 8. Perform proper hand hygiene, and put on gloves, mask, and protective eyewear, as appropriate for procedure. 1. Report accurate, objective information in chronological order. 2. Restore the patient’s safety. 3. Assess the extent of injury. 4. Notify the proper medical personnel needed to treat the patient if he or she is injured. 5. If the injured party is not a patient of the facility, refer him or her to the appropriate location for evaluation. 6. If the injured party is a patient, assess and implement any ordered therapies.
Preparing for Clinical Rotations
» Skill Check List
1-1 Incident Reporting
Correct Entry
Incorrect Entry
6 pm Patient found on floor at foot of bed with oxygen tubing tangled around the left ankle; able to respond to name when called. 2-cm abrasion noted across left forehead. Vital signs stable. Dr. Smith notified and arrived on floor at 6:15 pm. Nurse placed patient on fall-prevention protocol.
Patient found on floor at foot of bed, probably fell on way to bathroom. Small abrasion over left forehead. Dr. Smith notified. Patient instructed to use call light when needing to go to bathroom.
Administered albuterol sulfate 2.5 mL via nebulization. 2.5 mg ordered. Monitored vital signs q 15 minutes; called Dr. Jones; vital signs remain stable.
Administered 2.5 mL morphine sulfate at 4 pm without checking vial for concentration before administering. 2.5 mg albuterol sulfate ordered.
Needlestick to right index finger; caused minimal bleeding. Notified employee health department.
Needlestick to right index finger, likely from needle left in bed linen after blood drawing. Notified employee health.
Procedural Preparation
Implementation
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