HOSPITAL ORIENTATION QUIZ PRACTICE UPDATE QUESTIONS AND ANSWERS 2023

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Nursing

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Nov 24, 2024

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HOSPITAL ORIENTATION QUIZ PRACTICE UPDATE QUESTIONS AND ANSWERS 2023 RACE - Rescue / Alert / Contain / Extinguish PASS - Pull the pin / Aim / Squeeze / Sweep side to side THE HAZARDOUS COMMUNICATIONS ACT - This federal regulatory standard requires employers to inventory and label hazardous chemicals in the workplace and to inform and train workers about chemical hazards Its Up To You To - Read labels Study the Material Safety Data Sheets (MSDS) Use proper protective equipment Follow safety precautions Two primary sources of information on hazardous materials are - Product Lable and MSDS Product label - Gives BASIC information Look for key words such as warning, caution, poisonous Look for warning symbols Lable transfered materials MSDS - Describes the chemical physical and health hazards how to handle the chemical safely what to do in emergency Most common injury - Lower back strain Lifting - 1. Keep load close to your body. 2. Bend the knees and hips. 3. Tighten the abdominal muscles when you lift. 4. Avoid twisting as you lift. 5. Lift with legs and buttocks. 6. Maintain natural curves of the back. Pushing and Pulling - 1. Stay close to the load. 2. Avoid leaning forward. 3. Push rather than pull whenever possible. 4. Use both arms. 5. Tighten stomach muscles when pushing. Reaching - 1. Reach only as far as is comfortable, usually at shoulder level. 2. Test weight by lifting corner. 3. Let arms and legs do the work, keeping the back straight. 4. Tighten the stomach muscles as you lift. 5. Arrange work area to minimize reaching.

Twisting - 1. Kneel down on one knee. 2. Maintain the natural curves of the back. 3. Position yourself for the best possible leverage. 4. Turn entire body, keeping feet and hips pointing in the same direction. Bending - 1. Maintain the natural curves of the back. 2. Bend the legs and hips rather than the back. 3. When leaning forward, move your whole body not just your arms. Sitting - 1. Get a chair with good lumbar support. 2. Sit close to your work rather than leaning. 3. Change positions often to avoid fatigue. Keep arms and shoulders relaxed. Code Red - FIRE Code Blue - Cardiac Arrest or Respiratory Arrest Code Pink - Infant/Child Abduction or elopement Code Silver - Lost Adult Code Black - Bomb Threat Code Grey - Disaster (activate plan) Code Green - Combative / Violent Person Code Orange - Haz-Mat / Decontamination Code White - Armed Intruder / Active Shooter Code Yellow - Utility Failure When to wash your hands 6 - 1When coming into the clinical site and when going home 2Before and after eating 3When hands are visibly soiled 4Before and after putting on gloves 5After using the bathroom 6When the patient has clostridium difficile How to wash hands - Remove jewelry Use warm water Use friction, washing hands, wrists and between fingers Wash for at least 15 seconds Rinse and dry thoroughly When using alcohol-based hand sanitizers - Use a golf ball-sized ball of foam or a dime-sized squirt of gel 8

Rub your hands, covering all surfaces, until they are dry (at least 15 seconds) Avoid operating equipment until your hands are dry Finger Nails - Must be short and clean No artificial nails No nail jewelry Unchipped polish is permitted Standard Precautions - Standard Precautions are practices with ALL patients regardless of their diagnosis or presumed infection status PPE - Personal Protective Equipment Transmission-Based Precautions - Transmission-Based Precautions are designed for patients with known or suspected highly transmissible or epidemiologically important pathogens. Before entering a patient room - Read the precaution sign: Airborne, Contact, Droplet Wear the appropriate Personal Protective Equipment (PPE) Airborne Precautions - airborne particles that can be widely dispersed by air currents. (examples: TB, chicken pox, measles, shingles) Wear Approved N95 particulate respirator mask before entering Keep the patient room door closed Contact Precautions - For infectious agents easily transmitted by direct patient contact or by indirect contact with items in the patient's environment. (examples: MRSA, VRE) Wear gloves when entering room A gown and gloves are required when in close or direct contact to the patient, used patient equipment or supplies. Masks are requires if splashing Droplet Precautions - For infectious agents transmitted by large particle droplets, usually within 3 feet of the patient. (examples: bacterial meningitis, influenza, adenovirus, mumps, parvovirus b19, Rubella.) Surgical mask when entering the room Sharps Container - for disposal of sharp objects, needles, syringes, blades, and broken glass. Always replace the container when it is 2/3 full. Red container or bag - used for items that would release 100 cc's or greater of blood or body fluids when compressed, for microbiological cultures and specimens, for Class IV etiological agents (waste from patients with highly communicable diseases) and specified pathological waste. Linen - Used / soiled linen is placed in yellow linen bags. The Joint Commission on Accreditation of Healthcare Organizations - "views the delivery of services in a culturally and linguistically appropriate manner as an important healthcare safety and quality issue."

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American Medical Association defines cultural competence as - "the knowledge and interpersonal skills that allow providers to understand, appreciate, and care for patients from cultures other than their own." Cultural Factors - 1Time orientation 2Cooking and food preferences and taboos 3Social roles and family members 4Causes of illness 5Use of home and folk remedies 6Attitudes toward persons in authority 7Communication preferences (verbal and non-verbal) 8Views on death and dying Sexual Harassment - Sexual harassment is a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964; applies to companys with 15+ employes Prevention of sexual harassment - Prevention is the best tool to eliminate sexual harassment in the workplace Joint Commission's National Patient Safety Goals - to promote specific improvements in patient safety. The goals highlight problematic areas in health care and describe evidence and expert- based consensus to solutions to these problems. Improve the accuracy of patient identification - 1A: Use at least two patient identifiers when providing care, treatment or services 1C: Eliminate transfusion errors related to patient misidentification Improve the effectiveness of communication among caregivers - Standardize the list of abbreviations / Measures and assess, and if appropriate, take action to improve the timeliness of reporting / Implement a standardized approach to "hand off" communications Improve the safety of using medications - Identify and, at a minimum, annually review al list of look-alike/sound-alike drugs used by the organization / Label all medications, medication containers / Reduce the likelihood of patient harm associated with the use of anticoagulation therapy Reduce the risk of health care associated infections - Comply with current World Health Organization (WHO) hand hygiene guidelines or Centers for Disease Control and Preventions (CDC) hand hygiene guidelines / preventing surgical site infections / prevent central line- associated bloodstream infections. Accurately and completely reconcile medications across the continuum of care - When a patient leaves the organization's care, a complete and reconciled list of the patient's medications is provided directly to the patient or next carring facility, and as needed, to the family 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.

Encourage patients' active involvement in their own care as a patient safety strategy - Identify ways in which the patient and his or her family can report concerns about safety and encourage them to do so The organization identifies safety risks inherent in its patient population - identifies risk for suicide Improve recognition and response to changes in a patient's 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 Universal Protocol - Conduct a pre-procedure verification process Mark the procedure site A time-out is performed immediately prior to starting the procedures Patients Bill of Rights Orgin - A Patient's Bill of Rights was first adopted by the American Hospital Association (AHA) in 1973 and revised in 1992. Bill of Rights 1 - The patient has the right to considerate and respectful care. Bill of Rights 2 - The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current and understandable information concerning diagnosis, treatment and prognosis. Bill of Rights 3 - The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action. Bill of Rights 4 - The patient has the right to have an advance directive Bill of Rights 5 - The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient's privacy. Bill of Rights 6 - The patient has the right to expect that all communications and records pertaining to his/her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. Bill of Rights 7 - The patient has the right to review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary, except when restricted by law.

Bill of Rights 8 - The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. Bill of Rights 9 - The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient's treatment and care. Bill of Rights 10 - The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent. Bill of Rights 11 - The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate. Bill of Rights 12 - The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities. Extra Bill of Rights - The right to be free of Restraints and the right to comprehensive pain management HIPAA - HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT: HIPAA regulations require that individuals' medical information be kept secure and private HIPPA RULES - Share on a need to know basis / never release a minors info without parents permision / never speak info where people can hear you / keep computer screens and open charts away from the public / Abuse - mental, emotional, physical, or sexual injury to a child or person 65 years or older or an adult with disabilities or failure to prevent such injury. Neglect (child) - includes failure to provide a child with food, clothing, shelter, and/or medical care, and leaving a child in a situation where the child is at risk of harm. Neglect (senior) - includes taking Social Security or SSI checks, abusing joint checking account, and taking property and other resources. Restraint - any manual method, physical, or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs body or heady freely.

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behavioral Restraint - The restriction of patient movement for the management of violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member or others. Restraint Orders - Ordered by a physician / PRN orders are not accepted / The order must specifically state what method of restraint or seclusion is used / Indications for the restraint are documented in the nursing notes and/ physician progress notes. Restraint shall only be used for the protection of the patient, staff members or others. Core Measures - Core measures are a set of "Best Practice Standards" that have been proven to reduce morbidity, mortality and re-admission rates — improve patient care and save lives Core Measure Indicators - Acute Myocardial Infarction: AMI Pneumonia: PNE Heart Failure: HF Surgical Care Improvement Project: SCIP AMI Indicators - Aspirin within 24 hours before or after arrival / Beta Blocker within 24 hours after arrival / Adult smoking cessation / ACE Inhibitor or ARB for Ejection Fraction less than 40% / Aspirin at Discharge / Percutaneous Intervention (PCI) within 90 minutes / Thrombolytics within 30 minutes Heart Failure Indicators - Smoking cessation / LV function assessment / Discharge instructions / ACE inhibitor or ARB for ejection fraction of less than 40% Pneumonia Indicators - Oxygen assessment / Blood cultures drawn prior to antibiotics / Antibiotics within 6 hours of arrival / Appropriate antibiotics ordered / Pneumococcal / Influenza Screening and Vaccination / Adult smoking cessation Surgical Care Improvement Project - Antibiotics given within one hour of incision / Appropriate antibiotic selection / Post-op antibiotic discontinuation within 24 hours / At risk surgery patients have recommended venous thromboembolism (VTE) prophylaxis ordered / VTE prophylaxis received within 24 hours prior to incision or 24 hours after surgery end time

HOSPITAL ORIENTATION QUIZ PRACTICE UPDATE QUESTIONS AND ANSWERS 2023

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