NMBI Patient Safety 2 — Questions and Answers
Question 1: What is a 'near miss' in healthcare?
- An event that could have resulted in harm to a patient but was prevented or did not reach the patient (Correct answer)
- A medication that nearly expired
- A patient who nearly missed their appointment
- A nurse who was nearly late for a shift
Correct answer: An event that could have resulted in harm to a patient but was prevented or did not reach the patient
A near miss is an unplanned event that did not result in harm but had the potential to do so. Reporting and analysing near misses is crucial for patient safety as they reveal system vulnerabilities before actual harm occurs.
Question 2: What is the WHO Surgical Safety Checklist and when is it used?
- A three-phase checklist (Sign In, Time Out, Sign Out) used before, during, and after surgical procedures to reduce errors and complications (Correct answer)
- A checklist for cleaning surgical instruments
- A form for scheduling surgical theatre time
- A checklist used only in emergency surgeries
Correct answer: A three-phase checklist (Sign In, Time Out, Sign Out) used before, during, and after surgical procedures to reduce errors and complications
The WHO Surgical Safety Checklist has three phases: Sign In (before anaesthesia), Time Out (before incision), and Sign Out (before the patient leaves the operating room). It verifies patient identity, procedure, site, allergies, equipment, and team communication.
Question 3: What is the National Early Warning Score (NEWS) system used for in Irish hospitals?
- To detect early signs of clinical deterioration by scoring vital signs, enabling timely escalation and intervention (Correct answer)
- To score nurses' performance during shifts
- To determine which patients can be discharged
- To calculate medication dosages
Correct answer: To detect early signs of clinical deterioration by scoring vital signs, enabling timely escalation and intervention
NEWS assigns scores to vital signs (respiratory rate, oxygen saturation, temperature, blood pressure, heart rate, consciousness level). A higher aggregate score indicates greater clinical risk, triggering escalation protocols and more frequent monitoring.
Question 4: What is the purpose of a root cause analysis (RCA) following a serious patient safety incident?
- To identify the underlying systemic causes of the incident and recommend changes to prevent recurrence (Correct answer)
- To determine which staff member should be disciplined
- To calculate the financial cost of the incident
- To prepare a media statement about the incident
Correct answer: To identify the underlying systemic causes of the incident and recommend changes to prevent recurrence
RCA is a structured investigation method that goes beyond individual actions to identify systemic factors that contributed to an incident. It examines organisational, environmental, and process factors to make recommendations that address root causes rather than symptoms.
Question 5: What are the key principles of infection prevention and control in nursing?
- Standard precautions including hand hygiene, use of PPE, safe handling of sharps, environmental cleaning, and respiratory hygiene (Correct answer)
- Only wearing gloves during procedures
- Only washing hands at the start and end of a shift
- Infection control is the responsibility of the infection control team only
Correct answer: Standard precautions including hand hygiene, use of PPE, safe handling of sharps, environmental cleaning, and respiratory hygiene
Standard precautions apply to all patient care regardless of diagnosis. They include hand hygiene (the single most effective measure), appropriate use of PPE, safe sharps disposal, environmental cleaning, cough etiquette, and safe handling of linen and waste.
Question 6: What is the nurse's role in falls prevention?
- Assessing each patient's falls risk on admission and regularly thereafter, implementing preventive measures, and documenting all assessments and interventions (Correct answer)
- Falls prevention is solely the physiotherapist's responsibility
- Only assess patients after they have fallen
- Falls are an unavoidable part of hospital care
Correct answer: Assessing each patient's falls risk on admission and regularly thereafter, implementing preventive measures, and documenting all assessments and interventions
Nurses play a central role in falls prevention: conducting risk assessments using validated tools on admission and regularly, implementing interventions (bed height, call bells within reach, appropriate footwear, mobility aids), and reviewing after any fall or change in condition.
NMBI Patient Safety 2
What is a 'near miss' in healthcare?