Patient safety

Ns. Mardiyanti, Mkep, MDS

Tujuan pembelajaran
Mahasiswa mampu:
1.

Menjelaskan definisi patient safety

2.

Menjelaskan factor yang mempegaruhi patient safety

3.

Menjelaskan metode pengkajian pasient safety

4.

Memahami prinsip managemen risiko

5.

Mengidentifikasi macam-macam risiko terkait patient safety

6.

Memberi contoh intervensi keperawatan pada pasient yang berisiko

injuri

Definitions

Provision of safe nursing practice through the use of preventive

strategies found in organisational policies, procedures, protocols and
guidelines (Kozier&Erbs, 2012, p.794)

Sebuah pernyataan/komitmen perawat bahwa ia akan terus menerus

bekerja menuju management, treatment dan penghindaran praktik yang
tidak aman, dalam lingkup pelayanan kesehatan (Canadan nurses
association, 2002)

Safe nursing practice is concerned with the provision of a safe working

environment for clients, staff and visitors

Sources of risks include all forms of hospital error

(falls, medication errors, pressure areas, environmental hazard

including increased workloads, psychological stress)

All work-related injuries must be reported, investigated and remedial

actions taken if necessary monitored by Occupational health, safety
and welfare (diatur dalam K3RS)

Source of risks and potential for

hospital errors (Australian Department of Health)

Mishandling of blood and blood products

Clinical handover (e.g. poor communication of patients condition)

Client being poor historian that compromise effective communication (e.g.

unconscious clients, dementia, hearing/speech impairment, English as a second
language)

Health care acquired infections

Medication safety

Documentation, electronic and paper based

Inadequate falls prevention management program

Patient identification

Manual handling

Ruang lingkup patient safety

Safe medication practice

special attention of insulin, anticoagulants, narcotics and sedative.
bagaimana jika terjadi medication error???

Prevent failure:

1. Minimize nurse distraction during the medication administration process

2. Prinsip 10 benar dalam memberikan obat

Top 10 evidence-based interventions

to prevent falls and reduced
immobility
Conduct fall and injury rsk assessment upon admission

Reassess risk daily and with changes in patient condition

Implement patient-specific intervention to prevent falls and injury

Communicate risk across the team documentation, visual cues

Round every 2 h for high risk patients 3Ps Pain, Potty, Position-pressure

Individualize interventions individualized toileting schedule

Review medication

Incorporate multidisciplinary input for fall prevention

Include patients, families and caregiver to prevent falls

Hold post-fall huddles immediately after events to prevent other fall

Factors affecting safety

Age and development

Lifestyle

Mobility and health status

Sensory-perceptual alterations

Cognitive awareness

Emotional state

Ability to communicate

Safety awareness

Environmental factors

Health care setting

Nursing interventions and

management related to patient
safety
Pengkajian : riwayat penyakit/rekam medis dan pengkajian fisik
meliputi: usia dan developmental level, general health status, mobility
status, deficit sensory persepsi, deficit fungsi kognitif, serta pengkajian
keamanan lingkungan (e.g. rumah untuk persiapan klien pulang)

Risk assessment tools

Interventions
1. improve the accuracy of patient identification, especially when
administering bloods products and medication
2. Improve the effectiveness of communication among caregiver
3. Improve the safe use of medications
4. Reduce the risk of health care acquired infections
5. Accurately and completely reconcile medications across the continuum o
care