Safety and Infection Control Study Guide for the NCLEX-PN Exam

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Emergencies

Security Plan

Security plans define your facility’s policy for action if a breach of security occurs. These are important as they provide a plan for handling undesired events and help lead to a safe outcome for all. An infant abduction or an active shooter would be examples of a security breach.

Scope of Plan

This is the general outline of the plan. Knowing and understanding the general outline of the plan helps to keep it in motion and think about what needs to be done to execute the plan effectively. For example, if you have a “confidential” client, you need to know how to handle a person calling for information on that client.

Security Alert

Knowing how to engage and/or respond to a security plan is something a nurse should be comfortable with and knowledgeable of prior to any incident. You need to know what your role would be and who you would report to in that situation to fully be a part of that plan.

Monitor Plan’s Effectiveness

This should be done during and after the plan has been utilized. Continuously monitoring the plan ensures it is running smoothly, everyone knows their roles, and desired outcomes can be achieved. Reflecting on the plan once it has been completed involves noting things that worked and things that did not and how to improve the plan for future use.

Emergency Response Plan

An emergency response plan involves preparing for mass casualties related to natural or man-made disasters (such as motor vehicle accidents, bioterrorism, etc.). These plans are similar to the setup of security plans; however, they are more detailed and have specific client care-centered components in order to treat as many clients as possible to have the desired outcome of mass client survival.

Internal and External Disasters

Internal disasters are events that occur within the walls of the facility. For example, radiologic agents released in a lab accident, a bomb threat, and a fire would all fit in this category. External disasters involve events that occur outside of the facility walls. These would include things like hurricanes, flash floods, earthquakes, and transportation accidents.

Personnel Roles

Knowing your role is vital in an emergency plan. This allows you to act quickly to give clients the best chance at survival. Nurses may have responsibilities extended to their scope per policy and state. Specialty physicians and other healthcare providers all work under the umbrella as generalists so that the maximum number of clients can be treated as quickly as possible. A designated team member handles the media and traffic control. A disaster medical officer will decide how and where to allocate hospital resources.

Preparation

Hospitals typically have multiple drills for emergency plans annually. It is important for all healthcare team members, especially nurses, to participate in these drills so they will be comfortable with and knowledgeable of the plan, their personal roles, and how to execute needed parts of the plan.

Other Concerns/Decisions

Nurses will make decisions on client prioritization based on the facility’s disaster triage plan. Emergent, Urgent, and Nonurgent are categories for general conditions. A color system is implemented for mass casualties for efficiency in prioritization and time use. In order to be seen are red, yellow, green, and black. Know how the different triage systems for general conditions and mass casualties are used. Care will also be implemented based on that facility’s standing orders.

Reporting

In healthcare, any time there is an incident, event, or irregular occurrence regarding client care, it needs to be reported to the appropriate department. Reporting is vital to quality improvement in healthcare and is not something you as a nurse will be penalized for using. Reporting an incident or any undesired occurrences can also help to prevent similar errors or incidents with future clients.

Types of Incidents to Report

Medication errors, client falls, incorrect procedure technique, and deviation from policy or protocol are all types of incidents, events, or irregular occurrences that should be reported. Even if you see something you aren’t sure about, but think it isn’t best for the client, you should report it. Examples mandating an incident report are: a nurse giving the wrong medication to the wrong client, giving a medication to which a client is allergic, and a client falling during a nurse’s shift.

Monitor Client Response

A nurse should always monitor a client after an adverse event to ensure no harm or further harm comes to the client. A primary healthcare provider should be notified if any changes occur in the client’s health status, as they could indicate an underlying medical issue related to the prior incident.

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