أسئلة واجابات مقترحه لدورة الاعتماد المقبلة

Tell me how do you identify the correct pt?

 

Ask patient for 2 patient identifiers and the correct check against relevant documents.

 

 

Any Part of Body  على الاطراف توضع على  ID Band في حال تعذر وضع ال

(Visible)

 

Tell me what would you do if there is really no choice to attach patient’s wrist tag on any skin surface (i.e. severe skin damage)?

 

We will clip the identifier tags on the patient’s clothes

 

 

 

في حال حضور مرضى مجهولين على الطوارى  يعرف بمجهول (رقم1) ووقت الوصول والجنس

 

متى يجب التعرف على المريض :

 

  • Assessment and examination
  • Diagnostic procedures and Interventions, such as:
    • Taking blood and other specimens
  • Radiological procedure
    • Cardiac catheterization, Endoscopy
  • Providing treatment :
    • Surgery / Procedure
      • Administering blood or blood product
        • Dispensing and administering medication

 

 

Tell me how do your treatment is delivered to uncommunicative

or unconscious patient

 

Check with relevant and verified against relevant documents

 

Tell me what is the process of receiving critical results?

 

  • write it down, read it back” from receiver
  • take confirmation from person giving the result

 

Tell me how do you communicate patient: care?  

 

   ISBAR

Introduction

Situation

Background

Assessment

Recommendations

 

 

ماهو الوقت اللازم عدم تجاوزه لاخبار الطبيب  في حال ال

 

Hypoglycemia ……………….5 minute

Hyperglycemia ……………30minute

 

 

متى يتم الاخبار  عن نتيجة  ال  Gluco Check  انها Critical Result    

 

  • Adult

More than   450

Less than    50

 

  • Pediatric

More than   300

Less than   40

 

 

Tell me what would you do if the doctor is not around to order medications during an emergency?

 

  • Verbal /telephone orderis limited to urgent situations

 

  • Verbal /telephone order for anti neoplastic agents and narcotics will not be accepted.

 

  • It should be used only when ordering physician is not available to write the order

 

 

Tell me how do you communicate patient care?

 

  • Standardized critical contents that must be communicated in all types of handover:
    • Patient identification (2 identifiers; full name & file number)
    • Date of admission
    • Diagnoses and current condition of the patient
    • History of medical illnesses
    • Allergy
    • Recent changes in condition or treatment

 

 

 

Tell me, do you take any measures to improve the safety of high alert medications?

 

  • labeled with a “High Alert” sticker on
    • Container where drugs are stored
    • Dispensed drugs from pharmacy
  • Double check in preparation and administration.
  • Automatic stop order for all high alert medication infusion is valid for 24 hours
    • Don’t use abbreviation  as U for international unit
    • Verbal order NOT ALLOWED at all

 

Tell me, do you keep concentrated electrolytes in your floor?

 

No, we do not stock concentrated electrolytes except in special care area where the intent of their use and quantities are identified

Note: magnesium sulfate inj is available in the (E-trolley), for

Resuscitation purposes

 

 

 

 

Tell me what you do to ensure safe surgery or procedure provided to your patient?

For safe surgery ensure that:

  • Pre-procedure verification is carried out against the checklist to ensure correct patient, correct procedure, correct site, correct document and test performed.
  • Site marking is done by the surgeon as appropriate.
  • Time out is held immediately before the start of the procedure.
  • Sign out is held at the end of the procedure

 

Could you share with me on Time Out?

 

Time out is held immediately before the start of the procedure with all team members present. The team verify on the following:

  • Correct patient {IPSG 1).
  • Correct procedure, treatment/surgery.
  • Correct side and site.
  • Correct imaging report/medical records
  • Correct function equipment/requisites.

 

Tell me, when do you require site marking for the patient?

 

Is required for all patients having a surgery / invasive    procedure that involve the following:

  • Laterality (Rt & Lt)
  • Multiple structures (e.g. fingers, toes)
  • Multiple level (spine)

 

It is done with an arrow         marked adjacent to target site. We will

Involve the patient during the process and site marking is done by the procedurist who perform the procedure

 

When Site marking should take place?

 

When patient awake and aware and before went to operation room

 

 

Tell me more about Sign-Out

 

Performed before the patient leaves. The following components of

the sign-out are verbally confirmed by a member of the team, on the following:

  • Name of the surgical/invasive procedure that was recorded/written
  • Completion of instrument, sponge, and needle counts (as
  • applicable)
  • Labeling of specimens (when specimens are present during the
  • sign-out process, labels are read aloud, including patient name)
  • Any equipment problems to be addressed (as applicable)

 

Show me, how do you Handwash perform hand hygiene.

 

  • Wet hands
  • Use 1 full pump of antiseptic solution
  • Rub thoroughly using 7 steps {refer poster)
  • Rinse and dry hands.

Recommended minimal duration for antiseptic handwash is entire procedure from 40-60 second

Handrub Apply pulmful entire procedure 20-30 second.

 

 

Tell me, how do you know that these steps are sufficient to reduce the risk of infection?

 

Our hospital follows the World Health Organization (WHO) guidelines on hand hygiene in healthcare.

 

 

Tell me, in which situation would you perform a hand wash?

 

Do hands wash when:  Hands are visibly contaminated with blood or body fluids.

If expose to spore forming pathogene as Clostridium difficile

 

Do hands rub when: hands are not visibly soiled with blood & body fluids?

 

 

Tell me, how do you ensure a safe environment for your patient?

 

  • We will perform hand hygiene and also reduce the risk of patient falls
    • All patients who are admitted or transferred into the ward are assessed using the  tool (assess risk for fall)
  • When high fall risk is identified, targeted measures are planned and implemented.

 

Tell me, when do you know that your patients are at higher risk of falls?

 

Patients are reviewed every shift for change in condition/fall risk factors.

When should you reassess patient risk for fall ?

 

  • Changes in patient health or cognitive condition during hospitalization.
  • After transfer to another unit.
  • After surgery or tests and procedure.
  • Addition or change in medication.
  • Following a falling down in same admission

 

Tell me what you would do if your patient low risk for fall.

Apply safe technique

  • Safe environment
  • Assist with mobility
  • Fall risk reduction
  • Engage patient and family

 

 

 

Tell me what you would do if you witness a patient fall.

 

The priority is to assess the patient by registered nurse while he is still on the floor

 

  • Assess injury, vital sign & mental status  gluco check IF diabetic
  • Determine probable cause of fall (history, physical factors, medications, laboratory values).Inform supervisor &physician immediately
  • Use proper precaution when transferring the patient to bed
  • The physician initiate further DX orders and start management
  • Communicate to all shifts that patient has fallen and is at risk to fall.
  • complete falling down incident report should be completed and send to quality office within 72 hours
  • Detailed progress and NSG note

 

 

 

 

 

Tell me, what do you know about infection control?

Upon joining the hospital, we have orientation programs that include:

 

  • 5 moments for hand hygiene
  • Standard & transmission based precautions
  • Other specific infection control polices

 

Tell me, how do you prevent the spread of diseases in your hospital?

 

  • 5moments for hand hygiene
  • Practice of Standard Precautions for all patients
  • Practice of Transmission based precautions
    • Appropriate use of PPE
    • Staff Vaccination

 

Tell me, what do you do when you are required to assist a procedure for an infectious patient?

 

  • We will practice the Standard Precaution
    • 5 moment for hand hygiene
    • Gloves: Contact with blood and body fluid secretions excretions, and contaminated items, mucous membranes and non-intact skin.
    • Surgical mask, Eye protection with Goggles:
  • When performing procedures that are likely to generate aerosols and/or droplets/splashes of blood/body fluids e.g. suctioning,
  • bronchoscopy, chest physiotherapy, etc.
    • Eye protection with Goggles must be worn when placing a catheter or injecting material in the spinal or epidural space.
    • Apron/Gown: When clothing is likely to be soiled with blood/body fluids.

 

Tell me, how do you   know that the negative pressure room is working?

 

  • Ensure the exhaust fan switched on.
  • Check negative pressure gauge range
  • Test with a piece of tissue paper: Place tissue paper at the gap
  • at the base of the door. Tissue paper will be drawn into the room if it is working.

 

What would you do if you were pricked by a used needle or had a blood/body fluid exposure?

 

  • Do first aid by washing the puncture site or affected area with soap under running water.
  • Inform supervisor, to do risk assessments.
  • Ensure source patient’s blood is taken (If source patient is known).
  • Refer to infection control
  • Seek medical attention

 

 

Tell me, what happens if you witness a blood or body fluid spill?

 

   

اقل من 100 الاخلاء  ( لبس معدات الوقايه  من قبل عامل الخدمات)  ، حصر المنطقه , وضع فاين, وضعهم في الكيس الاصفر، تعقيم المنطقه بالكلور،   كتابة الحادث العرضي.

اكثر من 100: الاخلاء و التبليغ، حصر المنطقه  حصر بالتراب، و ماتبقى من التراب يوضع فوق الانسكاب’   وضعهم في كيس اصفرتعقيم المنطقه بالكلورـ كتابة حادث عرضي

 

 

 

 

Tell me, how do you know that the items are good to be used?

Check expiry dates & packaging integrity before use.

 

 

 

Tell me how you know about your job scope?

 

We have a   job description and it is shared with us upon appointment or if revised.

 

Tell me how the hospital prepares you to perform the work you are doing?

 

We will go through orientation   program for new employees by HR, nursing hospital and unit-based orientation program

 

Tell me who need to be BLS certified and how frequent it is being done?

 

  • All health team required to have a valid BLS certification.
  • Recertification every 2 years are required to have a valid BLS certification.

 

How do you receive ongoing development for your skills and clinical knowledge?

 

Attend department/ nursing in-services requirement sessions

 

 

How do you ensure that the staff clinical  knowledge and skills are consistent with patient needs?

 

كيف تتاكد من مهارات الموظف لتقديم الرعاية التمريضية ؟

 

  • يتم تقيم الاداء خلال الفترة التجريبية
  • يتم تقييم ال competency  كل 6 أشهر.

 

Does nursing staff participate in the hospital’s quality improvement activities?

 

Yes       EX…………….

 

Do you receive education or training about your roles in providing a safe and effective patient care facility?

 

Yes, we received training on our roles in the hospital programs for :

  • Fire safety
  • Security
  • Hazardous materials
  • Emergency
  • Medical equipment
  • Utility system

 

 

 

Tell me how do you identify the correct pt?

 كيف ينم التعرف على المريض

 

Ask patient for 2 patient identifiers and the correct check against relevant documents.

 

 

على الاطراف    ID Band في حال ا تعذر وضع ال

توضع على  : any part of body (visible)

 

 

Tell me what would you do if there is really no choice to attach patient’s wrist tag on any skin surface (i.e. severe skin damage)?

 

We will clip the identifier tags on the patient’s clothes

 

 

 

في حال حضور مرضى مجهولين على الطوارى  يعرف بمجهول (رقم1) ووقت الوصول والجنس

 

متى يجب التعرف على المريض :

 

  • Assessment and examination
  • Diagnostic procedures and Interventions, such as:
    • Taking blood and other specimens
  • Radiological procedure
    • Cardiac catheterization, Endoscopy
  • Providing treatment :
    • Surgery / Procedure
      • Administering blood or blood product
        • Dispensing and administering medication

 

Tell me how do your treatment is delivered to uncommunicative

or unconscious patient

 

Check with relevant and verified against relevant documents

 

Tell me what is the process of receiving critical results?

 

  • write it down, read it back” from receiver
  • take confirmation from person giving the result

 

Tell me how do you communicate patient: care?  

 

   ISBAR

Introduction

Situation

Background

Assessment

Recommendations

 

 

ماهو الوقت اللازم عدم تجاوزه لاخبار الطبيب  في حال ال

 

Hypoglycemia ……………….5 minute

Hyperglycemia ……………30minute

 

 

متى يتم الاخبار  عن نتيجة  ال  Gluco Check  انها Critical Result    

 

  • Adult

More than   450

Less than    50

 

  • Pediatric

More than   300

Less than   40

 

 

Tell me what would you do if the doctor is not around to order medications during an emergency?

 

  • Verbal /telephone orderis limited to urgent situations

 

  • Verbal /telephone order for anti neoplastic agents and narcotics will not be accepted.

 

  • It should be used only when ordering physician is not available to write the order

 

 

Tell me how do you communicate patient care?

 

  • Standardized critical contents that must be communicated in all types of handover:
    • Patient identification (2 identifiers; full name & file number)
    • Date of admission
    • Diagnoses and current condition of the patient
    • History of medical illnesses
    • Allergy
    • Recent changes in condition or treatment

 

 

 

Tell me, do you take any measures to improve the safety of high alert medications?

 

  • labeled with a “High Alert” sticker on
    • Container where drugs are stored
    • Dispensed drugs from pharmacy
  • Double check in preparation and administration.
  • Automatic stop order for all high alert medication infusion is valid for 24 hours
    • Don’t use abbreviation  as U for international unit
    • Verbal order NOT ALLOWED at all

 

Tell me, do you keep concentrated electrolytes in your floor?

 

No, we do not stock concentrated electrolytes except in special care area where the intent of their use and quantities are identified

Note: magnesium sulfate inj is available in the (E-trolley), for

Resuscitation purposes

 

 

 

 

Tell me what you do to ensure safe surgery or procedure provided to your patient?

For safe surgery ensure that:

  • Pre-procedure verification is carried out against the checklist to ensure correct patient, correct procedure, correct site, correct document and test performed.
  • Site marking is done by the surgeon as appropriate.
  • Time out is held immediately before the start of the procedure.
  • Sign out is held at the end of the procedure

 

Could you share with me on Time Out?

 

Time out is held immediately before the start of the procedure with all team members present. The team verify on the following:

  • Correct patient {IPSG 1).
  • Correct procedure, treatment/surgery.
  • Correct side and site.
  • Correct imaging report/medical records
  • Correct function equipment/requisites.

 

Tell me, when do you require site marking for the patient?

 

Is required for all patients having a surgery / invasive    procedure that involve the following:

  • Laterality (Rt & Lt)
  • Multiple structures (e.g. fingers, toes)
  • Multiple level (spine)

 

It is done with an arrow         marked adjacent to target site. We will

Involve the patient during the process and site marking is done by the procedurist who perform the procedure

 

When Site marking should take place?

 

When patient awake and aware and before went to operation room

 

 

Tell me more about Sign-Out

 

Performed before the patient leaves. The following components of

the sign-out are verbally confirmed by a member of the team, on the following:

  • Name of the surgical/invasive procedure that was recorded/written
  • Completion of instrument, sponge, and needle counts (as
  • applicable)
  • Labeling of specimens (when specimens are present during the
  • sign-out process, labels are read aloud, including patient name)
  • Any equipment problems to be addressed (as applicable)

 

Show me, how do you Handwash perform hand hygiene.

 

  • Wet hands
  • Use 1 full pump of antiseptic solution
  • Rub thoroughly using 7 steps {refer poster)
  • Rinse and dry hands.

Recommended minimal duration for antiseptic handwash is entire procedure from 40-60 second

Handrub Apply pulmful entire procedure 20-30 second.

 

 

Tell me, how do you know that these steps are sufficient to reduce the risk of infection?

 

Our hospital follows the World Health Organization (WHO) guidelines on hand hygiene in healthcare.

 

 

Tell me, in which situation would you perform a hand wash?

 

Do hands wash when:  Hands are visibly contaminated with blood or body fluids?

If expose to spore forming pathogene as Clostridium difficile

 

Do hands rub when: hands are not visibly soiled with blood & body fluids?

 

 

Tell me, how do you ensure a safe environment for your patient?

 

  • We will perform hand hygiene and also reduce the risk of patient falls
    • All patients who are admitted or transferred into the ward are assessed using the  tool (assess risk for fall)
  • When high fall risk is identified, targeted measures are planned and implemented.

 

Tell me, when do you know that your patients are at higher risk of falls?

 

Patients are reviewed every shift for change in condition/fall risk factors.

When should you reassess patient risk for fall ?

 

  • Changes in patient health or cognitive condition during hospitalization.
  • After transfer to another unit.
  • After surgery or tests and procedure.
  • Addition or change in medication.
  • Following a falling down in same admission

 

Tell me what you would do if your patient low risk for fall.

Apply safe technique

  • Safe environment
  • Assist with mobility
  • Fall risk reduction
  • Engage patient and family

 

 

 

Tell me what you would do if you witness a patient fall.

 

The priority is to assess the patient by registered nurse while he is still on the floor

 

  • Assess injury, vital sign & mental status  gluco check IF diabetic
  • Determine probable cause of fall (history, physical factors, medications, laboratory values).Inform supervisor &physician immediately
  • Use proper precaution when transferring the patient to bed
  • The physician initiate further DX orders and start management
  • Communicate to all shifts that patient has fallen and is at risk to fall.
  • complete falling down incident report should be completed and send to quality office within 72 hours
  • Detailed progress and NSG note

 

 

 

 

 

Tell me, what do you know about infection control?

Upon joining the hospital, we have orientation programs that include:

 

  • 5 moments for hand hygiene
  • Standard & transmission based precautions
  • Other specific infection control polices

 

Tell me, how do you prevent the spread of diseases in your hospital?

 

  • 5moments for hand hygiene
  • Practice of Standard Precautions for all patients
  • Practice of Transmission based precautions
    • Appropriate use of PPE
    • Staff Vaccination

 

Tell me, what do you do when you are required to assist a procedure for an infectious patient?

 

  • We will practice the Standard Precaution
    • 5 moment for hand hygiene
    • Gloves: Contact with blood and body fluid secretions excretions, and contaminated items, mucous membranes and non-intact skin.
    • Surgical mask, Eye protection with Goggles:
  • When performing procedures that are likely to generate aerosols and/or droplets/splashes of blood/body fluids e.g. suctioning,
  • bronchoscopy, chest physiotherapy, etc.
    • Eye protection with Goggles must be worn when placing a catheter or injecting material in the spinal or epidural space.
    • Apron/Gown: When clothing is likely to be soiled with blood/body fluids.

 

Tell me, how do you   know that the negative pressure room is working?

 

  • Ensure the exhaust fan switched on.
  • Check negative pressure gauge range
  • Test with a piece of tissue paper: Place tissue paper at the gap
  • at the base of the door. Tissue paper will be drawn into the room if it is working.

 

What would you do if you were pricked by a used needle or had a blood/body fluid exposure?

 

  • Do first aid by washing the puncture site or affected area with soap under running water.
  • Inform supervisor, to do risk assessments.
  • Ensure source patient’s blood is taken (If source patient is known).
  • Refer to infection control
  • Seek medical attention

 

 

Tell me, what happens if you witness a blood or body fluid spill?

 

  • اقل من 100 اخلاء الموقع تبليغ عامل النظافه و حصر الانسكاب و تجميع النفايات بكيس اصفر.من ثم التعقيم بالكلور و كتابة  حادث عرضي.

 

  • أكثر من 100 إخلاء الموقع , تبليغ المقسم Green Code ارتداء عامل النظافه معدات الوقايه, حصر الانسكاب و تجميع النفايات بكيس اصفر.من ثم التعقيم بالكلور و كتابة  حادث عرضي.

 

 

 

 

 

Tell me, how do you know that the items are good to be used?

Check expiry dates & packaging integrity before use.

 

 

 

Tell me how you know about your job scope?

 

We have a   job description and it is shared with us upon appointment or if revised.

 

Tell me how the hospital prepares you to perform the work you are doing?

 

We will go through orientation   program for new employees by HR, nursing hospital and unit-based orientation program

 

Tell me who need to be BLS certified and how frequent it is being done?

 

  • All health team required to have a valid BLS certification.
  • Recertification every 2 years are required to have a valid BLS certification.

 

How do you receive ongoing development for your skills and clinical knowledge?

 

Attend department/ nursing in-services requirement sessions

 

 

How do you ensure that the staff clinical  knowledge and skills are consistent with patient needs?

 

كيف تتاكد من مهارات الموظف لتقديم الرعاية التمريضية ؟

 

  • يتم تقيم الاداء خلال الفترة التجريبية
  • يتم تقييم ال competency  كل 6 أشهر.

 

 

 

 

Does nursing staff participate in the hospital’s quality improvement activities?

 

Yes       EX…………….

 

Do you receive education or training about your roles in providing a safe and effective patient care facility?

 

Yes, we received training on our roles in the hospital programs for :

  • Fire safety
  • Security
  • Hazardous materials
  • Emergency
  • Medical equipment
  • Utility system

 

 

Where can you get the data of quality ?Do you know where to find it?

 

  • Quality indicators including falls, medication errors, pressureulcers are provided from the Quality department.
  • Other Quality Data e.g. Hand Hygiene data can be found in thesystem.

 

 

What do you do when your department has not met the target set?

 

If data did not show improvement, explain why and what is being done to address the issues identified.

  • We perform analysis (if RCA is used, can show).
  • Implement targeted interventions to address the issues using the PDSA cycle and action plans.

.

 

What is  your last quality project?.

 

 

 

 

How do you identify the trainees and medicalstudents from thedoctors?

 

All medical students will wear their white coat and schoolNametag for identification at clinical areas. And all supervisors supply with student name.

 

 

How do you know what are the procedures that the residents are allow to do?

 

List of doctors privileged to perform procedures can befound in hospital system.

 

 

Tell me what are your High Alert medications?

 

 

 

 

 

 

What are look-alike sound alike medications?

 

  • There is a list of medication sound alike medications e.g. ADREnaline& NORadrenaline; hydrOXYzinehydr ALAzinThere is a list of look-alike medication e.g. Haloperidol inj & Bromhexinelnj

 

  • Action for Product Look alike: Place drugs apart, where possible andHighlight look-alike drugs using labels.
  • The list is found on the hospital system. SoundAlike and Look Alike Drugs.

 

Do you have a process for finding out what current Medications a newly admitted patient is taking?

 

Medication Reconciliation is carried out upon admission

 

Do you allow patients to use their own medications?

 

Yes, if medication is not available in the hospital. The medication must be identifiable by:

  • Proper labeling
  • Not expired
  • In good condition
  • Pharmacist should check that the drug and dose are correct.
  • The Doctor/ Nurse should indicate in the medication sheet “patient’s own

 

 

Do you allow patients to self-a administer medications?“.

 

Self-administration of medication is not allowed.

All medications are administered in the presence of the nurse

 

Do you accept verbal orders / Telephone orders?

 

Verbal / telephone medications orders are not accepted except emergency

Situation where delay in administration of medication will result in unfavorable outcome.

 

Do you prepare IV medications in this unit? Where do you prepare it? Show me.

 

  • IV medications are prepared on the medication trolley in the preparation room using aseptic technique.
  • Remove any items not required from preparation area
  • Disinfect preparation area with alcohol wipes
  • Perform hand hygiene
  • Reconstitute IV medications using aseptic technique
  • Perform hand hygiene before patient contact
  • After preparation, medications should be labeled with name of medication, dosage/concentration, date prepared, and patient’s name and administered immediately.

 

 

Do you keep Multi-dose medication? ..What is your policy on Multi-dose medication?

 

Multi-dose medication, e.g. Insulin Multi-dose via ls once opened need to be dated with “open date” and “discard date”. E.g. Insulin, discard period is ——-weeks once opened.

 

What is a medication error?

 

A medication error is A preventable event that may occur at any step of the medication use process (ordering, transcribing, dispensing, administrating

and monitoring). It may lead to inappropriate use or jeopardize patient safety.

 

What is a near miss?

 

A ‘near miss’ is an event or a situation that could have resulted inharm but did not, either by chance or through timely intervention.

 

 

What do you do when there is a medication error?

 

  • Patient1s vital signs will be monitored
  • The doctor will be informed immediately.
  • The nursing officer will be informedIncident

 

 

Tell me the procedures that require written consent?

 

  • Surgery
  • Anesthesia
  • Use of blood and blood products
  • Other high risk procedures and treatments e.g.  Chemotherapy, radiotherapy, biopsy, sedation.

 

 

What do you do if the patient does speak foreign language?

 

  • يوجد قائمه على الsystem ب|أسماء الاشخاص الذين  لديهم قدرةعلى التخاطب باللغات الاخرى.
  • يمكن  طلب المساعده من مركز اللغات  في الجامعه الاردنيه.

 

Tell me the validity of the consent.

 

Valid 30 days for procedure.

For blood transfusion for each order.

 

 

Tell me, what would you do in the event of fire?

 

  • Rescue all people in immediate danger
  • Activate fire alarm with breakglass .
  • Contain fire by closing doors
  • Extinguish fire with appropriate extinguisher if safe (Race and pass).

 

 

Tell me what do you do when faced with ethical dilemmas when caring for patients?

 

Hospital Clinical Ethics Committee is available for consultation

 

 

 

Tell me about the care you provided to your vulnerable groups of Patients

 

The vulnerable elderly -limit transfer to reduce disorientation; assessment and management should include maintaining fluid balance; pain management; pressure ulcer risk management ;falls and immobility; .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tell me, how do you protect patient’s confidential information?

 

According to our policy:

  • Do not disclose, whether directly or indirectly, patient’s

Information to any unauthorized   persons.

  • Do not leave records unattended in open areas.
  • Unattended computers are logged off.
  • Where possible, computer screens are displayed such that theyare not readily viewed by passers-by.

 

 

Tell me what happens when a patient request for their medical records?

 

  • Patients can request for their medical records. Copiesof Lab and X-ray reports may be released upon patient’s request.
  • It is not the usual practice of the hospital to release entireMedical records to patients.

 

 

How do you ensure only authorized person enters thepatient’s record?

 

  • Only authorized persons are allowed in the Anyone without badge ID will be questioned & identity will be verified.
  • Access to electronic clinical information systems is via unique user
  • Sharing of individual user IDs and passwords is prohibited.
  • Unattended computers are logged off.

 

Are you able to access all the files of the patient?

 

  • Individuals are authorized to gain access to patient’s clinicalrecords based on need and defined by job title and function.

 

 

 

How do you protect patient’s confidential Information?

 

  • Do not disclose, whether directly or indirectly, patient’sinformation to any UN authorized persons.
  • Do not leave records unattended in open areas.
  • Unattended computers are logged off.

 

 

How is the use of abbreviations being monitored?

 

  • The hospital has a list of approved abbreviation which isavailable on hospital system.
  • The use of non-approved abbreviations will be picked up duringmedical record audits.

 

 

 

Tell me how do you conduct patient’s &family’s education?

 

We identified learning: barriers, needs, and willingness to learn and preferred learning method

 

 

How do you conduct PFE for patients who are uncommunicative?

 

  • Identify and educate alternate learner (family). Assess alternatelearner’s learning barrier, need and preferred method.

 

How could you ensure safety to the patient who has just receive IV sedation?

 

  • Before procedure:

– There must be an informed consent taken

– Ensure patient is fasted.

 

  • During &post procedure,

– Monitored by qualified clinician or nurse

– There is continuous monitoring of ECG, pulse rate and oxygen saturation.

– Chart blood pressure, pulse every 5 min intervals.

– Check level of sedation at 5 minutes interval whenever, depending on the procedure, clinical condition and level of sedation.

 

 

Tell me, when do you. Know the patient is ready discharge criteria

 

  • If the sedated patient had received a reversal agent or agents, i.e.Flumazenil and/or Naloxone, the patient must be monitored for

at least 30mins after the time of administration of the reversal agent .

  • Dr must review and document the patient’s condition at the point of discharge.
  • The nurse may discharge the patient when authorized by the

According to discharge criteria of conscious sedation:

  • Aldert  score 8 and above.
  • Stable hemodynamic: Blood pressure and pulse rate within 20%baseline
  • Reversal of sedation: Patient is awake or back to baseline.
  • Dr Order is written.
  • No S&S that jeopardize patient safety

 

What is the process for patients who request to go for home leave?

 

  • The patient’s consultant or registrar confirms approval anddocuments in patient’s notes.
    • Home leave should end by   10 pm on the same day.
  • Home leave starts only after the patient is seen by the Dr at the morning ward round.
  • The patient/next-of-kin is advised on patient safety and careissues and time of return prior to home leave.
  • Patient is advised to return immediately if unwell and ward’scontact number is given.
  • If medication is required during the period of the home leave,medication is supplied to patient.

 

 

 

Do you have a policy on the use of restraint?

 

  • Physical restraints are only used with specific indications, suchas risk for self-harm, or risk of pulling out essential medical devices.
  • This order needs to be evaluated every 24 hours.
  • A new ordermust be written and reason/s for restraint must be indicated.
  • الربطه  slip knot  fasten the restrain to the bed frame not to the side rails .
  • During the period of restraint, the patient’s behavior, comfort, circulation and skin integrity will be monitored every 1hour.

 

 

Tell me, what do you check for when patients admitted to your ward?

 

  • Preliminary data
  • Assessing Nutrition
  • Assess vision
  • Assess Hearing
  • Neurological and mental assess
  • Assess mouth, throat, and nose.
  • Respiratory assessment
  • Cardiovascular system Assessment
  • Gastrointestinal assessment
  • Genitourinary /reproductive system
  • Musculoskeletal activities& functional./ Morase Scale
  • Assessing Nutrition
  • Skin assessment/ Braden
  • Pain assessment
  • Psychosocial / spiritual assessment
  • Obstetric assessment
  • Pediatric assessment
  • observe the care giver- or parents-child interaction and to participate in early detection of health problems and prevention of future difficulties
  • Neonatal assessment (The first checks by Apgar score, physical exam completed by the physician.
  • Psychiatric assessment.  (Patient body posture, dress, grooming and age appropriateness of appearance,Nurse should observe the rate, amount, style and tone of speech use during interview.
  • Screening for a history of current and past abuse is essential at the initial visits regardless of the presence or absence of abuse indicators,.
  • Screening for vulnerable population is essential to identify the population at risks, provide safety and to develop applicable polices and procedures’ or plan of care.

 

 

 

 

Do you assess patients for pain?

  • Pain assessment is done,
  • Upon admission
  • At least once per shift
  • After procedures.
  • Reassess after analgesia..
  • Upon transfer.
  • Upon discharge

 

 

How determine patient need end of life care, and what is the care?

Or

Tell me what are some of your initiatives for patients at end of life care?

 

 

 

 

 

 

 

 

 

When we do handover?

  • Shift to shift ——–by using ISBARformat + daily nursing flow sheet + medication endorsement

بعد ذلك يتم مراجهة ال nurses note  و عمل جوله على المرضى للتأكد من general condition  للمريض

 و تفقد ال drain  catheter و الحواجز السريريه و  الثلاجه و الجرس

 

  • From ER by telephone handover + emergency clinical note
  • Transfer by using SBAR form-
  • When pt move to DX procedures

الاشعه—— xray request

الجهاز الهضمي——عن طريق الملف  الطبي

القسطره——– الملف الطبي+ cardiac catheter request

غسيل الكلى——- الملف الطبي

Echo, EEG, physiotherapyوالطب النووي ——-proceidure request

 

  • من التخدير الى غرفة الانعاش.
  • بعد ال CPR
  • عند اخذ الممرضbrake

 

 

ما معنى ISBAR

 

I   identify pt name and nurse name المسلم و المستلم

S situation (state problem)

B back ground (risk for pu, fall, last operation, radiology, frequency of vital sign

A assess what happen in my shift and what is the intervention

R recommendation to next shift

 

 

Medication and isbar handover kept one month

 

متى نعمل assessment for fall 

  • Admission
  • In physiotherapy department

 

 

متى نعمل Reassess

 

  • Change pt condition
  • After transfer
  • After operation-proceidure
  • Adding medication
  • After falling

 

What is the falling risk prevention strategy?

 

  • If pt low risk——–safe technique——–
  1. safe environmentبريك السرير و الكرسي المتحرك الاضاءه جيده

الجرس قريب من المريض الارض جافه – طريق المريض خاليه من اي عوائق

  1. assist ptالجرس و الهاتف قريب من المريض
  2. fall reduction السرير منخفض وحذاء المريض مناسب
  3. Engage pt and family in health education

و هناك نشرات تثقيفيه

 

  • If pt moderate and high risk

Safe technique + colored risk band + colored card+ الحواجز السريريه

و مسؤولية الجميع حماية المريض من السقوط و هناك

Monthly environmental check + weekly checklist

 

 

What is post fall management?

 

  • تقييم المريض و هو على الارض
  • اخذ ال V/S  , GC,
  • كتابة حادث عرضي

 

What is the UN intended consequences of measure take to reduce risk for fall

 

التأثير النفسي عند وضع الحاجز كأنه محبوس/ الحواجز السريريه ربما تأذي الاطفال غند تقلبهم في اللسرير

اذا تم استخدام ال wrist restrain ربما يكون هناك احمرار في رسغ اليد

 

 

متى يتم التعرف على المريض؟

 

  • عند الدخول
  • عند عمل assessment
  • عند اجراء  عمل للمريض سحب دم/ قسطره
  • عند اعطاء الدواء
  • عند فتح ملف للمريض

 

  • اذا من الصعب وضع اسواره تعريفيه باليد توضع عى الكاحل
  • في حال جاء مريض على الطوارئ في حالة غيبوبه و لم يكن معه مرافق يعرف على انه مجهول 1 او مجهول 2 مع تسجيل وقت الوصول /الجنس/العمر تقريباالذي يعرف المريض او مقارنة صوره شخصيه للمريض
  • بالنسبه للخداج يتم وضع اسوارتان  واحده على ارسغ الايمن و الاخرى على الكاحل الايمن و عليهم نفس الرقم الموجود على اسوارة الام
  • لمريض المتوفي توضع label على جبين المريض و اخرى على ال cover

 

ما هي ال Post Mortem Care 

 

  • عمل flat ECG لمدة دقيقه
  • التوثيق السليم/وقت الوفاه
  • اخبار الاهل خلال ساعه
  • يجب ازالة كل ال invasive line ما عدا في حالة ال medico legal cases
  • حصر ممتلكات المريض مع وجود شاهد
  • المحافظه على الخصوصيه و خاصة عند نقل المتوفي
  • ممكن الاستعانه بال social worker

 

في حال ملاحظة ال Physical Assault / Abuse/ Neglect

 

يجب اخبار الطب الشرعي—–الباحثه الاجتماعيه—-، و التوثيق في الملف

 

ما هو مقياس الالم المستخدم في المستشفى

 

  • مقياس الألم الرقمي: يستخدم للمريض الواعي من عمر 7 سنوات فما فوق .
  • مقياس الألم (FLACC). ويستخدم للأطفال من سن شهر – 3 سنوات أو في أي من الأحوال التي لا يستطيع فيها المريض التعبير عن الألم مثل المرضى المضطربين عقلياً
  • مقياس شدة الألم باستخدام تعابير الوجه المختلفة (FACES Scale)ويستخدم للأطفال من عمر 3-7 سنوات.
  • مقياس الألم (CPOT) (Critical Care Pain Observational Tool):وهو مقياس سلوكي ويستخدم في وحدات العناية الحثيثة للمرضى الغير واعيين المستخدمين أو الغير مستخدمين لأنبوب التنفس الإصطناعي .حيث يتم تقييم ما يلي:
  • تعابير الوجه ،حركة الجسم، مستوى توتر العضلات ( تقييم مدى المقاومة خلال ثني ومد أطراف المريض)
  • نبرة الصوت أو مدى المقاومة لجهاز التنفس الاصطناعي
  • يتم تقييم المريض في حالة الراحة ويكتب حرف (rest )Rوفي حين قياس الألم في حالات اخرى يتم تحديدها (suction،dressing ،…. specific procedure)
  • Neonatal infant pain Scale (NIPS)) مقياس الالم: هو مقياس للألم يستخدم للأطفال حديثي الولادة ويستخدم في قسم الخداج

 

متى يم اعادة تقييم الالم؟

 

  • بعد 10-15 دقيقة من إعطاء دواء علاج الألم عن طريق الوريد.
  • بعد 30 دقيقة من إعطاء دواء علاج الألم عن طريق العضل أو تحت الجلد.
  • بعد 60 دقيقة من إعطاء دواء علاج الألم عن طريق الفم.
  • كل ساعتين إذا كان المريض يأخذ علاج الألم المستمر (Continuous Pain Medication Infusion)
  • مرة واحدة في الوردية الواحدة إذا كان المريض لا يشكو من الألم
  • بعد أي عملية نقل للمريض داخل المستشفى
  • بعد أي إجراء طبي علاجي أو تشخيصي مؤلم للمريض.

 

What are the six rights?

 

Six Rights: Right patient, right medication, right dose, right time, right route and right documentation

 

 

 

 

 

When you do skin assessment .

 

Upon admission and Reassess skin every shift

 

When you do Reassessment of BRADEN score

 

  • Upon transfer to another unit
  • Upon with change in patient condition e.g. post general anesthesia operative, post fracture, decrease level of consciousness

 

 

 

 

Give example of medical device pressure ulcer?

  • Nasogastric tubes
  • Feeding tubes
  • Endotracheal tubes
  • Tracheostomy tubes/collars/straps
  • Oxygen delivery (Mask, Nasal cannula )
  • IV/Central lines
  • Anti-Embolic stockings
  • Foley catheters/condom catheters.
  • Restraints
  • Bedpans
  • Abdominal binders
  • Identification bands
  • Orthopedic(Casts, Cervical collars, Back braces )

 

 

What is pre operation care?

 

  • Patient assess
  • Write order
  • Check lap test
  • Consent form(anesthesia, operation)
  • PFE

 

What is the pre op care at time of request?

 

  • Identify pt
  • Pre op checklist
  • Send pt file/medication sheet/ x ray/ old file

 

What is the post op care?

 

  • Endorse pt according to checklist
  • Position pt comfortable in bed
  • Assess level of consciousness
  • Check op site/ iv access/ v/s/ pain/fall prevention/
  • implement doctor order
  • Observe  s & s of bleeding
  • Deep breathing exercise
  • Maintain antiembolic therapy
  • Diet as order

 

 

What you do when you receive unit of blood?

 

  • Obtain patient baseline data.
  • Check the accurate collection of pre transfusion blood samples for typing and cross
  • Verify that an order for transfusion exists.
  • Confirm that the patient has given informed consent.
  • Teach the patient about the procedure and document this in PFT paper include: (associated risks and benefits, what to expect during the transfusion, sign and symptoms of a reaction, and when and how to call for assistance.)
  • Check for an appropriate and patent vascular access.
  • Make sure necessary equipment is at hand for administering the blood product and managing a reaction.
  • Receive blood product from transporter and check transfusion form, the time that blood product leave blood bank, and unit color or any abnormal appearance.
  • Double check the correct blood component for correct patient by nurse and physician on duty and document that on transfusion form.
  • Make sure the blood is left at room temperature not more than 30 minbefore start transfusion from the time that leave blood bank.
  • Transfusion should be started by a physician and a nurse
  • Identify patient by use patient name or file number, and ask patient about he/she name if it possible.

 

What is the frequency of vital sign during blood transfusion?

Vital Sign every 15 min in the first hour and every 30 min for the remaining time.

 

What you do if suspect transfusion reaction?

  1. stop transfusion
  2. Keep I.V line open with N/S 0.9 solution.
  3. Notify the physician on duty.
  4. Notify the blood bank technician (Blood bank No. in JUH 2626).
  5. Notify the nursing supervisor.
  6. Intervene for sign and symptoms as appropriate.
  7. Monitor the patient V/S.
  8. Take blood and urine sample if necessary.
  9. Sent the remaining of unit to the blood bank with incident report explain what happened.
  10. Document your note on nursing note paper.

 

 

 

What type of reaction?

 

Signs and Symptoms Type of reaction
· Classic triad of fever and chills, flank pain, and reddish or brown urine.

· Tachycardia and hypotension leading to shock, cardiopulmonary arrest, and death.

Acute hemolytic reaction

· Onset: within minutes to 24 hours of transfusion.

· Mild fever.

· Jaundice.

· Decreased post transfusion hematocrit.

· Elevated lactate dehydrogenase and serum billirubin levels.

Delayed hemolytic reaction

 

· Fever.

· Chills.

· Flushing

· Nausea

· Headache

· Vague discomfort

Febrile non hemolytic reaction

Onset: within minutes to hours of transfusion.

· Urticaria with or without itching

· Localized edema.

· Flushing

Mild allergic reaction

Onset: immediately or within 24 hours of transfusion.

· Lack of fever.

· Hypotension.

· Stridor.

· Bronchospasm.

· Dyspnea.

· Cramps.

· Flushing.

· Chest tightness.

· Decreased oxygen saturation

Anaphylactic reaction

· May occur in patients with IgA deficiency who have anti-IgA antibodies, causing severe to life-threatening immune response.

· Onset: immediately or within 24 hours after transfusion.

· Sudden onset of respiratory distress during or shortly after transfusion.

· Acute noncardiogenic pulmonary edema, pulmonary infiltrates with hypoxi.

Transfusion Related Acute Lung Injury (TRALI)

 

· Headache.

· High blood pressure.

· Increased pulse rate.

· Dyspnea

· Orthopnea.

· Neck vein distention.

· Nonproductive cough.

· Pedal edema.

· Decreased oxygen saturation.

Transfusion Related Circulatory Overload

· May occur with I.V.infusion of large fluid over relatively short time.

 

 

 

 

 

ما هو الامر الطبي الذي لا يمكن اخذه عن طريق . Verbal telephone order.

 

  • Anti neoplastic agent.
  • High alert medication.

 

 

ما هي المده المسموحه للطبيب لكتابة Verbal telephone order.

 

Within same shift if possible or within 24 hour.

 

 

 عندما يطلب منك احد الاطباء تحضير الادوات لعمل اجراء طبي ماهي الخطوات التي تتبعها لضمان مأمونية الاجراء الطبي  safety procedure  

  • التأكد من ال Privilege.
  • الالتزام بنموذج ال time out .

 

 

 من هو الشخص المخول بالتوقيع على ال consent form.

المريض البالغ العاقل المدرك.

 

 متى يتم اللجوء للوصي الشرعي؟

  • الاطفال.
  • المريض الذي يعاني من غيبوبه/ غير المدرك عقليا.

 

من هو الوصي الشرعي؟

  • الاب/الام.
  • ولي الاب.
  • وصي الجد.
  • المحكمه ( ولي من لا ولي له).

What is the label of MDV should contain?

  • تاريخ الفتح.
  • تاريخ الانتهاء.
  • ظروف التخزين.
  • التركيز الجديد. بعد الحله.

 

ما هي الخطوات اللازم اتباعها عند تحضير اي دواء ؟

Aseptic technique

  1. Ensure that medication trolley is put in a separate and safe environment away from direct patient contact.
  2. Proper hand hygiene with hospital approved soap and water or waterless alcohol-based cleanser is required.
  3. Cleaning the surface of medication trolley and all the trays with quaternary ammonium compound or alcohol.
  4. Medication trolley must contain sharp container, dry cotton, alcohol and all equipments needed for preparation.
  5. Correctly perform all calculations and labeling prior to admixture preparation.
  6. Reconstitute each injectable drug by using (single use) water for injection, or otherwise a (single use) suitable diluents according to drug stability list.

7 – In case of multi dose vials (MDVs) or reconstitution bags the integrity of the stopper should be checked and swabbed with alcohol before each use.

  1. Use new needle and syringe for each medication reconstitution.
  2. After each preparation label the medication.
  3. Store each patient medication in a separate clean and secured drawer.
  4. Put all prepared medications and cotton swab in tray then start for administration.
  5. Injection ports and hubs should be cleaned with alcohol swab before medication dilution or administration.
  6. Put all the used syringes and needles inside the sharp container according to sharp policy.
  7. Proper hand hygiene after touching patient or patient surroundings.

Notes

Wear personal protective equipment when there is potential exposure to blood and body fluids. -1

2- No eating or drinking during medication preparation and administration.

 

إذا رأيت نار صادره من غرفه ماذا تفعل؟

Race.

 

 كيف تستخدم الطفايه؟

Pass.

 

ما نوع الطفايه المستخدمه في حال حريق الملابس, الخشب, الورق.

BCF.

 

ما نوع الطفايه للادوات الكهربائيه.؟

طفاية  co2

 

أين اقرب مخرج في حالة الحريق؟.

 

يجب معرفة ألوان الكود.

 

 ماذا تفعل اذا تعرضت لعنف من الزوار/ المرضى؟

 

ابقى هادئا, اترك مسافة بيني و بينه, اترك الباب مفتوح و اطلب 2222 code white.

 

مسؤولية من التأكد أن الاجهزه تعمل بشكل جيد؟

مسؤولية الجميع.

 

ماذا تفعل اذا تعطل جهاز.

اضع عليه stickers  معطل و اخبر المسؤول.

 

اين تجد المعلومات الخاصه بالمواد الكيميائيه؟.

في ال MSDS.

 

ما هو نوع التدريب الذي حصلت عليه بخصوص ال Environmental  Safety .

  • فرز النفاياتwaste management.
  • Hazardous waste.
  • Infection control.

 

 

يجب معرفة اخر incident report  حصل في القسم.

 

يجب معرفة ال   focus PDCA   التي عملت في القسم؟

 

كيف يتم توزيع مهام العمل؟

حسب حالة المريض, حسب ال severity, و حسب الوصف الوظيفي.

 

كيف نقيس ال customer satisfaction

Patient satisfaction survey.

او عن طريق  .customer interview

 

ما معنى sentinel event .

بأنه أي حدث غير متوقع في بيئة الرعاية الصحية ينتج عنه وفاة أو إصابة جسدية خطيرة للمريض أو المرضى ، لا علاقة لها بالمسار الطبيعي لمرض المريض.

Events has result in in an anticipated death or permanent loss of function..

 

يوجد clinical protocol   موجود على ال system/  ركن الموظفين.…. الرجاء الانتباه

 

 

ما هو دورك في ال  Management  Information..

 

الكتابه بالملف, عدم تركه مفتوح, عدم ترك شاشة الكمبيوتر مفتوحه, التعامل مع المعلومات بسريه, هناك تفويض لشخص من أهل المريض للاطلاع على المعلومات الخاصه بالمريض( ليس كل شخص) , عدم مناقشة المعلومات الخاصه بالمريض في المصعد, او الكفتيريا, و يجب كتابة ال  Date, Time, Nurse Name  و عدم مشاركة الاخرين بال Computer Password.

 

يجب التشيك الثلاجه على الفورم المعتمد و اقفالها.

 

متى يتم فتح عربة الطوارئ؟.

  • بعد ال .
  • دواء انتهى مفعوله ( كل شهر يشيك عليها الصيدلي). و التأكد من الرقم الذي على المفتاح و الذي على الورقه.

 

التأكيد على ان ال guide line  لادوية عربة الطوارئ موجود عليها.

 

يجب الاهتمام بمرضى كبار السن  من حيث ال Assessment .

  • Vision, Hearing, Movement, Cognitive Thought Process, Psychological Social Aspect.
  • ويجب عكسها على ال Nursing Diagnosis

 

متى يتجدد Order  ال Restrain..

كل 24 ساعه

 

ما هي  الامور الواجب تقييمها عند وضع restrain   و كل متى؟..

 

كل ساعه نقييم الاتي :

  • Still Need For Restrain
  • Glasco coma scale
  • Limb loose and exercise
  • Limb Color.
  • Limb temperature
  • Capillary Refill
  • Skin Integrity
  • Change position
  • General condition (ask patient for Toileting need, Hunger, Thirst…)

 

2021-03-19
جميع الحقوق محفوظة 2020©مستشفى الجامعة الأردنية. تصميم وتطوير الممرض القانوني محمود مصلح الجعافرة
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