Boston physicians are leading an initiative that could eliminate errors and improve patient-centered care.
Española, N.M. – For years, this town has withstood a torrent of opioid-related deaths, and now claims one of the highest rates of opioid overdoses in the country.
Problem: Neuromuscular blocking agents are high-alert medications because of their well-documented history of causing catastrophic injuries or death when used in error. These drugs are used during tracheal intubation, during surgery of intubated patients, and to facilitate mechanical ventilation of critically ill patients.
A new study finds programs that appeal to the competitive spirit of physicians are effective in getting them to reduce their incidence of prescribing unnecessary antibiotics.
In October 2015, McKay-Dee Hospital in Utah revealed that as many as 4,800 people had been potentially exposed to hepatitis C (HCV) after a state investigation linked the same hepatitis genotype from a patient treated at the hospital to a nurse who was caught diverting drugs in 2014.
Drug monitoring laws are on the rise, but their effectiveness in curbing the prescribed use of hydromorphone, oxycodone, and other narcotics for pain is unclear.
Partially Filled Vials and Syringes in Sharps Containers Are Key Sources of Problems By the Institute for Safe Medication Practices A 36-year-old hospital care aide (nursing assistant) who had been diverting discarded drugs died after self-administering what she likely thought might be an opioid but was actually a neuromuscular blocking agent (Fayerman, 2016a-c). The aide … Continued
A study published in the Journal of the American Medical Association (JAMA) found that approximately 30% of antibiotic prescriptions written in the outpatient setting were inappropriate. Researchers found that several common conditions contributed to the majority of inappropriate antibiotic prescribing. Forty-four percent of outpatient antibiotic prescriptions were written to treat acute respiratory conditions, sinus infections, … Continued
By Patricia McGaffigan, RN, MS; Caitlin Y. Lorincz, MS, MA; and Tejal K. Gandhi, MD, MPH, CPPS
The availability of, and access to effective and safe treatments for pain remain serious problems in the United States (Institute of Medicine, 2011). Opioid medications are important for addressing short-term and chronic pain management. Given the benefits that they provide, usage of opioids has become widespread over the past decade. However, opioid medications also carry substantial risk, and their increased usage has introduced a host of unintended consequences across the care continuum. Given this, opioids have significant implications for patient safety. The National Patient Safety Foundation (NPSF) conducted a convenience flash poll survey to obtain a snapshot of opioid-related patient safety concerns, learning needs, and familiarity with existing seminal publications among healthcare professionals.
Medication errors in the perioperative area received widespread media attention with the publication of an article in the journal Anesthesiology (Nanji, Patel, Shaikh, Seger, and Bates, 2016). The perioperative area is one of the most medication-intensive locations in a hospital, often with more medications, particularly high-alert medications, administered per patient than other patient care units. Yet, this area of the hospital often operates with fewer medication safety strategies in place than most other patient care units. For example, the anesthesia provider often selects, prepares, labels, and administers medications without the benefit of electronic clinical decision support, pharmacy review of medication orders prior to administration, barcode scanning of products prior to administration, and other secondary checks by other healthcare providers (Nanji et al., 2016; Brown, 2014). This lack of normal checks and balances, along with the use of multiple medications, time-sensitive tasks, complex and stressful working conditions, distractions, and fatigue all contribute to making the perioperative area particularly error-prone when medications are administered.