The Risk of Workarounds
In April, Patient Safety and Quality Healthcare published an article summarizing a recent webinar presented through ourCenter for Safety and Clinical Excellence. The article is titled “Smart Pump Workarounds – What’s the Legal Risk?”, and it focuses on personal accountability on the part of caregivers in safely operating Smart IV pumps.
Caregiver accountability has been a hot topic in recent months. As it relates to IV medication safety, it’s a critical issue and worth paying attention to. It’s been shown that clinicians often implement process workarounds, including not utilizing the drug library, overriding soft dose and concentration alerts, reprogramming infusions as rate in ml/hr following hard limits, and occasionally removing IV tubing from pumps and delivering medication boluses by gravity to avoid a high dose alert.
Study Shows Nurses Exposed to Risks During Insertion and Removal of Peripheral IV Catheter
Sandy, Utah—About one in two nurses experience blood exposure, other than from a needlestick, on their skin or in their eyes, nose or mouth at least once a month when inserting a peripheral intravenous (IV) catheter, according to a new study by the International Healthcare Worker Safety Center at the University of Virginia.[1] Exposure to blood carries the risk of infection from pathogens such as human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV) and MRSA.
Northwest Michigan Surgery Center Selects RTLS from Versus
Traverse City, Michigan—Michigan’s largest surgery center, Northwest Michigan Surgery Center recently selected the Versus Advantages™ Real-time Locating System (RTLS) to help improve the patient care experience. Key focus areas include relaying patient status information to families in the waiting room and automated process flow management for clinical staff.
Wander-Risk Patients: Best Practices for Hospitals and Assisted-Living Facilities
Wander-Risk Patients: Best Practices for Hospitals and Assisted-Living Facilities
Older adults and senior citizens with Alzheimer’s disease and other forms of dementia are at elevated risk of wandering away from their medical care facility, which poses unique challenges for the hospitals and specialized care facilities that house these patients. Wandering puts them in harm’s way; they could fall, get into an accident, become a crime victim, or suffer from exposure to the elements.
AED Failures Connected to Deaths from Cardiac Arrest
Aug. 30, 2011—A study published online last week in Annals of Emergency Medicine reports that more than 1,000 cardiac arrest deaths over 15 years were connected to the failure of automated external defibrillators (AEDs); battery failure accounted for almost one-quarter of the failures.
Best Doctors Tackling High Misdiagnosis Rate in Cancer Cases
Boston, Massachusetts, June 2, 2011 – Best Doctors, the global company dedicated to helping people and their treating doctors get the right diagnosis and right treatment, announced it is tackling a record number of cancer cases this year, including numerous cases that were initially misdiagnosed.
St. Joseph Health System Focuses on Delivering Perfect Care with New Technology to Mitigate Risk and Improve Patient Safety
Orange, California, April 30, 2011—St. Joseph Health System, a $4.6 billion healthcare system headquartered in Orange, California, announced a partnership with RF Surgical Systems, the market leader in the prevention and detection of retained surgical sponges.
Doctors Talk Openly about Medical Errors in When Healthcare Hurts
AAMC Announces “Best Practices for Better Care” Campaign
ISMP: Oops, Sorry, Wrong Patient!
ISMP
Oops, Sorry, Wrong Patient!
Applying the JCAHO “two-identifier” rule beyond the patient’s room
When we think of “wrong patient” errors, the most common scenario that comes to mind is a nurse walking into a patient’s room and administering medications intended for one patient to another patient — often a roommate. However, “wrong patient” errors occur in a variety of ways.