Promoting patient safety and improving the quality of patient care
Tag: Dr Frank Overdyk
Of the more than 125 articles we posted in 2014, below are 10 of the most read and most discussed articles on opioid safety (order is by publication date).
As you read through these articles, please ask yourself – has a new standard of care been established requiring continuous electronic monitoring by hospitals of all patients receiving opioids? Continue reading “Top 10 Opioid Safety Articles in 2014”
After a brief pause to talk about the National Coalition to Promote Continuous Monitoring of Patients on Opioids, we are back to our weekly synopsis of patient safety articles and research. Continue reading “Weekly Must Reads in Patient Safety (Nov 21, 2014)”
By Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety), Frank Overdyk, MSEE, MD (Professor of Anesthesiology, Hofstra North Shore-LIJ School of Medicine), Lynn Razzano, RN, MSN, ONCC (Clinical Nurse Consultant, Physician-Patient Alliance for Health & Safety), Kenneth P. Rothfield, MD, MBA (Chairman of the Department of Anesthesiology at Ascension Health’s Saint Agnes Hospital, Baltimore; Adjunct Associate Professor of Nursing at the University of Maryland; soon assuming role of System Chief Medical Officer, St. Vincent’s Healthcare)
When medical tragedies occur, one of the very first questions asked by patients, families, the legal system, the press, and the public is: “were appropriate care standards met?” Continue reading “Medical standards of care and the Joan Rivers death”
Good news and bad news.
Yes, there have been other things going on in healthcare other than Ebola-mania … thanks @sacbee_news for this illustration putting Ebola in perspective:
The Good News
First, we’ll start with the good news, because most people love a celebration. Continue reading “Weekly Must Reads in Patient Safety (Oct 31, 2014)”
by Sean Power and Michael Wong
Alarm fatigue and nuisance alarms put patient safety at risk. The Joint Commission’s Sentinel Event Alert on alarm safety states that between 85 percent and 99 percent of alarm signals do not require clinical intervention — and these nuisance alarms desensitize clinicians. Continue reading “For Improving Patient Safety and Reducing Nuisance Alarms, Evidence Points to Revising Default Settings”
by Sean Power
The recent death of Helen Bousquet after what is being described by her son, Brian Evans, as “a basic routine procedure” at a hospital 40 minutes north of Boston highlights the need for better monitoring of patients after surgery. Mr. Evans is accusing the hospital of criminal negligence, according to an exclusive interview with Valley Patriot, as a result of how his mother’s visit to the hospital was handled by staff. Continue reading “Woman’s Death After Knee Surgery Calls Attention to Need for Better Monitoring”
by Sean Power
The Physician-Patient Alliance for Health & Safety presented at the International Anesthesia Research Society’s Annual Meeting in San Diego, California to discuss the latest advances in research and best practices in anesthesia clinical care. For a handout version of the poster presentation, please click here.
In its August 2012 Sentinel Event Alert, The Joint Commission warned: Continue reading “PPAHS Presents PCA Safety Checklist at IARS Annual Meeting”
by Michael Wong
(This article is reprinted with the permission of Patient Safety & Quality Healthcare (PSQH).)
This is the question that I have been asking myself ever since Centers for Medicare & Medicaid Services (CMS) recently announced proposed quality measures it is considering for adoption through rule making for the Medicare program. Continue reading “Does CMS Proposed Measure for PCA Safety Go Far Enough?”
PCA-related device events are three times as likely to result in injury or death. As Tim Ritter (Senior Patient Safety Analyst, Pennsylvania Patient Safety Authority) reminds us, “Over the six-year period from June 2004 to May 2010, data collected by Pennsylvania Patient Safety Authority revealed that there were approximately 4,500 reports associated with PCA pumps. Moreover, U.S. Food and Drug Administration’s (FDA) Manufacturer and User Device Experience (MAUDE) database demonstrates that PCA-related device events are three times as likely to result in injury or death as reports of device events involving general-purpose infusion pumps.” Continue reading “10 Reminders to Ensure Safer Use of Patient-Controlled Analgesia”
(These are excerpts of the poster presentation made at the recent annual meeting of the American Society of Anesthesiologists. It is reprinted with permission.)
Introduction
Preventable deaths in hospitals remain a major public health hazard worldwide. Analysis of registries for cardiopulmonary arrests (CPA) identified missed vital signs and symptoms of decompensation and spurred the development of RRT and MET teams. Although widely adopted, their impact on overall hospital morbidity and mortality remains unclear.
‘Alarm fatigue’, where poor ergonomics, integration and response to alarms on medical devices desensitizes providers to alarms was identified by the ECRI as the top health technology hazard for 2012, causing 500+ preventable deaths . The FDA, JC, AAMI, and ACCE have joined forces to remedy this patient safety hazard. Continue reading “Respiratory Depression: The Common Fatal Pathway for “Non Fatal” Conditions”