By Lynn Razzano, RN, MSN, ONCC (Clinical Nurse Consultant, Physician-Patient Alliance for Health & Safety) and Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)
The ECRI Institute recently released its Top Ten Technology for 2014. At the top of this list – alarm hazards. Although ECRI acknowledges that patient monitors are undoubtedly beneficial, ECRI says that the frequency of alarms can be detrimental: Continue reading “PCA Survey Indicates Response to ECRI Institute 2014 Top Ten Safety Technology Hazards and The Joint Commission’s National Patient Safety Goals for 2014”
by Sean Power
When The Joint Commission released its Sentinel Event Alert 50 on medical device alarm safety in hospitals it produced an infographic about the issue. The infographic summarizes the scope of the problem, shares data about reported alarm safety events, and offers recommendations to address the issue. The ECRI Institute also has a poster on alarm safety with recommendations for improving alarm management.
Let’s take a look at both resources. Continue reading “Two Resources on Alarm Safety from The Joint Commission and the ECRI Institute”
In Willow Grove, PA, 17-year old Mariah Edwards went into a surgical center to remove her tonsils and died.
ABC News recently reported that the outpatient tonsillectomy was a success. Following the procedure she was moved to a recovery room. In the lawsuit filed on behalf of the Edwards family, it provides that nurses administered a dose of the painkiller fentanyl, a potent, synthetic narcotic analgesic with a rapid onset and short duration of action. Continue reading “Recent Death of 17-Year Old From Unmonitored Tonsillectomy Should Never Have Happened”
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”
Editor’s note – This article, “Three Tips For Decreasing Alarm Fatigue” is reprinted with the permission of Internal Medicine News and Hospitalist News, which publishes “news and views that matter to physicians”.
by Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)
When patient monitor alarms sound too many times, this can discourage using the very monitors that are intended to keep patients safe and inform clinicians of a patient’s physiological state. However, research shows that using “smart alarm” technology and getting smart about alarm monitors can reduce clinically insignificant alarms. Continue reading “Three Tips For Decreasing Alarm Fatigue”
This article is reprinted with the permission of Patient Safety & Quality Healthcare (PSQH). Improving patient safety is one of the most urgent issues facing healthcare today. PSQH is written for and by people who are involved directly in improving patient safety and the quality of care.
According to ECRI Institute, an independent, nonprofit organization that researches the best approaches to improving the safety, quality, and cost-effectiveness of patient care, alarm hazards are the number-one health technology hazard for 2013. Continue reading “Four Technology Recommendations to Reduce Alarm Fatigue”
By Michael Wong
(This article has also been published in SurgiStrategies, which can be read here.)
According to its newly-updated, “How-to Guide: Prevent Harm from High-Alert Medication”, the Institute for Healthcare Improvement (IHI) looked at high-alert medications, which are “more likely than other medications to be associated with harm”.
One of the areas that the IHI singles out is narcotics. Continue reading “Monitoring Technology for PCA Pumps Can Prevent Adverse Events with Patient-Controlled Analgesia (PCA): So Why Are Hospitals Not Using It?”