Goal (5) reduce the risk of health care–associated infections .
Goal (6) reduce the risk of patient harm resulting from falls .
Freedom from accidental injury ,ensuring the establishment of operational systems and processes that minimize the likelihood of errors so they won’t occur:
A SAFETY CULTURE WORKSHOP
Is an atmosphere of mutual trust in which all staff?
Members can talk freely about safety problems and how to solve them ---without fear of blame or punishment .
1- Develop a patient safety committee.
2- Integrate the patient safety-related efforts within a coordinating council.
3- Assign one person to coordinate patient safety various areas.
4- Expand the scope of current committee responsibilities and accountability to include patient safety.
1- Not knowing the plan.
2- Communication issues.
4- Missing information.
5- Lack of resources.
6- Failure to plan, recognize and rescue others?
1- Support teamwork and respect others.
2- Educate staff.
3- Engage physicians.
4-Share lessons learned.
5- Encourage use of communicating.
6- Assign 1 (one) or 2 (two) clinical staff members.
7-Take a proactive approach to error.
8-Study and learn from near misses.
9- Search for information about how to do things safely.
10-Provide team training to a culture of safety.
11- Encourage patient and family involvement in the care process.
12- Share information about safety with others.
Psychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. A shared sense of psychological safety is a critical input to an effective learning system.
A patient safety committee is a multidisciplinary team that takes a proactive approach to patient safety; It provides coordination and oversight to advance an organizations safety program and implement safety-related policies and procedures .
The patient safety committee coordinate the following:
1- The risk management.
2- The environmental safety.
3- The infection control.
4- & the quality improvement.
The patient safety committee manage risk in the organization by performing the safety care processes.
1- Should standardize the definitions and categorize medical errors.
2- Establish or enhance an error, near miss reporting mechanism.
3-Identify data collection plan, reporting structure, as well as performing scheduling.
Standardized &categorize medical errors Identify data collection plan& reporting structure Establish an error-near miss reporting mechanism Patient safety plan
The leadership is to build an environment that recognize the importance of safety.
1- Create & maintain a culture of safety.
2- Encourage decision making.
3- Implement patient safety program throughout the organization.
4- Ensure that the processes are designed well, using available information from internal or external sources about potential risks to patient and successful practices
Monitor patient safety and redesign high-risk processes to prevent a sentinel event from occurring.
An inpatient received 2 (two) unit of the incorrect type of blood at the time. The patient’s blood was drawn for a type/cross match, the sample was mislabeled with another patient's name. The transfusion was given to the patient whose name appeared on the type/cross match lab report, not the patient whose blood was in the lab specimen vial.
Poorly designed system for labeling laboratory specimen.
If this problem continuing uncorrected, for sure it could caused anther incidence that lead to a blind end.
1- Gather the facts.
2- Choose team.
3- Determine sequence of events.
4- Identify contributing factors.
5- Select root causes.
6- Develop corrective actions.
7- & Follow-up plan.
LIBRARY CONNECTIONS & ADVOCACY
How is Your Library
Involved in Patient Safety
(or how will it be)?
With literature searches in Training, Education & in the telling stories; participation creating & sharing information through alert services; supporting & institutional resources & needs. Creating & Sharing Information for patient education on the website information pages:
Student Curriculum development
CME/ requirements assistance
Including patient safety when focusing on computer skills,
During orientation classes and introductions
On-line tutorials and resources preparation
In reference services, with patients and families, health professionals
On Patient Safety committees, teams and boards
Attending related M&Ms, councils, committees and meetings