Ensuring safety of patients, visitors and staff in hospital premises is the responsibility of the hospital management. However, these three groups are required to have an awareness of their roles and responsibilities to ensure a safe environment.
At the end of this lecture participants will be review the following:
Improving safety of high alert medications at AFHSR IPSG3
Storage, handling of concentrated electrolytes & Error prevention strategies at AFHSR IPSG 3.1
AFHSR Look Alike_Sound Alike medication management IPSG3.1.1
Correct-site, Correct-procedure, Correct-patient Surgery IPSG-004
Safety Facility Management
Protecting the safety of our employees and the environment is a core value within Facilities Management. We will not be satisfied until our workplaces are safe from hazards, our employees are injury-free, our services are safe, and our commitment and record of protecting the environment are unmatched.
The engineer's secrets for prevention of hospital acquired infectionsLallu Joseph
Engineering controls to be put in place in hospitals to prevent hospital acquired infections- HAI
Areas covered- Hand Hygiene Infrastructure, Reprocessing, Environmental Controls, Isolation Rooms, Operating Rooms, CSSD, Emergency Rooms, ICRA,
I performed a presentation to the board of directors in Labib Medical Center on the Early Warning Score with a view to introducing this tool which has been standardised across centers in the UK. The evidence states that this tool reduces mortality and morbidity rates and also reduces admissions into Intensive Care Unit.
An Orientation to quality and patient safety for new hire in health care faci...kiran
An introduction to quality and patient safety for new employees in health care with basic concepts on quality and patient safety that every new hire must know.
At the end of this lecture participants will be review the following:
Improving safety of high alert medications at AFHSR IPSG3
Storage, handling of concentrated electrolytes & Error prevention strategies at AFHSR IPSG 3.1
AFHSR Look Alike_Sound Alike medication management IPSG3.1.1
Correct-site, Correct-procedure, Correct-patient Surgery IPSG-004
Safety Facility Management
Protecting the safety of our employees and the environment is a core value within Facilities Management. We will not be satisfied until our workplaces are safe from hazards, our employees are injury-free, our services are safe, and our commitment and record of protecting the environment are unmatched.
The engineer's secrets for prevention of hospital acquired infectionsLallu Joseph
Engineering controls to be put in place in hospitals to prevent hospital acquired infections- HAI
Areas covered- Hand Hygiene Infrastructure, Reprocessing, Environmental Controls, Isolation Rooms, Operating Rooms, CSSD, Emergency Rooms, ICRA,
I performed a presentation to the board of directors in Labib Medical Center on the Early Warning Score with a view to introducing this tool which has been standardised across centers in the UK. The evidence states that this tool reduces mortality and morbidity rates and also reduces admissions into Intensive Care Unit.
An Orientation to quality and patient safety for new hire in health care faci...kiran
An introduction to quality and patient safety for new employees in health care with basic concepts on quality and patient safety that every new hire must know.
PATIENT AND STAFF SAFETY MANAGEMENT.pptxanjalatchi
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
PATIENT AND STAFF SAFETY MANAGEMENT.pptxanjalatchi
What is Patient Safety? Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
International Patient Safety Goals (IPSG)Monika Kanwar
International Patient Safety Goals (IPSG) were developed in 2006 by Joint Commission International (JCI). It helps accredited organizations address specific areas of concern in some of the most problematic areas of patient safety.
Chapter 13 Risk Management in PsychiatryPsychiatri.docxketurahhazelhurst
Chapter 13: Risk Management in
Psychiatry
Psychiatric Care
• Healthcare and treatment of persons with
acute and/or chronic mental illness
• Provided in various types of healthcare
settings
– Specialty facilities
– Special unit in a hospital
– Ambulatory centers
– Private offices
Informed Consent
• Psychiatric patients have the right to select
their treatment (as do all patient) unless
deemed incompetent.
• For the patient to be considered
competent to consent to treatment, they
must be able to:
– Communicate a choice
– Understand information about the treatment
– Recognize the clinical situation
– Manipulate information rationally
Informed Consent and Research
• Research guidelines must adhere to the general
informed consent requirements
• The National Bioethics Advisory Commission
issued a report entitled “Ethical and Policy Issues
in Research Involving Human Participants” which
outlines basic principles for research studies
• The Office for Human Research is another
resource for guidelines on obtaining consent,
especially for children
Right to Treatment
• Right to the Least Restrictive Alternative
• Closure of Psychiatric Facilities
• Involuntary Outpatient Treatment
• Medical Necessity
• Insurance Coverage
• Psychiatric Advanced Directives (PAD)
Right to Refuse Treatment
All patients have the right to refuse
treatment, even patients with mental illness.
• Psychotropic Medications
• Involuntary Hospitalization
• Involuntary Outpatient Treatment
Clinical Risks
• Psychopharmacology and Side Effects
• Electroconvulsive Therapy
• Suicide
• Discharge and Aftercare Planning
• Seclusion and Restraint
• Elopement and Wandering
• Child and Adolescent Psychiatry
Confidentiality and Stigma
• Public view of mental illness
• Privileged Communication
• Duty to Protect/Warn
High Risk Incidents
• Violence and Mental Illness
• Violence in the Institution
• Availability of Illicit Substances
• Professional Sexual Misconduct
• Staff-Patient Sexual Misconduct
Other Areas of Concern
• Fraud and Abuse
• Public Safety
• Noncompliance with treatment regimen
Summary
• Patients with mental illness have the same
rights as all patients unless deemed
incompetent.
• There are additional risk management
concerns involved in treating patients with
mental illness.
Chapter 12: Risk management for
Infection Control Programs
Goal of Infection Control
• To prevent the transmission of infections to
patients, visitors and healthcare personnel
• In the United States, infection control
programs are required by various agencies:
– OSHA
– CMS
– TJC
– State and Local Depts. of Health
Infection Control Program
A formalize infection control program includes
• Procedures for determining the risk of
transmission of infectious agents
• Enforcement or procedures
• Protocols to manage the risk
The organization’s leadership is responsible for
implementing these programs ...
Things to ensure and check off the list before a patient is shifted to the OR for surgery. The responsibility rests mainly with the resident doctor and the registered nurse to ensure complete preoperative preparation of the patient.
Safe transfer of patients is of utmost priority to minimize unwanted complications. Patients, especially the critical ones experience some amount of physical stress during the process of transfer which may result in the stress being manifested in altering one or more physical markers or parameters
Medication errors are a major concern in the healthcare fraternity. Although unintended, medication errors continue to happen everyday resulting in patient harm.
Basics of nursing initial assessment needed to be done when a patient is received in the department. Done by the registered nurse, initial assessment is the basis on which further care is planned.
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Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
2. Why is Safety of importance?
• A hospital is a people- intensive place
• Provides services round the clock
• Free access to enter at any time
• Hospital atmosphere is one full of emotions of
excitement, life, happiness, death, sorrow
• A hospital operated under continuous strain. It
gives rise to irritation, confrontation, conflicts
and aggression
7. Current scenario
• Repeated errors and system failures
• Action on known risks very slow
• Detection system in its infancy
• Many events not reported
• Understanding of causes is limited
• Limited measurement of impact
• Blame culture alive
• Defensiveness and secrecy
8. Medical errors
• One in 10 patients is harmed while receiving hospital care
https://www.who.int/features/factfiles/patient_safety/en/
• Upto 10 in 100 admitted patients contract HAI
• Unsafe care is likely one of the 10 leading causes of death and
disability across the world
• Nearly 5.2 million witness harm due to medical errors every
year in India
• More than 1 mn. patients die annually from surgery
complications
10. Why do errors happen?
• In most cases it is not wilful negligence but systemic
flaws, inadequate communication, wide – spread
process variation and ignorance
11. Types of Errors
• Adverse health care event – during clinical
care and causing physical or psychological
injury to the patient
• Error – use of incorrect plan of action
• Near miss – an event that might have resulted
in harm
• Medication errors
• Sentinel errors – unexpected events that
result in death or serious physical or
psychological injury
13. Patient Safety Goals
• Improve accuracy of patient identification
• Improve the effectiveness of communication
among caregivers
• Improve safety of using medication
• Reduce risk of HAIs
14. • Reduce risk of patient harm resulting from
falls
• Special emphasis on dangerous abbreviations,
infection control, LASA medication, time outs
15. Medication Safety
• Medication orders should be written legibly and
should include:
a) Patient name
b) Medicine generic name
c) Dosage, frequency and route of administration
d) Name and signature of physician, and
e) Date and time the order was written. i.e. SNDT
format and in ALL CAPITALS
16. • Any abbreviations used in medication orders
should be agreed upon and jointly adopted by
the medical, nursing, pharmacy and medical
records staff
17. ... Cont’d Medication Safety
• Before dispensing the drug, the pharmacist
must receive the physician’s original order or a
direct copy of the order (except in emergency
situations)
• To check at least 2 patient identifiers before
administering medication; Patient name and
Medical Record Number
18. ... Cont’d Medication Safety
• Discourage telephonic orders. Do not accept
verbal orders
19. Surgical Safety
• Consent of patient/ relative in writing
• Proper identification of patient with name,
wrist band
• Proper identification mark of parts to be
operated
20. Cont’d.. SURGICAL SAFETY
• Pre – anaesthetic check up
• Anaesthetic safety
• Ensure no foreign body left inside
• Safety measures when transferring patients
• Prevention of surgical wound infections
• Use of surgical safety checklist
21. Environment safety
• Adequate light
• Adequate ventilation
• Stairs with hand rails
• Slip preventing floors
• Fire extinguishers and
alarms
22. Cont’d... Environment Safety
• Prevent noise pollution
• Heavy and fixed bed
• Safety belt on
wheelchairs and trolleys
• No water logging in
bathrooms
• Call bell system for all
patients
• Adequate screens for
patient privacy
23. Installation Hazards
• Regular checking of equipment
• Proper earthing to avoid shocks
• Regular maintenance and repair
• Training of nurses and technical staff
24. When to report?
• When you think a device has or may have
caused or contributed to the following
outcome for patient, staff member or visitor
1. Close calls or other potential harms
2. Minor injury
3. Serious injury
4. Death
25. Your role
• Identify actual and potential problems,
adverse events and close calls with medical
services
• Report the problem or adverse event to your
supervisor according to policy and procedure
• Make sure your report includes details
• Remove the device, keep all affected items
26. Electrical safety
• Safety fuses with each equipment
• No loose wires or connection
• Properly plugged and fixed
• Electricity backup battery/ generator
• If short circuits happen, inform immediately
27. Fire safety
• Use fire proof material
• Fire exits, fire extinguishers, fire hydrants in all
buildings
• Smoke detectors and water sprinklers on all
floors
• Fire drills
28. Blood safety
• Proper grouping and cross matching
• Test HIV, hepatitis and VDRL
• Proper labelling
• Control of mismatch reaction
• Screening against HIV, hepatitis, VD, malaria
• Inform and report adverse reactions
29. Infection control
• Proper disposal, segregation, transportation
and disposal of BMW
• Sanitation of different parts of the hospital
• Use of sterile procedures
• Safety in use of autoclave, needle destroyers
30. cont’d... Infection Control
• Formation of hospital infection control committee
• Investigation of all hospital infections
• Use of proper antibiotics in right doses given at the
right time
• Reorientation of RMOs and nurses
31. Laboratory safety
• Carefulness to avoid needle prick and blood
spill
• Regular pest control measures
• Care in handling acids, reagents, inflammables
Editor's Notes
Every error has a root cause, every cause has a solution. One unintentional error-miss, repeated error-crime. Error can be prevented with one’s initiative in the system
For new devices, have safety inspection, compatibility, education and keep manual and appropriate purchasing documents. When in doubt, have certified equipment (CE) check. Incident reporting
