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PATIENT SAFETY in hospital settings for better patient care
- 2. SPEAKER: Capt Dania James GUIDE: Maj Navneet Kaur
- 3. PATIENT SAFETY AS A HEALTH ISSUE • Patient safety is a serious global public health issue. • There is a 1 in 300 chance of a patient being harmed during health care.
- 4. ETHICAL CONSIDERATIONS • The Pledge of Florence Nightingale • “I will abstain from whatever is deleterious or mischievous, and will not take or knowingly administer any harmful drug.
- 5. DEFINITION Patient safety solutions/practices: • System design or intervention • Ability to prevent or mitigate patient harm • The processes of health care
- 6. GOALS • Improve the accuracy of patient identification. • Improve staff communication. • Improve the safety of medication administration. • Reduce the risk of healthcare associated infection
- 7. GOALS CONTD…
- 8. PATIENT SAFETY SOLUTIONS WHO • Patient identification • Communication during patient hand-over • Performance of correct procedure at correct site • Control of concentrated electrolyte solutions • Assuring medication accuracy at transitions in care
- 9. PATIENT SAFETY SOLUTIONS CONTD.. • Avoiding catheter and tubing mis-connections • Single use of injection devices • Improved hand hygiene to prevent health care- associated infection • Look-Alike, Sound-Alike(LASA) medications
- 11. LASA
- 12. SOUND ALIKE Tab Clotrimazole Tab Co-trimazole LOOK ALIKE Inj. Imipenum Inj. Ceftazidime LASA (CONTD)
- 13. • ERRORS ORDER • INJ DOBUTAMINE Inj Dopamine • SYP DIGOXIN Syp Digene DISPENSING ERRORS
- 14. SUGGESTED ACTIONS • Proper storage of drugs for eg by using colour coding or by using Tall man lettering(Inj DOPAmine & DOBUTAmine) • Store the medication in separate location or in non-alphabatical order • Minimize the use of verbal and telephone order.
- 15. Cont…… • Emphasize the need to carefully read the label each time a medication is accessed and again prior to administration, rather than relying on visual recognition, location or other less specific clues
- 16. TELEPHONIC ORDER Read back and repeat back policy IN EMERGENCY Documentation VERBAL ORDER
- 18. Importance Of Patient Identification Responsibility: All caregivers Three identifiers – Name, Rank, Service no. When to identify: • Providing treatments or procedures eg. medication administration • Before Surgery/ Procedure • Collecting samples • Before Transfusion • Reporting Critical value • Before serving diet Do not use Bed Number
- 19. Patients requiring Special attention • Outpatients • Newborn babies • Unconscious patients • Identification during disaster • Vulnerable patients
- 22. • Handover stamp for patient transfer to diagnostic departments • Discharge handover stamp to capture contents of handover during discharge DISCHARGE /TRANSFER
- 24. • Surgery on the wrong limb or digit • Peripheral nerve block on wrong limb • Extraction of wrong tooth • Kidney removed from wrong side • Operation on wrong eye • POP on wrong leg • Chest tube inserted into wrong side Examples of Wrong Site Procedure
- 25. • Human error eg lack of vigilance • Distractions eg mobiles • Failure of communication • Inexperience, inadequate supervision • Drug reactions, equipment failure • Fatigue, stress, lack of sleep Wrong Site Procedure- Causes
- 28. • Improved communication • Correct patient, site and procedure • Informed consent • Availability of all team members • Adequate team preparation and planning • Confirmation of patient allergies PREVENTIVE MEASURES
- 30. WHO Concentrated electrolyte solution MUST BE DILLUTED Checked by two trained personnel HIGH RISK WARNING
- 33. BEST POSSIBLE MEDICAL HISTORY Updating the list as new order MEDICAL RECONCILIA TION Communicat e to next care provider
- 35. WHO • Emphasize to non-clinical staff, patients, and families that devices should never be connected or disconnected by them. • Trace all lines from their origin to the connection port • Include a standardized line reconciliation process as part of handover communications • Require the labelling of high-risk catheters
- 37. SINGLE USE INJECTION DEVICES
- 38. Are you reusing syringes?
- 39. Safe Injection A safe injection should not harm the patient, expose the health-care worker to any avoidable risks, or result in waste that is dangerous to the community Promote the single use of injection devices . ► Infection control principles,safe injection practices, and sharps waste management.
- 41. Luer Lock/Luer Slip Auto-disable Syringe • Auto-disable syringe: • After use, the needle will be retractable to the barrel and the Plunger will be locked, so it is safety after use. • 1) A protection to health care worker and safety for patient • 2) Guaranteed single use, prevents infection from re-used needles, prevents needle-stick Injuries
- 42. Improved hand hygiene to prevent health care- associated infection
- 43. HAI • Healthcare-associated infections (HAIs)– infections patients can get while receiving medical treatment in a healthcare facility–are a major, yet often preventable, threat to patient safety. • HAIs are both prevalent and costly.
- 44. How To Prevent HAI • Build an Infection Control Committee • Policies to control infection • Bundles of Care • Surveillance • Adopt hand washing policy
- 45. CLEAN HANDS ARE SAFE HANDS….
- 46. 5 Moments
- 48. “…there are some patients we cannot help, there are none we cannot harm...”