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Pme lecture 2012presentationpart3

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The document discusses recommendations to prevent accidental heparin overdoses in neonates after an incident where 3 neonates died from overdoses. It recommends eliminating high concentration heparin vials, requiring independent double checks of drugs, and reducing similar drug packaging. Unintended medication discrepancies are common at hospital admission and accurate medication histories are important. National patient safety goals include reconciling medications, reducing infections, and falls.

Health & MedicineBusiness
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2012 Patient Safety Goals ,[object Object],[object Object],[object Object],[object Object]
Case Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Unintended Medication Discrepancies at the Time of Hospital Admission 6% Severe harm potential 61% No harm potential 33% Moderate harm potential More than half of patient have  1 unintended medication discrepancy at hospital admission Reference: http://www.ahrq.gov
Unintended Medication Discrepancies at the Time of Hospital Admission ,[object Object],Reference: http://www.ahrq.gov
2012 National Patient Safety Goals ,[object Object]
2012 National Patient Safety Goals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Centers for Disease Control (CDC) Report ,[object Object],http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6008a4.htm?s_cid=mm6008a4_w
TEST YOUR KNOWLEDGE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Answers on next slide
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Urinary tract infections, all are risk factors
Definitions-CDC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guideline for Hand Hygiene in Health-care Settings. MMWR 2002 ; vol. 51, no. RR-16.
Indications for Hand Hygiene-CDC ,[object Object],[object Object],Guideline for Hand Hygiene in Health-care Settings. MMWR 2002 ; vol. 51, no. RR-16.
Specific Indications for Hand Hygiene ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guideline for Hand Hygiene in Health-care Settings. MMWR 2002 ; vol. 51, no. RR-16.
Recommended Hand Hygiene Technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guideline for Hand Hygiene in Health-care Settings. MMWR 2002 ; vol. 51, no. RR-16.
Additional Safety Concerns ,[object Object]
Falls in the Elderly ,[object Object],[object Object],[object Object]
Fall Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fall Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Meds Requiring Fall Alert ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fall Assessment-High Risk ,[object Object],[object Object],[object Object],[object Object],[object Object]
Interventions- Initiate Safety Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Additional Safety Concerns ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2012 Patient Safety Goals ,[object Object],[object Object],[object Object],[object Object],[object Object]
High Risk Patient Populations ,[object Object],[object Object],[object Object],[object Object]
Case Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Reference: http://www.ahrq.gov
Case Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Happened? ,[object Object],[object Object],[object Object],[object Object]
Interventions For High Risk Patients ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychiatric Patients ,[object Object],[object Object],[object Object]
2012 Patient Safety Goal ,[object Object],[object Object],[object Object],[object Object]
Patient Safety Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patient/Family ,[object Object],[object Object],[object Object],[object Object],[object Object]
Available Resources for Patient Education include ,[object Object],[object Object],[object Object],[object Object]
TEAM WORK IS THE KEY

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Pme lecture 2012presentationpart3

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  • 4. Unintended Medication Discrepancies at the Time of Hospital Admission 6% Severe harm potential 61% No harm potential 33% Moderate harm potential More than half of patient have  1 unintended medication discrepancy at hospital admission Reference: http://www.ahrq.gov
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  • 36. TEAM WORK IS THE KEY

Editor's Notes

  1. Hand hygiene is a general term that applies to either handwashing, antiseptic handwash, alcohol-based handrub, or surgical hand hygiene/antisepsis. Handwashing refers to washing hands with plain soap and water. Handwashing with soap and water remains a sensible strategy for hand hygiene in non-healthcare settings and is recommended by CDC and other experts. Antiseptic handwash refers to washing hands with water and soap or other detergents containing an antiseptic agent. Alcohol-based handrub refers to the alcohol-containing preparation applied to the hands to reduce the number of viable microorganisms. Surgical hand hygiene/antisepsis refers to an antiseptic handwash or antiseptic handrub performed preoperatively by surgical personnel to eliminate transient and reduce resident hand flora. Antiseptic detergent preparations often have persistent antimicrobial activity.
  2. Healthcare workers should wash hands with soap and water when hands are visibly dirty, contaminated or soiled and use an alcohol-based handrub when hands are not visibly soiled to reduce bacterial counts.
  3. Hand hygiene is indicated before: patient contact, donning gloves when inserting a central venous catheter (CVC), and inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don ’t require surgery. Hand hygiene is also indicated after contact with a patient ’s intact skin, contact with body fluids or excretions, non-intact skin, or wound dressings, and after removing gloves. Gloves should be used when a HCW has contact with blood or other body fluids in accordance with universal precautions.
  4. These recommendations will improve hand hygiene practices of HCWs and reduce transmission of pathogenic microorganisms to patients and personnel in healthcare settings. When decontaminating hands with an alcohol-based handrub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry. When washing hands with soap and water, wet hands first with water, apply the amount of soap recommended by the manufacturer, and rub hands together for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water, dry thoroughly with a disposable towel, and use the towel to turn off the faucet.