What’s New in the Patient Safety World
April 2013
AHRQ Recommended Patient Safety Practices
AHRQ (the Agency for Healthcare Research and Quality) has updated its list of strategies to improve patient safety that are supported by research and clinical evidence (AHRQ 2013).
Ten of the
strategies identified are "strongly encouraged" for adoption based on
the strength and quality of evidence:
1.
Preoperative
checklists and anesthesia checklists to prevent operative and postoperative
events.
2.
Bundles that
include checklists to prevent central line-associated bloodstream infections.
3.
Interventions
to reduce urinary catheter use, including catheter reminders, stop orders, or
nurse-initiated removal protocols.
4.
Bundles that
include head-of-bed elevation, sedation vacations, oral care with chlorhexidine,
and subglottic-suctioning endotracheal tubes to prevent ventilator-associated
pneumonia.
5.
Hand hygiene.
6.
"Do Not
Use" list for hazardous abbreviations.
7.
Multicomponent
interventions to reduce pressure ulcers.
8.
Barrier
precautions to prevent healthcare-associated infections.
9.
Use of
real-time ultrasound for central line placement.
10.
Interventions
to improve prophylaxis for venous thromboembolisms.
Twelve other strategies
are "encouraged" for adoption based on a slightly lesser strength and
quality of evidence:
1.
Multicomponent
interventions to reduce falls.
2.
Use of clinical
pharmacists to reduce adverse drug events.
3.
Documentation
of patient preferences for life-sustaining treatment.
4.
Use of informed
consent to improve patients' understanding of the potential risks of
procedures.
5.
Team training.
6.
Medication
reconciliation
7.
Practices to
reduce radiation exposure from fluoroscopy and computed tomography scans.
8.
Use of surgical
outcome measurements and report cards, such as the American College of Surgeons
National Surgical Quality Improvement Program.
9.
Rapid response
systems
10.
Utilization of
complementary methods for detecting adverse events/medical errors to monitor
for patient safety problems.
11.
Computerized
provider order entry.
12.
Use of
simulation exercises in patient safety efforts.
Summaries of several
of the recommended practices and the evidence behind them are available in a
special supplement
to the Annals of Internal Medicine. Others will appear in an upcoming issue
of BMJ Quality and Safety.
References:
AHRQ. Making Health Care Safer II. An Updated Critical Analysis of the Evidence for Patient Safety Practices. March 2013
http://www.ahrq.gov/research/findings/evidence-based-reports/makinghcsafer.html
Making Health Care Safer: A Critical Review of Evidence Supporting Strategies to Improve Patient Safety. Annals of Internal Medicine 2013; 5 March 2013; 158(5 Part 2): 365-440
http://annals.org/issue.aspx?journalid=90&issueid=926462
Print “PDF
version”
http://www.patientsafetysolutions.com/