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Patient Safety Tips

Patient safety is a pressing issue in hospitals, with medical error being one of the leading causes of death and injury in the United States—causing as many as 44,000 to 98,000 deaths per year in hospitals, according to a recent report by the Institute of Medicine. Practitioners can take the following ten steps to improve patient safety in the hospital.

  1. Accurately identify patients.
    • Use at least two patient identifiers, particularly when administering medications or blood products, taking blood samples and other specimens for clinical testing, or providing any other treatments or procedures.
    • Never use the patient’s room number as an identifier.

  2. Use effective communication among caregivers.
    • When conveying verbal or telephone orders and critical test results, verify the complete information by having the person receiving the information repeat it for you.
    • Be timely in reporting test results and values to caregivers.
    • To encourage effective communications, it helps to standardize a procedure for passing along communications, which includes the opportunity to ask and respond to questions.Additionally, hospitals should assist staff in preventing miscommunication by keeping a standardized list of abbreviations, acronyms, and symbols that should not be used because they can be misinterpreted.

  3. Safely administer medication.
    • Use medications and medication containers that are labeled, including syringes and medicine cups.
    • Review the drugs used by the hospital that look alike or have similar-sounding names to prevent confusion.

  4. Prevent infections.
    • Simply following recommendations for proper hand hygiene, hospital staff can put a stop to outbreaks, reduce the transmission of antimicrobial resistant organisms, and lower overall infection rates in the hospital. For best practices in hand hygiene, use the hand hygiene guidelines from the Centers for Disease Control and Prevention.

  5. Document medications across the continuum of care.
    • Ensure the hospital receives an up-to-date list of the patient’s current medications upon the patient’s admission. Accuracy and completeness are critical. If the patient is transferred, this list should be reconciled with any changes in medication received at the hospital and passed along to the new setting with the patient.

  6. Periodically assess the patient’s risk of falling.
    • Assess and regularly reassess a patient's risk for falling. Some predictors include: mobility issues, cognitive impairment, confusion, attached equipment, and medication regime. Hypnotics, sedatives, analgesics, psychotropics, antihypertensives, laxatives and diuretics are associated with the risk of falling. Take action to address any identified risks through physical measures, psychological measures, and environmental measures, such as exercise, pain management, orientations to the surroundings, bed adaptations and side rails. Also, alert the patient, family and staff of the falling risk.

  7. Eliminate the risk of wrong-site, wrong-patient, wrong-procedure surgery.
    • Create and use a protocol that verifies the site, patient, and procedure beforehand. The protocol should include confirmation of key documents, such as medical records. Also, involve the patient in a process to mark the surgical site in preparation for the surgery. View the universal protocol provided by The Joint Commission.

  8. Address the risk of influenza and pneumococcal disease in older adults.
    • It can take more than generating awareness that vaccines are available to adequately protect older adults.
    • Develop a protocol for administrating the flu vaccine and pneumococcus vaccine in older adults that includes a process for documentation. The Center for Disease Control and Prevention provides some recommended strategies for increasing adult vaccinations from its Web site.

  9. Encourage the active involvement of patients and their families in their health care.
    • Spend time explaining information about a patient’s medical condition and procedures. Importantly, schedule time to ask and respond to any questions the patient or family members may have. Patients play an important role in their own health. Families can be equally important to educate because of the medical care and emotional support they give the patient outside the hospital.

  10. Discuss with the patient how they can report concerns about safety and encourage them to do so.
    • Always encourage patients to speak up if they have questions or concerns. For example, a patient should speak up if they experience reactions after receiving medication at the hospital. The Joint Commission sponsors the Speak UpTM initiative to educate patients on the importance of raising a voice. Posting the brochures and poster are reminders and displays of support for the patient taking a role in their healthcare.
Practitioners can take action for patient safety by paying attention to these key areas identified by the National Patient Safety Goals. For more information, consult The Joint Commission which provides National Patient Safety Goals that instruct hospitals on critical areas and solutions that can prevent medical errors from occurring.