ED management : the monthly update on emergency department management
-
Unsafe injection practices with respect to the misuse and unsafe use of vials is being targeted by The Joint Commission (TJC). The accrediting agency has issued a Sentinel Event Alert, putting hospitals on notice that they need to take strong steps to insure that health care workers fully understand and are carrying out practices that protect patients from the dangers of vial misuse. ⋯ Experts suggest vial misuse is often due to a lack of understanding of how to apply safe injection practices. To make improvements, experts recommend that hospital administrators first take steps to observe what is happening in their care environments, and then develop targeted action plans.
-
A dramatic improvement in door-to-balloon times for STEMI patients is one example of how John Dempsey Hospital at the University of Connecticut Health Center in Farmington, CT, is using checklists and other tools for standardization to improve safety and care. The hospital is part of a three-year statewide initiative of the Connecticut Hospital Association to adopt high-reliability practices and eliminate errors that cause patient harm. The approach is enabling hospitals to learn from each other and share best practices that facilitate improvement. ⋯ The hospital now holds daily safety huddles to keep the staff focused on a patient-first approach. Administrators also distribute weekly and monthly publications to keep staff apprised about safety events, success stories, and the latest data. To reduce patient harm, more than 3,000 staff members will undergo training on high-reliability techniques.
-
A new analysis of data gleaned from the 2011 Medication Safety Self-Assessment for Hospitals shows that while hospitals have made great strides in adopting safe medication practices since the survey was first used in 2000, there is still considerable room for improvement, particularly in areas related to patient information, staff competency and education, and drug information. More than 1,300 hospitals voluntarily submitted data for latest survey, which was developed by the Institute for Safe Medication Practices (ISMP). ⋯ The authors of the new report stress that ED administrators and providers should take the lead in adopting many of the recommended safe medication practices. Going forward, the ISMP recommends that hospitals adopt specific technology enhancements, make full use of clinical pharmacists, appoint chief medication safety officers to oversee improvement efforts, and move to strengthen training and competency on medication safety.
-
A cadre of prominent medical groups, including the ACEP, ENA, AGS, and SAEM, has unveiled a comprehensive set of Geriatric Emergency Department Guidelines to aid hospitals that are either in the process of opening senior-focused EDs or revamping their policies and procedures to better meet the needs of an aging population. The guidelines offer recommendations related to staffing, infrastructure, education, and transition-of-care strategies. In addition, they outline a host of screenings that studies have shown are beneficial for older adults. ⋯ Guideline authors state that the guidelines take an evidence-based approach to managing senior patients. While more cost and outcomes data are needed, experts say that senior-focused improvements to emergency care can reduce admissions and return visits to the ED while also boosting patient satisfaction. Future efforts will focus on prioritizing the guideline recommendations so that ED administrators concerned with improving senior care will tackle the most important changes first.