Health devices
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One of the U. S. National Patient Safety Goals promulgated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is to "improve the safety of using infusion pumps" by ensuring that pumps are protected against free-flow. ⋯ For more than 20 years--in numerous articles presented in Health Devices and its sister publication Health Devices Alerts--ECRI has offered guidance to help hospitals avoid the dangers of free-flow. The current article is the latest in a series of reports addressing JCAHO's goal; it describes the dangers, provides updated guidance for interpreting JCAHO's goal, and categorizes the available pump models according to the level of free-flow protection offered. This report supersedes Health Devices Alerts Special Reports S0008 (August 23, 2002), S0018 (March 21, 2003), and S0029 (November 14, 2003).
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Portable ventilators are often used with patients who require long-term breathing support. Current-generation models are compact and lightweight and offer some of the same features that once were available only on costly intensive care ventilators. As technological advances continue to prolong life for critically ill patients and make life possible for both children and adults with otherwise fatal conditions, portable ventilators are helping to make these patients more comfortable and more mobile. ⋯ The third unit is Not Recommended because of significant drawbacks associated with its ease of use, alarms, and portability. For in-hospital transport, we rate one unit Preferred because it has many features beneficial for transporting critically ill patients. A second unit is Acceptable, while the third is Not Recommended, again because of its many drawbacks.
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For 2005, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is no longer including alarm safety among its National Patient Safety Goals. JCAHO states that it has taken this action to keep the list of 2005 goals manageable. ECRI believes that removing the goal sends the wrong message to hospitals.
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In our January 2004 Guidance Article "Alarm-Enhancement Systems for Ventilators," we discussed several categories of ventilator alarm enhancements that communicate ventilator alarms to locations where they are more likely to be detected by caregivers. One of these options is interfacing ventilators with networked physiologic monitors. ⋯ While such interfaces can offer considerable advantages, our testing has also revealed some problems. These problems are not severe enough to rule out the monitoring-interface option, but they are significant, and hospitals need to be aware of them.