This action might not be possible to undo. Are you sure you want to continue?
Patient Safety – Start up:
“Patient safety” the new mantra is now revealing out its structure as a major component to be concentrated by the health care providers. Patient Safety that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. Lack of patient safety – the silent killer having its impact more than any other disease or traffic accidents and it is holding a record of leading position in maintaining highest mortality in the world. Lack of patient safety is not a non- curable, it is preventable. WHO realized this and initiated “World Alliance for Patient Safety”, was launched in October 2005 at WHO Headquarters, as an outcome of the 55th World Health Assembly resolution on patient safety. India followed the WHO and started WHOGlobal Patient Safety Challenge” in India by launching the National Initiative on Patient Safety (NIPS) and it was launched by the Honourable Health Minister Shri. Ghulam Nabi Azad on September 14th, 2009. Even the Honourable Health Minister has expressed regarding the lack of data regarding patient safety in the Indian Scenario and also announced to place National Patient Safety Policy and expressed interest in including Patient Safety concepts in Medical education. Now the question is Whether the Patient safety is –a new initiative or a part of routine medical activity. Histories are revealing that 100 B.C. Charuka, Sushruta like medical professionals in India as well as all over the world has followed strict policies in patient safety and they have prioritised patient safety is the key component of medical practice. In the long run we have only lost it, but it is not too late that we have now recognized that is the major component to be followed. Not only as a special initiative, it is the basic component that each patient expects when they are entering the hospital. It is also the responsibility of health care professionals to deliver that without any compromise in it.
Patient Safety – Initiative:
Patient safety, the safety of the patient has to start from the entry gate of the hospital and till their exit. It is also not a responsibility of an individual in a health care system; it is the part of the whole. As we have missed out patient safety in long run and we want to build it back, as it cant be back in one day and not as wholesome. We have to start it from smaller level and make it to bigger. Even the initiative of patient safety has to start in all the levels of hierarchy (i.e.) top level to lower level. Common factors in Patient safety:
Policy formulation & Review
Information and technology safety
Medical treatment Safety
Surgical related safety
Infrastructure Safety: Infrastructure plays major role in improving patient safety. Infrastructure should be constructed in a matter that it will ready to face hazards without making any human loss. Fulfilling a commitment to safe and high-quality care will not be possible without significant investment in patient safety infrastructure. Even improving the existing infrastructure by holistic integration of all systems within the building technology infrastructure – heating, ventilation, climate, cooling, energy generation, emergency power and energy distribution, access control, video surveillance, fire detection, alarming, evacuation and extinguishing. In addition, further building technology systems such as lifts and escalators, water technology systems, laboratory and medical technology systems as well as monitoring of information and communication systems can be integrated. It will help the health care providers in ensuring the quality as well as safety to the infrastructure as well as to the patients. Information and technology safety: In concern to health care, most of the time errors are due to poor communication of information or error in communication. From registration patient information has to be entered correctly. Even small factor has big impact in treatment procedures. For ex, instead of 54 years it is entered as 45 while typing, the impact has a lot of deviation in determining mortality factor while computing APACHE (Acute Physiology and Chronic Health evaluation) tool in ICU. Communication has to be considered as a key issue in medical errors as the transformation of information from Doctors to nurses in medications, from lab to doctor in results, from diet dept. to patient in food ordering etc. Patient also should cooperate in this information scenario, as they can get clarification about their treatment procedures if they have any doubt, provide right information about their health conditions, expressing allergies in medicines, already consuming medicines etc. It will help the doctor to prescribe the right combination of medicine along with already consuming medicines. Technological errors has to be avoided by conducting periodical calibration and testing of critical care equipments, evaluating the result of the
equipments in comparing with 3 or 4 hospitals nearby as a process of counter checking, following quality assurance principles in testing systems etc. In concern to computers, ensuring the proper functioning of HIS (Hospital Information System), monitoring and reporting system. It will help us to track the operational system error and help us to eradicate it. Periodical evaluation of total information system and technology system help us to upgrade and to eliminate medical errors permanently. Medical treatment safety: Medical treatment safety starts from patient registration itself. In patient registration most common error will occur when patient data are directly entered by the computer operator by getting oral information from patients. Key information in patient registration is name, age, sex, address etc. Error can start when there is a wrong entry from the above. It is important that patient information to be filled by patient only through patient registration form. It is important that computer operator has to type correctly and it is counter checked before issuing file to the patient. In Doctor Consultation and treatment procedure, patient has to provide correct information like history, medicines consuming, previous diagnostics reports etc. From doctor’s point of view, doctor has to assess the patient completely before concluding and also it is mandatory to check allergic conditions before prescribing medicines. In diagnostic medical treatment, it is mandatory to provide right report to the right patient. It is the responsibilities of the respective diagnostic department to ensure and also counter check twice before issuing the report. It is also the responsibility of the doctor to give guidelines to their patients to contact him / her during any complications developing during treatment course. Medical treatment safety check list has to be prepared and maintained by respective patient relative coordinators of the respective OPD to ensure smooth and safety functioning of the system. Medical treatment safety check list includes: (i) (ii) Correctness of patient details Correctness of consulting Doctor details
Correctness of information delivery provided by patient (History, treatment availed, medicines consuming etc.) as well as doctor. (Treatment procedure, medication prescribed, communication in crisis etc.)
Correctness of reports from diagnostics etc.
Social worker of the hospital can guide the patient in medical and other health care related issues to achieve the safety as well as support in ensuring quality health care delivery. Surgical related safety: Surgical safety is the major component to be concentrated to control the mortality due to lack of patient safety. Surgical safety of the patient has to start from Inpatient rooms itself before shifting patient to OT for starting pre surgical / anesthetic procedures. For this surgical safety, all the hospitals can use the surgical safety tool provided by WHO. Tool enclosed. Nursing Safety:
Nurse’s main responsibility is to provide safe and effective care within constantly evolving health care systems. Nurses are the only set of employees interacting with one another, doctors, aides and technicians and finally to patients to provide holistic care to patients. Even nurses are the staffs spending most of the time with patients and monitoring their care continuously. In general medication, to avoid the errors nurses should, take steps to accurately identify the correct patient to receive medication before administering it. take steps to accurately identify the correct medication to be received before administering it to the patient.
take steps to accurately identify the correct dosage of medication before administering it to the patient. take steps to accurately identify the correct route the patient is to receive the medication before administering it. take steps to administer medication in a timely fashion as ordered by the physician. take steps to accurately document the medication administration after administering it.
In concern to surgical procedure also nurses should be proactive in guiding the doctors and ensuring the correctness of materials used before and after surgery. Nurses should take specialized care in monitoring and documenting the activities of surgical care patient every 30 minutes once to identify any complication or difficulties faced by the patients. Nurses should develop strong communication system to all the patient centric people (i.e.) Doctors, Diagnostics, Imaging and all the supportive systems. It will help them to get immediate access in crisis. Errors can be avoided by following standards procedures, monitoring the system continuously, counter checking and documenting of all the activities in patient cycle (i.e. from admission of patient till discharge). Nurses should communicate with patient periodically about the care they are providing to the patient and it will help them to counter check the action plan. Check list for each procedure has to be developed, monitored and controlled by quality department to ensure the safety of the patient. Medication Safety: Medication errors can be controlled by ensuring that the right medicine in right dosage is given to right patient in the right time through right route. Requirement of clear understanding from Doctors regarding the medication prescribed and also gets clarified immediately before administering it. As most of the medicines sounds alike if it is oral and also doctor’s handwriting is bit difficult in understanding if it is written. Important point to be noted here is Medical adverse. Few strategies in medical adverse,
Deploy an immediate response team at the first sign a patient is getting worse. Prevent avoidable deaths from heart attacks by delivering reliable, evidence-based care. Prevent adverse drug events by double-checking medications with the patient, on their charts and in databases. Prevent central line-associated bloodstream infection through a series of evidence-based interventions. Prevent surgical site infection to all surgical patients by Surgical SOP implementation. Prevent ventilator-associated complications to ventilated patients by developing and implementing SOP (Standard Operating Procedure) for ventilated patients.
Respective departmental head has to develop Standard Operating Procedure for each procedure including medication procedures and also he / she should check periodically to ensure that the SOP’s are followed in the department. Policy formulation and Review: Quality of Care and patient safety are the two primary components have to be concentrated by all the health care providers. Each hospital has to develop a committee in concentrating these 2 activities. Periodical meetings are conducted to assess the system flow, discussing on incidence about medical errors, developing strategies and policies to avoid medial errors and also periodically updating the policies as a part of total quality management. These committee should go On-site observation round weekly once for each department to identify the right process flow and also guiding the respective department in improving their quality of service. Main purpose of this Patient safety initiative by WHO and India is to give confidence to patients that they are receiving quality care and also to express that every health care provider is showing keen interest in reducing medical errors. Every time health care organizations are united to eradicate some disease, why cant this time to eradicate disease of an organization. Lets all work together to eradicate medical errors and ensure quality to the patients.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue reading from where you left off, or restart the preview.