A panel of 20 patient safety stakeholders has identified a list of 22 patient safety practices ready for adoption by healthcare providers, according to a new report.
The report, "Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices," was prepared by the Southern California-RAND Evidence-based Practice Center for the Agency for Healthcare Research and Quality, and is an update of a 2001 report.
The 22 patient safety strategies were identified through searches of multiple computerized databases, gray literature and the judgments of a 20-member patient safety panel, according to the report. The panel reviewed 41 practices and determined that 10 had sufficient evidence of effectiveness and implementation and should be "strongly encouraged" for adoption:
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.
An additional 12 practices should be "encouraged" for adoption based on the strength and quality of evidence, according to the report:
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.
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The report, "Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices," was prepared by the Southern California-RAND Evidence-based Practice Center for the Agency for Healthcare Research and Quality, and is an update of a 2001 report.
The 22 patient safety strategies were identified through searches of multiple computerized databases, gray literature and the judgments of a 20-member patient safety panel, according to the report. The panel reviewed 41 practices and determined that 10 had sufficient evidence of effectiveness and implementation and should be "strongly encouraged" for adoption:
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.
An additional 12 practices should be "encouraged" for adoption based on the strength and quality of evidence, according to the report:
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.
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