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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Patient safety | 5/10 | https://en.wikipedia.org/wiki/Patient_safety | reference | science, encyclopedia | 2026-05-05T04:26:13.019610+00:00 | kb-cron |
Identification upon request of health care personnel, using scanners (similar to readers for passive RFID tags or scanners for barcode labels) to identify patients semi-automatically upon presentation of the patient with a tag to staff Automatic identification upon entry of patient. An automatic identification check is carried out on each person with tags (primarily patients) entering the area to determine the presented patient in contrast to other patient earlier entered into reach of the used reader. Automatic identification and range estimation upon approach to the most proximate patient, excluding reads from more distant tags of other patients in the same area Any of these options may be applied whenever and wherever patient details are required in electronic form Such identifying is essential when the information concerned is critical. There are increasing numbers of hospitals that have an RFID system to identify patients, for instance: Hospital La Fe in Valencia, Spain; Wayne Memorial Hospital (US); Royal Alexandria Hospital (UK).
=== Computerized provider order entry (CPOE) === Prescribing errors are the largest identified source of preventable errors in hospitals (IOM, 2000; 2007). The IOM (2006) estimates that each hospitalized patient, on average, is exposed to one medication error each day. Computerized provider order entry (CPOE), formerly called computerized physician order entry, can reduce medication errors by 80% overall but more importantly decrease harm to patients by 55%. A Leapfrog (2004) survey found that 16% of US clinics, hospitals, and medical practices are expected to utilize CPOE within 2 years.
Complete safety medication system A standardized bar code system for dispensing drugs might prevent 25% of drug errors. Despite ample evidence to reduce medication errors, complete medication delivery systems (barcoding and Electronic prescribing) have slow adoption by doctors and hospitals in the United States, due to concerns with interoperability and compliance with future national standards. Such concerns are not inconsequential; standards for electronic prescribing for Medicare Part D conflict with regulations in many US states.
==== Specific patient safety software ==== A standardized, modular technology system that allows a hospital, clinic, or health system to record their Incidents, including falls, medication errors, pressure ulcers, near misses, etc. These systems can be configured to specific workflows, and the analytics behind them will allow for reporting and dashboards to help learn from things that have gone wrong (and right). Some vendors include Datix, RL Solutions, Verge, Midas, and Quantros.
=== Technological Iatrogenesis === Technology-induced errors are significant and increasingly more evident in care delivery systems. This idiosyncratic and potentially serious problem associated with HIT implementation has recently become a tangible concern for healthcare and information technology professionals. As such, the term technological iatrogenesis describes this new category of adverse events that are an emergent property resulting from technological innovation creating system and microsystem disturbances. Healthcare systems are complex and adaptive, meaning there are many networks and connections working simultaneously to produce certain outcomes. When these systems are under the increased stresses caused by the diffusion of new technology, unfamiliar and new process errors often result. If not recognized, over time these new errors can collectively lead to catastrophic system failures. The term "e-iatrogenesis" can be used to describe the local error manifestation. The sources for these errors include:
Prescriber and staff inexperience may lead to a false sense of security; that when technology suggests a course of action, errors are avoided. Shortcut or default selections can override non-standard medication regimens for elderly or underweight patients, resulting in toxic doses. CPOE and automated drug dispensing were identified as a cause of error by 84% of over 500 healthcare facilities participating in a surveillance system by the United States Pharmacopoeia. Irrelevant or frequent warnings can interrupt workflow. Solutions include ongoing changes in design to cope with unique medical settings, supervising overrides from automatic systems, and training (and re-training) all users.
=== Evidence-based medicine ===
Evidence-based medicine integrates an individual doctor's exam and diagnostic skills for a specific patient, with the best available evidence from medical research. The doctor's expertise includes both diagnostic skills and consideration of individual patients' rights and preferences in making decisions about his or her care. The clinician uses pertinent clinical research on the accuracy of diagnostic tests and the efficacy and safety of therapy, rehabilitation, and prevention to develop an individual plan of care. The development of evidence-based recommendations for specific medical conditions, termed clinical practice guidelines or "best practices", has accelerated in the past few years. In the United States, over 1,700 guidelines (see example image, right) have been developed as a resource for physicians to apply to specific patient presentations. The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom provides detailed "clinical guidance" for both health care professionals and the public about specific medical conditions. National Guideline Agencies from all continents collaborate in the Guidelines International Network, which entertains the largest guideline library worldwide. The International Standard ISO 15189:2007 for Accreditation of Medical Laboratory requires laboratories to continuously monitor and improve the quality of their facilities. Advantages:
Evidence-based medicine may reduce adverse events, especially those involving incorrect diagnosis, outdated or risky tests or procedures, or medication overuse. Clinical guidelines provide a common framework for improving communication among clinicians, patients and non-medical purchasers of health care. Errors related to changing shifts or multiple specialists are reduced by a consistent plan of care. Information on the clinical effectiveness of treatments and services can help providers, consumers and purchasers of health care make better use of limited resources. As medical advances become available, doctors and nurses can keep up with new tests and treatments as guidelines are improved. Drawbacks: