All Entries in the "WHO" Category
Top 10 most read blogs posts from 2011
The new year is upon us. I thought before we dive into what’s to come for patient safety and quality in 2012, we might want to look back at 2011 and see what grabbed the attention of the patient safety world.I calculated the top ten by how many times each post was viewed. They are:
10. Joint Commission and FDA to focus on alarm fatigue
The Joint Commission (TJC) told The Boston Globe that it would work with the Food and Drug Administration (FDA) to make alarm fatigue—a worrisome problem in most hospitals—a priority.
9. Disruptive behavior, negligence, endangered patients, and millions of dollars
In August, settlements for old patient safety incidents in Boston and recent investigations in Dallas found more recent patient safety infarctions.
8. Rewarding near-miss reporting
This post discusses the importance–and challenge–of getting staff to report near misses, highlighting an example in one surgical suite in Johns Hopkins Hospital in Baltimore that implemented its Good Catch Awards.
7. Joint Commission issues Sentinel Event Alert about workplace violence
The Joint Commission issued an alert on workplace violence in July 2010, but workplace violence was a hot enough topic to remain at the top in 2011.
My personal story of a patient and family whose anger and frustration grew as they faced an elusive plan of care and a care team who seemed uncommunicative.
5. New York Times article exposes radiation therapy errors
Another post that was published in 2010, but the issue of radiation errors and over-radiation remained hot in 2011. This post highlights one of the first articles in a series The New York Times ran from 2010 and into 2011 on radiation concerns.
4. Medication error prompts lawsuit for Massachusetts General Hospital
A medication error that resulted in a death and a lawsuit was met with a communicative response from hospital representatives, who said systematic improvements implemented since the error now help staff to avoid making similar errors.
3. Boston hospital admits three spinal surgery errors in two months
Published at the very end of 2010, this is yet another post on a hospital admitting to errors—this time surgical site errors—that did not need to happen. Beth Israel Deaconess Medical Center in Boston is in the spotlight after its surgeons made errors in three separate spinal operations in two months.
This post explaining how a resident failed to carry out an order on her mobile device after she was interrupted by a personal text messaged grabbed the attention of Patient Safety Blog readers. With this anecdote as proof, social media concerns have leaped from HIPAA violations to immediate threats to patient safety.
1. Can a video really help curb infections?
Perhaps videos are just more fun to watch. This post embedded the winning video of the APIC Infection Prevention Film Festival, which lays blame on frontline providers who fail to do everything they can to “do no harm—” in this case, failing to wash their hands.
What do you think? Any of your favorites missing? Let me know.
Can a video really help curb infections?
For quite some time now, hospitals have been creating and posting videos to create awareness about proper infection control protocol for patient caregivers (most focus on hand washing or vaccination).
The Association of Peri-operative Nurses (AORN) and 3M had a contest for nurses to submit videos on hand hygiene. The World Health Organization (WHO) posted a video on hand hygiene, and even the Department of Health and Human Services (HHS) had a contest for people to submit a public service announcement video for preventing flu. And of course, hospitals have created videos on their own to help raise awareness and educate.
Videos are fun—they have the power to get staff out of their daily routine, dancing in sterile hospital hallways and awkwardly singing their newly-crafted lyrics over popular hits (think “I’m Gonna Wash My Hands” or “Pump It”). I also assume that while the video is being made, hospital staff are more focused on proper patient safety protocol. But do videos actually make a lasting effect on ensuring staff wash their hands or get vaccinated?
After watching the APIC Infection Prevention Film Festival winner’s video, I think some might. About forty entries were submitted, but the winner takes a less gimmicky approach and “depicts the tragedy and irony of healthcare-associated infections, transforming the statistics into a story of a patient who gets an infection,” according to the APIC press release. In my opinion, the video directly connects the simple–and sometimes annoying–act of hand washing to the safety of the patient, leaving the responsibility square on the shoulders of healthcare professionals. In fact, I would go as far as to say that the fun, light-hearted videos may be downplaying the danger. But that’s just what I think; I’d love to hear what you think of the video posted below. Over dramatic? Right on target? Play movie critic and share your thoughts below.
Today is National Time Out Day!
Today, June 16th, is National Time Out Day–is your hospital marking the day with any sort of special fair or event? I thought I’d share this page of resources from the Association of periOperative Registered Nurses (AORN), a group that is leading the effort in promoting not only the day, but the sentiment of National Time Out Day year-round.
AORN is asking healthcare providers to make a “Time Out Commitment”, designed to “increase awareness of and compliance to taking a time for every patient, every time before the start of a surgical procedure.” The program will provide educational tools to increase awareness about wrong-site,-person, and -procedure surgery. You can find more about the Commitment here.
Don’t forget to check out the collection of Time Out videos that AORN has put together, at the bottom of its resources page! These videos are from hospitals around the country, showing off how they perform a time out prior to surgery.
WHO publishes checklist for treating patients with H1N1
Although H1N1 has not been prominently featured on this blog, this checklist from the World Health Organization (WHO) caught my eye because it goes over important infection control and prevention techniques that should be used with every possible H1N1 patient that enters your facility. The WHO Patient Care Checklist: new influenza A (H1N1) released last month by the WHO, can be modified to fit any local practices your facility has also incorporated into treating flu patients. It was tested at facilities around the globe, including Brigham and Women’s Hospital in Boston, MA.
For development of the checklist, the WHO sought advice from experts in:
- infection control
- clinical management of pandemic-prone Influenza
- health care checklists
To read more about the checklist, and to find a version written in Spanish, click here to go to the WHO’s Web site.
CNN is reporting that a vaccine for H1N1 will be made available in the U.S. by October. Today, secretary of health and human services Kathleen Sebelius spoke at a “flu summit” mandated by the Obama administration in an effort to launch a national campaign about H1N1. Experts worry that the flu will spread faster once the fall hits and the normal flu season begins.
To read more about today’s summit, click here.
Has your hospital struggled to prepare for an influx of H1N1 cases? Do you anticipate more training in the future?
WHO announces new hand hygiene campaign
Piggy backing off its “Clean Care is Safer” campaign launched in 2005, The World Health Organization (WHO) announced its latest initiative on May 5th. Titled “Save Lives: Clean Your Hands,” the initiative attempts to illustrate how deadly failing to use proper hand hygiene practices can be. Several events took place around the world on May 5th in honor of the initiative’s launch.
The WHO has also posted lots of tools on it’s Web site for those hospitals interested in the initiative, including case studies, videos, and a graphic display touting the “Five Moments for Hand Hygiene” that specifies the five most important times bedside caregivers can perform hand hygiene. They also offer advice on how to educate staff members, a method for gathering feedback on any hand hygiene initiatives started in a facility, and a sample action plan for those hospitals who need guidance.
The concept of cleaning our hands to prevent the spread of infection is not new, yet it’s something that is just not done enough in the healthcare setting. The WHO’s new spin might spur on some creative ideas within your own facility. Has your hospital signed up to be a a part of this new initiative? More than 4,500 hospitals worldwide have done so.
