Dr Safety

Prevent Venous Thromboembolism: One of our goals is to eliminate preventable deep vein thrombosis [DVT] and pulmonary embolism [PE], collectively known as venous thromboembolism (VTE) and commonly called "blood clots."  Two million patients are diagnosed with DVT every year in the US. Up to half of these patients may not have symptoms until PE develops. There are 200,000 deaths annually due to PE. Our goal is to deliver appropriate VTE prophylaxis [prevention] to all of our patients: The first step is assessing a patient's risk of developing VTE. There are many tools available to do this. The one I like was developed by Dr Caprini and published in 2005. Risk assessment should be done at every physician visit especially if the patient's mobility is decreasing or other co-morbidities have developed. Once risk has been assessed, a plan including appropriate therapy to prevent VTE should be developed with the patient.   Most hospitalized patients will pr...

Disruptive and Inappropriate Behavior: "Conduct by an individual working in the organization that intimidates others to the extent that quality and safety could be compromised. These behaviors, as determined by the organization, may be verbal or non-verbal, may involve the use of rude language, may be threatening, or may involve physical contact." [The Joint Commission. Glossary: E-Edition 2009] " ‘Any behavior which impairs the health care team’s ability to function well creates risk,’ says Gerald Hickson, M.D., associate dean for Clinical Affairs and director of the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center. Such behaviors include reluctance or refusal to answer questions, return phone calls or pages; condescending language or voice intonation; and impatience with questions. Overt and passive behaviors undermine team effectiveness and can compromise the safety of patients. All intimidating and disruptive behaviors are unprofes...

U.S. Human Cases of Swine Flu Infection (As of April 29, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths Arizona 1 California 14 Indiana 1 Kansas 2 Massachusetts 2 Michigan 2 Nevada 1 New York City 51 Ohio 1 Texas 16 1 TOTAL COUNTS 91 cases 1 death

Please use the link below to get accurate information about the current influenza cases worldwide. This is not a "pandemic" or "epidemic" at this time. Wash your hands frequently and stay home if you are sick. Avoid sick contacts. From the CDC: "Human cases of swine influenza A (H1N1) virus infection have been identified in the United States. Human cases of swine influenza A (H1N1) virus infection also have been identified internationally. The current U.S. case count is provided below. An investigation and response effort surrounding the outbreak of swine flu is ongoing. CDC is working very closely with officials in states where human cases of swine influenza A (H1N1) have been identified, as well as with health officials in Mexico, Canada and the World Health Organization. This includes deploying staff domestically and internationally to provide guidance and technical support. CDC activated its Emergency Operations Center to coordinate the agency's respons...

Many patients are harmed every day because they are incorrectly taking their prescribed oral anticoagulation therapy, warfarin. This very important "blood thinner" has an unpredictable reaction in many patients and interacts with many medications creating unsafe situations for patients in which serious bleeding and possibly death may occur. If you are taking warfarin you should take this opportunity to discuss its safe use with your clinician and pharmacist. Please be sure to take your medication exactly as prescribed by your doctor or healthcare provider. From ISMP: “A recent report by the Institute for Safe Medication Practices (ISMP) notes that some health professionals and patients may not realize that Jantoven is a brand name for the drug warfarin. That could result in inadvertently prescribing and dispensing two warfarin-containing medications for the same patient. ISMP cites the case of a patient who had been taking warfarin at home and continued the drug while in the ...

15 million Americans are harmed each year in our hospitals. Half of these events are related to medication safety. Many people are harmed because they accidentally take their blood thinner medicine incorrectly. Warfarin is an oral anticoagulant medicine, or blood thinner, that is used to treat patients with blood clots or to prevent blood clots from forming in patients with heart arrhythmias such as atrial fibrillation. Warfarin may also be used after orthopedic surgery to prevent blood clots or in patients with artificial heart valves. Many patients on warfarin may also be taking aspirin or other anti-platelet medications. In a retrospective cohort study published recently in Chest, Johnson, et . al found that 38% of warfarin users were also taking an antiplatelet medicine resulting in a 2.1x greater risk of major hemorrhage [adjusted odds ratio 95% CI 1.01-4.4]. There was no benefit noted in the combination users. [ Johnson, SG, et.al. Outcomes Associated with Combined Antipl...

Flu season is here! It is not too late! Patients give many reasons for not getting their annual flu shot, including — “It causes the flu"; "I don’t need it"; "It has side effects"; "It’s not effective"; "I didn’t think about it"; "I don’t like needles!” The fact is that every year in the United States about 36,000 people die from influenza. Greater than 90 percent of these deaths occur in individuals 65 years of age and older. You can help yourself overcome these odds and their personal barriers through education. Protect yourself, your family and friends. Get Your Flu Shot – Not the Flu.