Dr Safety

Patient safety is paramount in our quest for high quality and reliable healthcare. As caregivers, we struggle with an inconvenient truth: Humans make mistakes. No human performs perfectly 24 hours per day, seven days a week. Unfortunately, perfection is expected of physicians and nurses. Such unrealistic expectations lead us to use a system of training and punishment that operates under the myth of perfect medical performance. The goal is not attainable, yet we perpetuate this myth day after day. The myth also precludes us from properly examining the systems issues that fail to protect patients from human error. A medical error is defined as the “failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim…including problems in practice, products, procedures and systems.” Even after more than 10 years of national effort, medical errors persist at alarming rates. A group of investigators reported there were approximately 37,600,000 annual

It is imperative to the safe care of our patients that an accurate and complete medication history is taken at every visit. Medications must be reviewed for compliance with the agreed upon treatment plan as well as for drug interactions and side effects. National Patient Safety Goals:  *Take extra care with patients who take medicines to thin their blood. *Record and pass along correct information about a patient’s medicines.   Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Make sure the patient knows which medicines to take when they are at home. Tell the patient it is important to bring their up-to-date list of medicines every time they visit a doctor. This is especially important for patients prescribed anticoagulation therapy. If an adequate medication history is not taken, patients may be prescribed warfarin and continue to take an over the counter drug like aspirin. This dangerous combination pu

Our patients are at the center of every decision we make. All members of the healthcare team must be willing and able to advocate for their patients’ safety. Advocacy and assertion are crucial tools in the fight to protect patients from harm. All team members are empowered to “STOP THE LINE!” when something is amiss in the care of their patient. Every team member, [Nurses, physicians, technicians, therapists, medical students, nursing students, aides, pharmacists and other professionals] must be ready to advocate for their patients’ best interests when their viewpoints do not coincide with that of the decision maker. You must make your concerns known at once in a constructive manner. Your concerns should be voiced at least twice to make sure you are heard. Alert your supervisor if your voice is not heard by the team leader or decision maker. A helpful communication empowerment tool is known as CUSS . In using CUSS one should state clearly:                         I am

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