Health Care

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Big tech problems

Hospital executives who’d like to get a jumpstart on preparing for the new year should start focusing on improving these 10 healthcare technology safety issues from ECRI’s annual report:

1. Alarm hazards. Alarm fatigue is a big problem in today’s hospitals, and ECRI identifies it as the No. 1 safety issue hospitals will face with healthcare technology in 2015. With all the noises coming from patient alarms at any time of the day, clinical staff often become desensitized to them. This not only puts patients in danger, it can also cause patients to have trouble resting during their hospital stay. And the lack of sleep could be detrimental to their recovery as well. So it’s key for hospitals to do what they can to keep false alarms at a minimum.
2. Data integrity. With the rise of electronic health records (EHR) systems, it’s becoming more and more difficult for hospitals to keep patient info secure and accurate. Data entry errors made by clinical staff and business associates can put patients in grave danger. Problems can include accidentally pasting patients’ data in the wrong medical record, using pre-populated templates with info that’s not relevant to a patient’s condition or missing info due to problems with systems and data delivery. Hospitals need to evaluate their data entry process for their EHR systems to avoid these problems.
3. Mix up of IV lines. It’s common for hospital patients to receive multiple IV infusions at once. But if a clinician or nurse makes just one error with the infusion site or rate of administration for a medication, a patient can become very ill. This risk increases with multiple IV lines – one study showed the likelihood of an adverse drug event increased by 3% for each IV medication a patient received. Using a clear labeling system with multiple IV lines, and reminding staff to double-check that each connector is attached to the proper administration site, can do wonders for preventing these mistakes.
4. Inadequate reprocessing of endoscopes and surgical instruments. Hospitals can save money with reusable surgical instruments and devices, such as endoscopes. But it’s key to disinfect them correctly during reprocessing. Otherwise, patients are in danger of contracting serious infections and illnesses. Remind staff that the most important part of reprocessing is the initial cleaning of the instrument or device immediately after use. If all residue isn’t properly removed, the subsequent disinfection process won’t be as effective as it needs to be.
5. Missed ventilator disconnections. If there’s any sort of problem involving a ventilator disconnection, a patient could suffer severe brain injury – or even death. Most ventilators have sensors and alarms to warm clinical staff when a problem occurs. But the alarms often aren’t set correctly and don’t sound at the proper time. So it’s crucial for staff members to verify they’re properly set, particularly the ventilator’s low-pressure alarm, which indicates a drop in breathing circuit pressure, and the low-minute-volume alarm, which monitors the volume of gas returning to the ventilator.
6. Patient-handling device errors and failures. Problems with devices used to transport and lift patients from hospital beds are safety hazards to both patients and clinical staff. In fact, per statistics from the Occupational Safety and Health Administration (OSHA), becoming injured after using a patient lift device is one of the top reasons for Workers’ Compensation claims among healthcare workers. While some issues are caused by using the device incorrectly, others are due to mechanical failure, such as low batteries and malfunctioning lift components. Besides regularly educating staff about the importance of practicing safety when moving patients, putting a program in place for managing, testing and inspecting lift equipment can prevent many of these problems.
7. “Dose creep” with diagnostic radiation. Over time, patients’ exposure to radiation has gradually increased because of advances in radiography technology that have led to clearer image quality. While this makes diagnosing problems easier, increased radiation even in small doses can adversely affect patients’ health, down the line. Your hospital’s radiologists should closely monitor equipment to ensure that it’s using the lowest possible levels of radiation required for imaging. Many equipment manufacturers are now using a standardized exposure index (EI), which can help staff determine acceptable radiation exposure levels for common procedures and let them know if they’re deviating from the norms.
8. Robotic surgery and complications. No longer restricted to the most advanced hospitals, robotic surgery is becoming more common in all kinds of facilities. With this new healthcare technology comes new risks, particularly if training isn’t comprehensive. Training should take several factors into account, including how the surgical team and other equipment should be arranged to accommodate the robot, and how to avoid repositioning of the patient or accidental movement of the operating table. To avoid major problems, hospitals should constantly evaluate their robotic surgery teams, making sure everyone has the correct credentials and knowledge to perform the procedures.
9. Cybersecurity. Because so many devices are able to store patients’ protected health information (PHI), it’s difficult for hospitals to keep patients’ data secure. Between clinicians accessing health records and hospital internal email messages via tablets and smartphones, and digital hackers becoming more sophisticated in their techniques to steal PHI, hospitals face many cybersecurity challenges with new healthcare technology. The first line of defense is working closely with your IT department and any medical device manufacturers to make sure the equipment your hospital uses has the most recent security updates installed. Any device used to store or access PHI should be encrypted, and network access should be limited only to those who need it. Another area to review: password security. Clinicians and other hospital staff should use strong, unique passwords when accessing email and your EHR to keep patient information safe.
10. Problems with recall and safety management programs. A new addition to ECRI’s Top 10 list this year, the use of recalled equipment can compromise patient safety. While hospitals typically receive recall notices for medical devices and equipment in a timely fashion, the appropriate action isn’t always taken right away. Many times, this happens because hospitals treat these notifications more as administrative burdens rather than critical patient safety measures. To correct this problem, your hospital should have recall management protocols in place that help staff quickly identify recalled equipment and take the appropriate steps to correct the problem before equipment failure causes patient harm.