Internationally Patient Safety Goals.pptx

International Patient Safety Goals

1. International Patient Safety Goals Dr. Ankit Singh

2. International Patient Safety Goals GOAL 1: Identify patients correctly GOAL 2: Improve staff communication GOAL 3: Use medicines safely GOAL 4: Use alarms safely GOAL 5: Prevent infection GOAL 6: Identify patient safety risks GOAL 7: Prevent mistakes in surgery

3. Purpose The purpose of the National Patient Safety Goals is  to improve patient safety . The goals focus on problems in health care safety and how to solve them .

4. Goal 1: Identify Patients Correctly Use two patient identifiers UHID – Unique hospital identification number ( P202203100923 ) and patient Name ( Ms. / Mr. xxx ) Other patient identifications IP number – IP20220310182 Wrist band Normal In- patient – Blue with white Newborn - Pink with white

5. Wrist band Wrist Band name Color Allergy Red Fall risk Yellow Latex Allergy Green Restricted extremity Pink Vulnerable patient Orange DNR Purple

6. Triage band – Australasian triage scale Priority Category Color Deceased Black 1 Immediate Red 2 Delayed Yellow 3 Minimal Green

7. Importance of patient identification To prevent error and patient harm Patient identification to be checked in all aspects like Admission and Discharge Handover Shifting and receiving the patient All invasive and non – invasive procedure Invasive procedure – Any surgery Non invasive procedure - NST All investigations – Blood investigations, CT, MRI, X-ray

8. Goal 2: Improve staff communication Staff to staff communication – use SBAR method S - Situation B - Background A - Assessment R - Recommendation This method is used to give handovers and it will give complete data of patient

9. Critical value intimation Use read back policy- Eg : Sodium: 135 mEq /L it should be repeated by the staff like Sodium : 135 mEq /L with Name and UHID Verbal medication orders and other information received through phone calls should use a read-back policy for better confirmation and to prevent error.

10. Verbal orders should be documented in the case sheet with date, time and Physician name Documentation should be legible and should not overwrite Only standard abbreviation should be used – HB ( Haemoglobin ) Do not use any symbols and shortcuts

11. Goal 3: Use medication safely Every medications should be labeled Use capital letter while writing medications Dual check for high- alert medications Document drug allergy, ADR and follow up Crash cart checklist to be updated and regular check at each shift .

12. Separate Adult and pediatric crash cart to be maintained Use the Tallman method for identifying LASA drugs – Look alike and Sound alike Eg : DOPA mine – DOBUTA mine Color coding High alert – RED Look alike - GREEN Sound alike – BLUE Emergency drugs - RED

13. Do not use open medication Staff should be aware of medication uses and side effects Nursing officer should not prescribe any medications Proper documentation for all medications with date, time, and signature Do not use any sample medications

14. While receiving medication from pharmacy staff should cross check with prescription order. Loaded medication should not store for long time, use as earlier as possible Date of opening and valid date should be mentioned for all multi-load drug vial Multi-load drug vial – maximum 10 pricks and valid for 28 days Medication errors to be documented

15. Goal 4: Use alarms safely Monitor alarms to be checked regularly about the sound quality Aware of Normal and abnormal sounds Maintain a checklist for all monitors

16. Goal 5: Prevent infection Protocols for prevention of infection

17. HIC : Forms Catheter related blood stream infection form VAP – Ventilator Associated pneumonia UTI – Urinary tract infection form Surveillance of surgical site infection

18. HIC bundles ( VAP, SSI, UTI, CRBSI ) Quality indicators Visiting guidelines for critical care Disinfection protocols Personal protection equipments Proper Biomedical waste segregation

19. Goal 6: Identify patient safety risk Safety measures Grab bars for steps and washrooms Side rails for all beds Anti skid floor, tiles and mats Bed height in low position Proper lightening Use caution board while mopping Remove unwanted equipment from patient area Fall risk alert band - Yellow

20. Reduce the risk of fall Fall history Initial fall risk assessment – Morse fall scale Complete observation Not leaving patient alone Medication history Patient using walking aids need complete observation Incident form to be documented

21. Goal 7: Prevent mistakes in surgery Use WHO surgery safety checklist to prevent error Sign in – before induction of anesthesia Time out – Before skin incision Sign out – before any member of the team leaves the operating room and before patient leaves the operating room

22. Sign in – before induction of anesthesia Patient identification Procedure name Informed consent NPO status Surgical site marking Test dose Type of Anaesthesia Multi Para monitor functioning status Drug allergy Pre-medication confirmation

23. Risk of blood loss Aspiration risk Resuscitation equipment Pre – assessment and diagnosis Parts preparation Use of anticoagulants Availability of blood product Any specific concern

24. Time out – Before skin incision Patient identification Procedure name Sterilization indicators Additional concern Counts of sponge and instruments Antibiotic prophylaxis Introduction of team members by themselves by name and role. Confirmation of side of incision

25. Relevant investigation reports and images Equipment and implants checking Any specific equipment requirement Critical and unexpected steps Case duration Anticipated blood loss Surgical site infection bundle to be undertaken

26. Sign out – before any member of the team leaves the operating room and before patient leaves the operating room Completion of instruments, sponge, needle, sharps and any other counts Name of procedure done Key concern for recovery and management Specimen obtained from the patient

27. Specific post procedure instruction Note: The checklist to be completely filled and signed before patient leaving the OT

28. Thank you