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30 Safe Practices in 30 Minutes Creating a Safe Medical Practice.

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Presentation on theme: "30 Safe Practices in 30 Minutes Creating a Safe Medical Practice."— Presentation transcript:

1 30 Safe Practices in 30 Minutes Creating a Safe Medical Practice

2 Michael A. O’Connell MHA, FACMPE, FACHE Vice President of Clinical/Support Services Goal: Increase Patient Care & Quality by Minimizing Mistakes and Reducing Risk

3 Part One Patient Safety & Quality: 2 nd Biggest Concern for CEOs of community hospitals. Reference: ACHE Division of Member Services, Research

4 1 Why create a Culture of Safety? 1) Implement safety before, not after the fact. Be proactive! 2) Prevent breaks to patient & employee safety.

5 Just 2 Elements of a safe culture High Reliability Learning Teamwork Activated Patient Just

6 3 Rule: Keep sprinkler heads far from air vents. Have a professional clean them if/when dusty. Sprinkler Heads Cause of Hazard: Dust Effect: Malfunctioning Reference:

7 4 Rule: 18 inch clearance from the bottom of the sprinkler head. Exception: Perimeter Shelving – As long as no sprinkler is directly above. Sprinkler Heads Cause of Hazard: Obstruction Effect: Reduced Effectiveness Reference:

8 5 R = RESCUE A = ALARM C = CONTAIN E = EXTINGUISH R.A.C.E. Code Red Response Reference: Med Senses Rule: Call Code Red FIRST.

9 6 P.A.S.S. Code Red Response P = Pull the pin A = Aim nozzle S = Squeeze handle S = Sweep the base Reference: Med Senses Rule: Fire Extinguisher proper usage.

10 7 Rules: ▪ Are Exit Signs pointing the right direction? ▪ Are Fire Exit Paths clear? ▪ Are Fire Doors in working order? Fire Exits Cause of Hazard: Obstruction or Misdirection Effect: Prevents Evacuation during Code Red Reference: OSHA Reference: U.S. Gov. Office of Compliance

11 8 Blanket Warmers Cause of Hazard: Overheating Effect: Injury to Patients, Fire Rule: Test temperatures regularly and document. Post maximum temperature range on all warmers (130ºF). Reference: Environment of Care

12 9 Electrical Outlets Cause of Hazard: Overages Effect: Shock, Fire, Wire damage Rule: Do not use power strips. Use items with a grounding conductor. Have sockets tested regularly. Unplug unnecessary items. Reference: U.S. Gov. Office of Compliance

13 10 Personal Appliances Cause of Hazard: Not built for commercial use. Effect: Fire hazard, electrical wiring damage, & damage to appliance Rule: All appliances within patient care areas must have a grounding conductors. Conduct leakage current tests on all appliances. Prohibit power strips or extension cords unless approved by the Facilities department. Reference: Safety Management Services, Pages 8-9

14 11 Improper Item Storage Cause of Hazard: Clutter Effect: Fire hazard, Infection control hazard Rule: Begin to reduce clutter as much as possible. Make it a point to have hallways, patient rooms, storage areas, and stations/desks clear of clutter. Reference: The Joint Commission Managing Hospital Clutter on a Daily Basis Checklist

15 12 Rule: Use fire-retardant furniture and curtains to minimize the potential from harm due to a fire. Furniture, Curtains Cause of Hazard: Fuel for a fire Effect: Fire hazard Reference: The Joint Commission

16 13 Employee Emergency Response Knowledge Cause of Hazard: Unable to respond appropriately Effect: Risk to employees & patients Rule: Educate Employees annually on safety measures, proper Code responses, and where to find more information on what to do in an emergency. Reference: OSHA

17 14 Disaster Plan Cause of Hazard: Unwritten, not displayed Effect: Lack of preparedness Rule: Create an easy-to-use Emergency Response Quick Guide to have at all desks/stations. Update annually. Reference: The Joint Commission

18 15 Texting Cause of Hazard: Distraction while driving, lack of patient security Effect: Accidents, HIPAA violations Rule: 1. Promote not texting-and-driving to all employees regularly. 2. Disallow all texting in clinical environments. Exception: Implementing a HIPAA-secure texting applications. Reference: The Joint Commission

19 16 Parking Lots Cause of Hazard: Dark lots Effect: Unsafe lots, increased criminal activity Rule: Light all parking lots and walking areas to/from lots. Reference: Parking Lot Safety

20 17 Employee Lockers Cause of Hazard: Unlocked Effect: Vandalism/stolen items, liability Rule: All employees are to have a lock on their locker, and use it, at all times.

21 18 Smoking Cause of Hazard: Oxygen tanks, patient/employee health Effect: Fires, patient/employee unhealthy environment Rule: Ban and enforce no smoking on facility grounds. Stop hiring employees who smoke. Reference: U.S. News Today

22 19 Chemical Storage Cause of Hazard: Easy access, unsafe storing procedures Effect: Non-approved personnel usage, injuries, chemical spills, theft Rule: Differentiate between locked toxic/hazardous chemicals and others (i.e. formaldehyde vs. paint), implement a safe storage policy/procedure based on category.

23 20 Radiation Cause of Hazard: Lack of Radiology verification Effect: Unsafe, unnecessary exposure Rule: Dual confirmation of location to receive radiation exposure. Reference: U.S. FDA

24 21 Chemical Exposure Cause of Hazard: Cleaning methods Effect: Skin & respiratory irritation Rule: Limit chemical odors by cleaning when patients are not around, use products with less odor, & make sure cleaned area is dry before patients/employees are in the area. Reference: Joint Commission

25 22 Employee Identification Cause of Hazard: Lack of appropriate identifying agent Effect: Imposters cannot be identified Rule: All employees have a standard- issued photo I.D. badge and are required to wear it visibly. Reference: Joint Commission

26 23 Credentials Cause of Hazard: Misrepresentation of credentials Effect: Danger to patients, other employee Rule: Have HR verify all credentials and degrees prior to new employees start, and verify existing employees who have not been verified. Reference: Joint Commission

27 24 Flu Shots & Immunizations Cause of Hazard: Lack of staff being up-to-date Effect: Further transmission of flu, etc. to staff and patients Rule: Confirm that all employees are up-to- date on immunizations. Require direct patient contact personnel to have the flu shot and other vaccinations. Reference: Joint Commission

28 25 Trash Cause of Hazard: Unsafe collection and disposal Effect: Infection possibilities, injuries Rule: All collection cans should have lids, and they should be kept down. Empty regularly. Separate items properly upon disposal (i.e. Biohazardous waste vs. paper). Reference: Basel Action Network

29 26 Staffing Cause of Hazard: Unsafe staffing Effect: More mistakes, more risks Rule: Staff a variety of skills each shift so that the bases are always covered. Ensure competency. Create & follow minimum standards for core staffing. Reference: Joint Commission, pg. 11-14

30 27 Red Bags Cause of Hazard: Biohazardous waste Effect: Infection spread, injuries Rule: Continue staff education on items for Red Bag disposal. Use an approved vendor to remove Biohazardous waste. Keep all Bills of Lading as documentation. Reference: U.S. Dept. of Energy Lab

31 28 Mercury Cause of Hazard: Spills Effect: Damage to humans and the environment Rule: Reduce mercury usage by replacing sphygmomanometers, thermometers, and Cantor & Miller Abbot tube with non- mercurial alternatives. Reference: EPA

32 29 HIPAA Cause of Hazard: Unsafe usage or disclosure; forgetfulness Effect: HIPAA violations Rule: Ensure safeguards and implement refreshers to staff on speaking quietly, etc. when discussing PHI, because usually the policy is violated accidentally. Reference: U.S. Dept. of Health & Human Services

33 30 Entrances & Waiting Areas Cause of Hazard: Lack of personnel present & monitoring Effect: Injuries Rule: Have staff present in all entrance areas and seating areas monitoring patients and visitors in case of falls, fainting, other sudden-onset problems to increase staff reaction time.

34 Safety Resources 1. The Essential Guide for Patient Safety Officers, 2nd Ed.The Essential Guide for Patient Safety Officers, 2nd Ed. 2. A Clinical Improvement Action Guide, 3rd EditionA Clinical Improvement Action Guide, 3rd Edition 3. Making Health Care Safer IIMaking Health Care Safer II 4. Establishing a Culture of Patient SafetyEstablishing a Culture of Patient Safety 5. Measuring Patient SafetyMeasuring Patient Safety

35 Key Takeaways – Why Safety? Thank you! 1) Take a fresh perspective, and look around for risks all around you. Safety is everyone’s responsibility. 2) Make safety a priority because it’s the right thing to do. Not just to follow a requirement or standard.

36 Questions? Michael O’Connell, FACMPE 216-587-8087

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