Magazine article Drug Topics

New Evidence Shows Patient Safety Could Be Improved

Magazine article Drug Topics

New Evidence Shows Patient Safety Could Be Improved

Article excerpt

Patient safety in the nation's hospitals and nursing homes could be improved immediately by adopting 11 well-proven practices that today are not routinely performed, according to the Agency for Healthcare Research & Quality.

"The nation's healthcare leaders need to know what the science says about where the opportunities exist to make patient care safer right now," said Tommy Thompson, secretary of Health & Human Services, which oversees AHRQ. Out of 79 patient safety practices reviewed in detail, the 11 most highly rated in terms of evidence supporting their effectiveness were (in descending order):

*Appropriate use of prophylaxis to prevent venous thromboembolism in patients at risk

*Use of perioperative beta-blockers in appropriate patients to prevent perioperative morbidity and mortality

*Use of maximum sterile barriers while placing central intravenous catheters to prevent infections

*Appropriate use of antibiotic prophylaxis in surgical patients to prevent perioperative infections

*Asking that patients recall and restate what they have been told during the informed-consent process *Continuous aspiration of subglottic secretions (CASS) to prevent ventilator-associated pneumonia

*Use of pressure-relieving bedding materials to prevent pressure ulcers

*Use of real-time ultrasound guidance during central line insertion to prevent complications

*Patient self-management for warfarin to achieve appropriate outpatient anticoagulation and prevent complications

*Appropriate provision of nutrition, with a particular emphasis on early enteral nutrition in critically ill and surgical patients

*Use of antibiotic-impregnated central venous catheters to prevent catheter-related infections

To the surprise of the researchers, more than a dozen practices that patient safety authorities have long-- considered very important did not make the top 11 list because they haven't been studied enough. …

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