As a patient, it’s scary be in the hospital. It’s equally scary when your loved one is in the hospital. We all worry about health and recovery. Most of us don’t worry about the risk of getting sicker from health hazards in the hospital. But we should. It turns out there are dangers lurking in every corner. Thanks to ECRI*, there is a list of 10 health hazards in hospitals and other healthcare facilities for 2019. This post covers 5 hazards – next week’s post will cover the remaining five.
Why is this list of health hazards so important?
As with every other sector, people make mistakes, technology fails, and accidents occur. But with healthcare, patient lives are at stake. The goal of the ECRI list is to identify possible sources of danger or difficulty related to technology, so hospitals and other healthcare facilities can take steps to minimize the risk of patient harm. (Note – it seems to me that not all the items on their list are what one would generally consider related to technology, but this is how ECRI classified the list. Either way, these are all important hazards that need attention.)
How does ECRI choose these hazards?
ECRI chooses the potential sources of danger they believe warrants the greatest attention for the coming year. The list does not delineate the most frequently reported problems or the issues causing the most severe consequences. Instead, their list highlights which risks they think should receive priority now.
It’s worth noting that the experts at ECRI believe all the hazards on the list can be avoided or minimized through the careful management of technologies. And of course, not all hazards exist at every hospital or healthcare facility.
And the hazards are….
1. Hackers disrupting healthcare operations
Argh – hackers! Cybersecurity attacks are a significant threat to healthcare operations. Attacks can make devices or systems inoperative, degrade their performance, or expose or compromise data. Remote access systems are of a particular concern because they are accessible to the public.
What can facilities do to deter hackers?
Safeguarding assets requires identifying, protecting, and monitoring all remote access points. Additionally, facilities should follow cybersecurity practices, including strong password policies and maintaining and patching systems.
2. Mattresses oozing bodily fluids.
This is just gross. Even after routine cleaning, blood and other body fluids can remain on, or within, mattresses or mattress covers. As a result, subsequent patients can be exposed to previous patients’ fluids and can develop an infection. There have been reports of patients lying on an apparently clean bed or stretcher when blood from a previous patient oozes out of the surface! Yikes!
How does this happen?
Mattress covers protect the mattresses, not the people on the bed. If a cover isn’t properly cleaned and disinfected, or if its integrity is compromised, patients could come into contact with infectious materials. (Note – facilities do not clean or disinfect the mattresses themselves between patients.)
How can facilities solve the dangerous mattress problem?
Healthcare facilities must use appropriate products and procedures for cleaning and disinfecting mattress covers. Additionally, staff should regularly inspect mattresses and covers for signs of damage or contamination.
There’s a serious issue in the way of solving this problem.
Not all mattress cover suppliers recommend products and procedures that facilities can use to successfully remove surface contaminants without compromising the cover’s integrity. If cleaning the cover impairs its integrity, weak spots can allow leaks. Clearly this is a problem that needs immediate attention!
3. Surgical sponges left in patients.
When surgical staff accidentally leave sponges inside a patient, there is a risk of infections and other serious complications, including the need for secondary operations. Although it is standard procedure to manually count the sponges before finishing a procedure, errors still occur. Available data suggests that every year thousands of US patients could experience a retained surgical item (RSI), with surgical sponges the most common item left inside a patient.
How can surgical teams avoid leaving sponges inside patients?
Fortunately, technologies that supplement the manual counting process are available and have been shown to be effective when used correctly.
4. Improperly set ventilator alarms.
It’s dangerous for patients on mechanical ventilators when the user-adjustable ventilator alarms are not set correctly. Unfortunately, leaks, disconnections, manufacturing defects, and other failures are fairly common and can quickly lead to serious harm or even death if the ventilator issue is not promptly identified and fixed.
How can facilities fix ventilator alarm problems?
Properly set alarms can prevent patient harm. Since problems with ventilators are common and often life-threatening, the alarm systems must be working properly in order to alert staff to problems. Yet ECRI institute continues to see deaths caused by malfunctioning alarms during component disconnections and failures.
Healthcare facilities need policies on setting user-adjustable ventilator alarms and protocols for verifying that staff is following policies and component connections remain secure.
5. Contamination of flexible endoscopes after disinfection.
Doctors use endoscopes to peer inside the patient’s body. If an endoscope has any microbes on its surface, the patient can develop a serious, even fatal, infection. Unfortunately, cleaning and disinfecting flexible endoscopes between uses is challenging. Additionally, the improper handling and storage of clean, sterilized scopes can cause dangerous recontamination.
What should facilities do to maintain clean scopes?
Staff should follow guidelines to make sure scopes are completely dry after disinfection. Additionally, all employees must wear clean gloves when handling disinfected scopes – something that seems obvious but doesn’t always happen. Lastly, staff should transport disinfected and dried endoscopes in a dedicated, clean, enclosed container that does not come into contact with any unclean surfaces.
This is all scary!
These hazards are scary but burying our heads in the sand and pretending there are no problems isn’t the solution. Although no hospital is 100% hazard free, some hospitals are better than others at reducing risk for patients. Visit the Zaggo Resource Center and read these blog posts to learn more about choosing a hospital:
- Does it Matter Which Hospital You Use? Yes!
- Wondering How to Choose the “Best” Hospital? Find out How Doctors Would Choose a Hospital for Their Own Care.
*ECRI Institute is a nonprofit organization dedicated to bringing the discipline of applied scientific research to discover which medical procedures, devices, drugs, and processes are best, all to enable the improvement of patient care.