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Hospital Safety Concerns for 2020

photo modern hospital building The prospect of medical procedure and/or a hospital stay scares most of us. We worry about our recovery. And we are nervous that we might not wake up from anesthesia. Furthermore, what if the doctor makes a mistake? Or, what if there is a failure of some kind along the way? These concerns are legit. Bad stuff happens sometimes. Each year, ECRI releases a report on their Top 10 Health Technology Hazards. The information is intended to help healthcare facilities improve safety issues relating to medical devices and systems. But as a patient or family caregiver, it’s helpful to know about these hospital safety concerns for 2020 too!

Why is this list so important?

As you can imagine from your personal use of various technology-based systems, things can and do go wrong. But when things go wrong with health technology, patients can be harmed or even killed. In order to minimize the risk from health technology, healthcare facilities must understand the possible sources of problems.

How does ECRI choose which hospital safety concerns for 2020 to include?

ECRI identifies the 10 hazards they believe warrant the greatest attention for the coming year. To be clear, the hazards on this list are not necessarily the most frequent issues, or those with the most severe consequences. Instead, their list “list reflects our judgment about which risks should receive
priority now.”

The good news? ECRI believes healthcare facilities can avoid or minimize the risks associated with these hazards. Below are the first 3 hospital safety concerns for 2020, including ECRI recommendations for improvements. For the rest of the technology hazards, read part 2 and part 3 of this series.

1. Surgical stapler hazards.

surgical scar with staples - hospital safety concerns for 2020Doctors use staplers to either staple (seal) tissue, or to cut and staple tissue. These staplers are complex devices that require skillful, careful techniques. But sometimes the staples fail and sometimes doctors misapply them. And the consequences can be severe, including death. Harms include blood loss during surgery, tissue damage, unexpected postoperative bleeding, and failed joining of blood vessels.

What causes these stapler problems?

The ECRI report indicates that the way doctors use the stapler, not the device itself, is responsible for most of the adverse consequences. Possible errors include choosing the wrong staple size and stapling tissue that is too thick or too thin.

How common is this problem?

Although the overall rate of issues is quite low relative to the frequent use of surgical staplers, problems are regularly reported. In fact, a recent FDA analysis found 412 deaths, 11,181 serious injuries, and 98,404 malfunctions since 2011.

How can this hazard be reduced?

The best way to avoid stapler errors and harm is through effective training and hands-on practice with the specific model of stapler the doctor will use. It can’t hurt to ask your doctor what kind of training and practice he/she has had with the stapler that he/she will use in your procedure.

Learn more.

For information on reducing the risk of other types of surgical complications and harm, read these blog posts:

2. Point-of-care ultrasound harm.

photo ultrasound machine - hospital safety concerns for 2020Healthcare staff use point-of-care ultrasound (POCUS) to diagnose and guide interventional procedures at the patient’s bedside. The use of POCUS scanners is rapidly expanding, but a lack of oversight can put patients in danger. Specifically, users sometimes lack the training, experience and skill to properly use the devices, which can lead to patient harm due to the use, or lack of use, of the technology.

What kinds of danger?

Patients can be misdiagnosed when staff relies on POCUS when a more comprehensive exam is needed, or when POCUS is not used when it should be, or from inappropriate use of the device.

How can this hazard be reduced?

Healthcare institutions should adopt policies and procedures that cover training, credentialing, exam documentation, and data archiving. Additionally, institutions should address issues related to specific specialties, including defining exam protocols that conform to established guidelines and recommendations.

What can you do?

As with most other medical tests and procedures, it’s always a good idea to get a second opinion. Are you getting the test and procedure you need? And if something doesn’t seem right, or a staff member doesn’t seem to know what he/she is doing, speak up!

3. Contamination.

photo surgery - hospital safety concerns for 2020Patients who come in contact with contaminated devices, tools and other items can be exposed to dangerous germs. Although proper cleaning, disinfecting and sterilization of items can significantly reduce the risk of dangerous germs, not all medical (and dental) offices follow proper sterilization procedures.

What kinds of healthcare settings have contamination issues?

Contamination issues can occur in any kind of healthcare facility – from doctors’ and dentists’ offices, to ambulatory care centers and hospitals. But, it’s important to note that not all facilities have similar resources for infection prevention and control. Large facilities and hospitals usually use central sterile processing departments which can significantly reduce the incidence of contamination.

How common is this issue?

Although the prevalence of contaminated items is unknown, the ECRI report states “the potential exists for this to be an insidious, widespread patient safety risk.”

What can healthcare facilities do to reduce contamination?

Healthcare facilities without a central sterile processing department should adopt safety measures to insure the proper sterilization of items. ECRI recommends designating a qualified staff member or contractor to support the infection prevention and control practices. Additionally, facilities should provide adequate training, and conduct periodic competency testing, for all staff working with sterilizing equipment.

What can you do?

Because contaminated items can look clean to the naked eye, it can be impossible to detect contamination. Although if an item looks dirty, definitely speak up!

Unfortunately, patients have no control on how well a hospital or facility sterilizes their instruments and other items. But, if you need a procedure that will involve the use of invasive instruments, you can ask your doctor how they keep their instruments contamination-free. Moreover, you can look up healthcare-acquired infection rates on Medicare’s Hospital Compare website and on The Leapfrog Group’s website.  But beware – these sites don’t provide data on infections from medical instruments. However, you can get a sense of how a hospital rates on other infection control measures.

Learn more.

For general information on health care-related infections, read my blog posts:

 

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