Patient Safety and the Aging Population Seminar

8/3/2019 Patient Safety and the Aging Population Seminar

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Patient Safety and the Aging

Population

A SEMINAR


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No amount of medical care in the world can improve the health

and quality of a patient's life if the approach to care or the

environment isn't safe. As basic as learning to look both ways

before crossing the street, or setting your scissors down

before you break into a run, are the tenets of keeping

infections at bay, double checking drugs before they are

administered, even removing or operating on the right body

parts.


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Safety

the condition of being safe from undergoing

or causing hurt, injury, or loss

a device (as on a weapon or a machine)designed to prevent inadvertent or hazardous

operation


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Among the errors are:

Nosocomial Infections

Hospital and community acquired infections: Hospital patients

may develop infections making their illnesses and treatment

more difficult. Those with compromised immune systems, suchas those with an open wound from injury or surgery, those who

require catheters for drainage or drug delivery, or the elderly

whose systems aren't as strong as they used to be, are most at

risk. Minimizing adverse outcomes of health care for inpatients is

of prime importance to hospitals and a major focus of Quality

Assurance activities. A very significant indicator of quality care is

the nosocomial infection rate.


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Drug errors

From problems interpreting a doctor's handwriting on a

prescription, to mistakes in their translation at the pharmacy, to

administration problems with dosage, time frames or route of

administration, to too many similar and confusing drug names,

drug errors account for thousands of deaths per year.


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Surgical errors

Wrong site surgeries, or patient

misidentification comprise the bulk of surgical

errors. Some surgeries don't work as well as the

surgeon or patient would like, but that's not the

same as one that goes awry, causing an error.

Surgeries conducted with heat sources for tasks

like cauterizing may also result in fires.


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Causes of healthcare error

Human Factors. "Bad apples' or incompetent healthcare providers are a common cause". Many of theerrors are normal human slips or lapses, and not theresult of poor judgment or recklessness.

Variations in healthcare provider training &experience, fatigue, depression and burnout.

Diverse patients, unfamiliar settings, time pressures.

Failure to acknowledge the prevalence and seriousness

of medical errors. Medical complexity

Complicated technologies, powerful drugs.


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Intensive care, prolonged hospital stay.

System failures

Poor communication, unclear lines of authority ofphysicians, nurses, and other care providers.

Complications increase as patient to nurse staffing ratio

increases.

Drug names that look alike or sound alike.

The impression that action is being taken by other groups

within the institution.

Reliance on automated systems to prevent error.

Cost-cutting measures by hospitals in response to

reimbursement cutbacks.


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Environment and design factors. In emergencies, patient care may

be rendered in areas poorly suited for safe monitoring.

Infrastructure failure. According to the WHO, 50% of medical

equipment in developing countries is only partly usable due to lack

of skilled operators or parts. As a result, diagnostic procedures or

treatments cannot be performed, leading to substandard

treatment.

The Joint Commission's Annual Report on Quality and Safety 2007found that inadequate communication between healthcare

providers, or between providers and the patient and family

members, was the root cause of over half the serious adverse

events in accredited hospitals. Other leading causes included

inadequate assessment of the patient's condition, and poorleadership or training.


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Safety programs


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Near-miss reporting

A near miss is an unplanned event that did not

result in injury, illness, or damage - but had the

potential to do so. Reporting of near misses by

observers is an established error reduction

technique in aviation, and has been extended to

private industry, traffic safety and fire-rescue

services with reductions in accidents and injury.


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Electronic Health Record (EHR)

The Electronic health record (EHR), previously

known as the Electronic medical record (EMR),

reduces several types of errors, including those

related to prescription drugs, to emergent and

preventive care, and to tests and procedures.


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Computerized Provider Order Entry

(CPOE)

Prescribing errors are the largest identified

source of preventable errors in hospitals. The

IOM estimates that each hospitalized patient, on

average, is exposed to one medication error

each day. Computerized provider order entry

(CPOE), formerly called computer physician

order entry, can reduce medication errors by80% overall but more importantly decrease

harm to patients by 55%.


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Complete Safety Medication System

A standardized bar code system for dispensing

drugs might prevent 25% of drug errors. Despite

ample evidence to reduce medication errors,

compete medication delivery systems

(barcoding and Electronic prescribing) have slow

adoption by doctors and hospitals in the United

States, due to concern with interoperability andcompliance with future national standards.


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Health literacy

Health literacy is a common and serious safety

concern. A study of 2,600 patients at two

hospitals determined that between 26-60% of

patients could not understand medication

directions, a standard informed consent, or

basic health care materials. This mismatch

between a clinician's level of communicationand a patient's ability to understand can lead to

medication errors and adverse outcomes.


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AGING


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Ageing in humans refers to a multidimensional

process of physical, psychological,and social change. Some dimensions of ageing

grow and expand over time, while others

decline.


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Theories of Aging


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The Telomerase Theory of Aging

Order to Disorder Theory

The Rate of Living Theory

Gene Mutation Theory

Caloric Restriction Theory

Autoimmune Theory

Cross-Linkage Theory

Redundant DNA TheoryErrors and Repairs Theory

Mitochondrial Theory

Thymic-Stimulating Theory

Death Hormone Theory (DECO)

Hayflick Limit Theory

Limited Number of Cell Divisions

Theory

Waste Accumulation Theory

The Free Radical Theory

The Genetic Control TheoryThe Neuroendocrine Theory

The "Wear and Tear" Theory


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Aging Organs

BONESAND JOINTS MUSCLESANDBODY FAT

EYES

EARS

MOUTH AND NOSE

SKIN

BRAIN AND NERVOUSSYSTEM HEART ANDBLOOD VESSELS

MUSCLESOF BREATHING AND THELUNGS

DIGESTIVESYSTEM

KIDNEYSAND URINARY TRACT

RE

PROD

UC

TIVE

ORGANS

ENDOCRINESYSTEM

BLOOD PRODUCTION

IMMUNESYSTEM

Documents

Patient Safety and the Aging Population Seminar