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PubMed2003

Medication safety issue brief. Series II, Part 6: Tapping into your staff's energy.

The front-line workers in a hospital are its greatest resources, particularly when it comes to improving safety. After all, they know the crucial details about day-to-day operations and can offer innovative solutions to problems. But staff members don't always feel comfortable getting involved in change. To tap this hidden well of talent, hospitals leaders should train staff in systems thinking, cultivate a culture of safety and make it easy for employees to contribute their ideas.

Creativity↗
PubMed2005

Medication safety issue brief. Eliminating dangerous abbreviations, acronyms and symbols.

The use of abbreviations, acronyms and symbols in prescribing and transcribing medication orders too often results in the misinterpretation of the order's intent. Busy health care practitioners often use these shortcuts to indicate drug names, dosages, the patient's condition and route of administration. The result can be omission errors, extra or improper doses, administering the wrong drug, or giving a drug in the wrong manner. Stopping the use of unapproved abbreviations, acronyms and symbols can go a long way toward preventing these errors, but that's proven difficult to accomplish. This briefing examines ways that hospitals can put an end to the practice.

Abbreviations as Topic↗
PubMed2005

Medication Safety Issue Brief. Bar Code implementation strategies.

Bar code technology is hailed as a tool to prevent medication errors from occurring where they could cause the most harm--at the point of care. It provides an extra layer of protection for front-line caregivers and helps hospitals comply with Joint Commission on Accreditation of Healthcare Organizations' standards and patient safety goals. Specifically, it helps hospitals meet requirements to verify orders and patients before medication administration. It ensures that nurses administer the right drug to the right patient in the right dose at the right time and by the right route.

Clinical Pharmacy Information Systems↗
PubMed2005

Medication safety issue brief. Counterfeit drug prevention and identification.

The U.S. drug supply is purportedly one fo the safest in the world and yet counterfeit medications do make their way to pharmacy shelves and into the hands of unsuspecting patients. The World Health Organization reports that about $35 million in counterfeit drugs are sold n the United States each year. Worldwide, between 6 percent and 10 percent of prescription drugs on the market are counterfeit, WHO estimates. The Food and Drug Administration conducted 22 investigations into counterfeit drugs in 2002 and again in 2003; that's up from an average of five investigations per year through the late 1990s. Counterfeit drugs can cause serious harm to patients, including allergic reactions, and deny them access to potentially life-saving treatments.

Drug Industry↗
PubMed1985

National survey of the usage of lung expansion modalities for the prevention and treatment of postoperative atelectasis following abdominal and thoracic surgery.

A national survey of hospitals was conducted to evaluate the usage of lung expansion maneuvers in the prevention and management of postoperative atelectasis associated with abdominal and thoracic surgery. Equal numbers of hospitals were randomly selected from the nine American Hospital Association regions and from bed-size groups of 50 to 200 beds, 201 to 400 beds, and greater than 400 beds. Preoperative and postoperative prophylactic therapy was found to be similar in all groups except for a lower usage of intermittent positive-pressure breathing (IPPB) in the western third of the United States compared with the central third. In the treatment of postoperative atelectasis there are significant differences in the use of chest physical therapy, IPPB, and intermittent continuous positive airway pressure based on hospital size. Objective measurements of tidal volume or inspiratory capacity as a guide to therapeutic decisions are performed more frequently in the western regions. Surgical statistics relative to the number of abdominal and surgical procedures done and the incidence of postoperative atelectasis are also presented.

Abdomen↗
PubMed1979

AHA looks at nurse credentialing.

AHA's National Conference on Categories or Nursing Practice explores the weaknesses and strengths of the credentialing system and the ramifications of proposed changes.

Accreditation↗
PubMedDate not supplied

Tonsillectomy and adenoidectomy: incidence and mortality, 1968--1972.

To determine the number of tonsillectomies and adenoidectomies (T-As) from 1968 to 1972 and their associated morbidity and mortality rates, a questionnaire was sent to all the hospitals listed in the Directory of the American Hospital Association (6,759). The data were analyzed and statistical projections were made. An analysis was also made of the summary report of the "Study on Surgical Services for the United States," with regard to the incidence of T-A was also made. The results are presented in the following report.

Adenoidectomy↗
PubMedDate not supplied

Hospital and pharmacy characteristics associated with mortality rates in United States hospitals.

We attempted to determine hospital and pharmacy characteristics associated with mortality rates in 4864 United States hospitals. Data were obtained from the Health Care Financing Administration, the American Hospital Association, and the National Clinical Pharmacy Services survey. Univariate and multivariate regression models were used to determine which hospital characteristics were associated with mortality. A similar regression analysis was performed on 718 hospitals for which detailed pharmacy information was available. In a multivariate regression model, some characteristics of 4864 hospitals associated with reduced mortality rates were high-technology index (R2 = 0.09, p < 0.001), severity of illness (R2 = 0.048, p < 0.001), number of hospital beds (R2 = 0.016, p < 0.001), and medical personnel (R2 = 0.012, p < 0.001). This analysis accounted for 41% of the mortality rate variance. For the 718 hospitals and pharmacies, some of these characteristics were high-technology index (R2 = 0.157, p < 0.001), severity of illness (R2 = 0.07, p < 0.001), number of pharmacists/average daily census (R2 = 0.021, p < 0.001), and combined hospitalwide clinical pharmacy services (R2 = 0.016, p < 0.01). The results of this analysis were similar to those in the only other large study in this area, but that excluded pharmacy characteristics. This is the first study to show a statistically significant association between pharmacist and pharmacy variables and reduced hospital mortality rates.

Hospital Bed Capacity↗
PubMed1998

Making do with fewer nurses in the United States, 1945-1965.

PURPOSE: To analyze the perceptions that nurses and hospital administrators had about the nursing shortage between 1945 and 1965 and the actions they took. Reasons nurses' wages remained low during this period of shortages and high demand were also examined to expand knowledge of nursing labor during a critical time in nursing history. METHOD: Historical analysis of primary and secondary sources generated between 1945 and 1965 including: (a) American Nurses' Association's (ANA) central files in Washington, DC; (b) ANA archives at the Mugar Memorial Library, Boston University; (c) official proceedings of the ANA's and American Hospital Association's (AHA) conventions; (d) nursing and hospital journals; (e) ANA and U.S. Government statistical documents and reports on the status of nursing labor; and (g) monographs on nursing, hospitals, the history of women's labor and the history of women in the 1940s, 1950s, and 1960s. FINDINGS: Hospital administrators and nurses disagreed on the causes of the nursing shortage and its remedies in the 20 years after World War II. Hospital managers believed the shortage occurred because many nurses left the work force to remain at home with their families. Nurses, however, identified low wages and deplorable working conditions as the cause. CONCLUSIONS: Hospital managers were successful at easing the shortage and controlling nursing costs by employing ancillary workers to replace RNs. Nurses took several different actions to deal with poor working conditions: initiating the ANA Economic Security Program, joining unions, and leaving hospital nursing.

History, 20th Century↗