10 Patient Safety Tips for Hospitals

Medical errors may occur in different health care settings, and those that happen in hospitals can have serious consequences.  The Agency for Healthcare Research and Quality (AHRQ), offers these 10 evidenced-based tips to prevent adverse events from occurring in your hospital.

1. Prevent central line-associated blood stream infections. Be vigilant preventing central line-associated blood stream infections by taking five steps every time a central venous catheter is inserted:  wash your hands, use full-barrier precautions, clean the skin with chlorhexidine, avoid femoral lines, and remove unnecessary lines.
    
2. Re-engineer hospital discharges.  Reduce potentially preventable readmissions by assigning a staff member to work closely with patients and other staff to reconcile medications and schedule necessary follow up medical appointments.
    
3. Prevent venous thromboebolism.  Eliminate hospital-acquired venous thromboem-bolism (VTE), the most common cause of preventable hospital deaths, by using and evidence-based guide to create a VTE protocol.
    
4. Educate patients for using blood thinners safely.  Patients who have had surgery often leave the hospital with a new prescription for blood thinners to keep them from developing dangerous blood clots.  However, if used incorrectly, blood thinners can cause uncontrollable bleeding and are among the top causes of adverse drug events.
    
5. Limit shift durations for medical residents and other hospital staff if possible.  Evidence shows that acute and chronically fatigued medical residents are more likely to make mistakes.  Ensure that residents get ample sleep and adhere to 80 hour work week limits.  Residents who work 30-hour shifts should only treat patients for up to 16 hours and should have a 5-hour protected sleep period between 10pm and 8am.
    
6. Consider working with a Patient Safety Organization.  Report and share patient safety information with Patient Safety Organizations (PSOs) to help others avoid preventable errors.
    
7. Use good hospital design principles.  Follow evidence-based principles for hospital design to improve patient safety and quality.  Prevent patient falls by providing well-designed patient rooms and bathrooms and creating decentralized nurses’ stations that allow easy access to patients.  Reduce infections by offering single-bed rooms, improving air filtration systems, and providing multiple convenient locations for hand washing.  Prevent medication errors by offering pharmacists well-lit, quiet, private spaces so they can fill prescriptions without distractions.
    
8.  Measure your hospital’s patient safety culture. Survey hospital staff to access your facility’s patient safety culture.
    
9.  Build better teams and rapid response systems.  Train hospital staff to communicate effectively as a team. 
    
10. Insert chest tubes safely. Remember UWET when inserting chest tubes.  The easy-to-remember mnemonic is based on a universal protocol from the Joint Commission and stands for Universal Precautions, Wider skin prep, Extensive draping, and Tray position.

For free copies of more detailed information and AHRQ tools, call the AHRQ Publications Clearinghouse at (800) 358-9265.

(Information obtained from the AHRQ Publication No. 10-M008, December 2009)