The Agency for Healthcare Research and Quality (AHRQ) this week listed the top 10 patient safety strategies that providers can immediately implement to prevent nosocomial infections and medical errors.
For the report, published in the journal Annals of Internal Medicine, AHRQ in 2008 commissioned researchers from the RAND Corporation, Johns Hopkins University, ECRI Institute, University of California-San Francisco, and Stanford University to assess more than 150 safety issues.
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The ready-to-implement strategies that the researchers "strongly" encourage providers to adopt immediately are:
1. Pre-surgery checklists and anesthesia checklists;
2. Bundles to prevent central-line infections that include checklists;
3. Interventions to reduce urinary catheter use, such as catheter reminders and nurse initiated removal protocols;
4. Bundles to prevent ventilator-associated pneumonia, such as head-of-bed elevation and sedation vacations;
5. Mandated hand hygiene practices;
6. A do-not-use list for hazardous abbreviations;
7. Interventions to reduce pressure ulcers;
8. Precautions to prevent hospital acquired infections;
9. Real-time ultrasonography use while placing central lines; and
10. Interventions to improve prophylaxis for venous thromboembolisms.
"Providers should not delay adopting these practices," according to the researchers—who include patient safety expert Peter Pronovost. They add, "Enough is known now to permit healthcare systems to move ahead."
Lead author Paul Shekelle of the RAND Corporation said that the only reason facilities may not see changes from such interventions is if employees do not take them seriously (Gever, MedPage Today, 3/5; Barclay, Medscape Medical News, 3/4; Shekelle et al., Annals of Internal Medicine, 3/5).
Pronovost on quality improvement
Hear Dr. Peter Pronovost discuss the disconnect between front-line clinician and executive views of quality care, and how Johns Hopkins developed an infrastructure to bridge the gap by supporting clinicians to lead system-wide quality improvement.