New ED processes remove barriers
While removing the many barriers to National Patient Safety Goal compliance that exist in the ED is not always easy, it can be done, as demonstrated by some of the safety improvement processes instituted in the ED at the University of Kentucky Medical Center in Lexington.
For example, in order to improve patient identification, you've got to introduce a standard method, notes Mary Rose Bauer, MSN, quality compliance coordinator for emergency trauma services and a co-author of a recent article in The Joint Commission Journal on Quality and Patient Safety that addressed many of these issues. "Since we're communicating across an entire system, it's important not only for the staff to understand what the identifiers are and when to use them, but to provide scripting," she says. "This is most important, so when the staff approach the patient, they have a standard way of talking to them so they get the correct information."
In her ED, for example, every staff member says, "Tell me your name, and tell me your date of birth." "You do not want some people walking up to a patient and saying, 'Hi, Mrs. Smith, I see your data of birth is such and such,'" Bauer offers. "This tends to lead to problems in patient safety."
Here are some other methods used in the ED to ensure safe practices are followed:
- A pharmacist has joined the ED staff and works during the busiest times for the department. The pharmacist reviews medication reconciliation, standardized drug concentrations, and look-alike and sound-alike drugs. "We have totally reorganized our Pyxis so that we do not have look-alike drugs in areas right next to each other," Bauer notes.
- Standardized abbreviations are displayed on posters in the department and also are listed on the medication reconciliation form. "We also have audits performed by a pharmacist so that everyone knows where the problems lie and what needs to be done in terms of staff education," says Bauer. The ED is more than 97% compliant for physicians and nursing staff, she notes.
- The SBAR (Situation, Background, Assessment, Recommendation) system is used to improve the effectiveness of communications. "We have not only educated the staff, but every staff member has a little card they keep on their ID badge that spells out specific information you need to give in a handoff — certain things we must do before the patient is passed on to the floor," says Bauer.
Finally, she says, "during every staff meeting we have some form of Joint Commission training. We review all the National Patient Safety Goals and look at our compliance rates."
While removing the many barriers to National Patient Safety Goal compliance that exist in the ED is not always easy, it can be done, as demonstrated by some of the safety improvement processes instituted in the ED at the University of Kentucky Medical Center in Lexington.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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