Safety resources for perioperative clinicians

Suzanne C. Beyea

Many challenges exist to providing safe patient care. Perioperative nurses protect patients from electrical injury, skin injury, infection, and various hazards inherent in the OR. Knowledge about patient safety is ever-expanding, and awareness of available resources can help nurses and other clinicians promote patient safety. Many organizations have developed resources to assist clinicians and administrators in these efforts. This column highlights some of the resources dedicated to promoting patient safety.

PATIENT SAFETY RESOURCES

Patient safety and quality care are the focus of numerous Internet sites. Two of these include the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) web site at http://www.jcaho.org and the National Patient Safety Foundation (NPSF) web site at http://www.npsf.ory.

The Joint Commission. The JCAHO web site features information about the National Patient Safety Goals and provides helpful answers to frequently asked questions about implementing the related recommendations. This web site includes statistics about sentinel events reported to JCAHO, as well as online Sentinel Event Alerts, which provide valuable information about factors that contribute to medical errors and strategies to prevent them. This web site also contains information about JCAHO standards, which are specifically designed to promote the highest quality of care. One example is the recently revised Infection Prevention and Control Standards, which can be found at http://www.jcaho.org/accredited +organizations/patient+safety/injection+ control/ic+index.htm. Another JCAHO resource of particular interest to perioperative clinicians is the recently released Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery available at http://www.jcaho.org/accredited+organizations/ patient + safety/universal+protocol /index.htm.

The National Patient Safety Foundation. The NPSF web site provides extensive resources about programs, conferences, and publications; links to other patient safety resources; and information about National Patient Safety Week. An extensive listing of helpful web site links for patients and their family members includes online safety sheets and brochures related to patient safety. Numerous patient safety videotapes, books, brochures, reports, and newsletters also are provided.

One resource every clinician should monitor is the NPSF's Current Awareness Literature Alert, a twice-monthly publication about current literature related to patient safety. This resource offers clinicians an easy way to identify articles on topics of interest and gives a short description of the articles. The NPSF also offers a moderated list serve, which is an e-mail based online patient safety discussion forum. Two versions (ie, regular and digest) are offered, and the opportunity to ask questions about patient safety and obtain answers and additional information is available.

PERIOPERATIVE SAFETY RESOURCES

A number of resources are designed specifically for perioperative clinicians. These include resources from AORN and the Anesthesia Patient Safety Foundation (APSF).

AORN, AORN routinely publishes columns and articles related to patient safety in the AORN Journal. The Journal's table of contents indicates safety-related articles with the logo for AORN's Patient Safety First initiative. AORN's annual publication, Standards, Recommended Practices, and Guidelines, provides helpful guidance for perioperative nurses across the nation and the world to establish clinical practices that promote patient safety.

AORN also provides continuing education materials and education sessions that are specific to patient safety. For example, safety-related programs are included at AORN's Congress and specialty conferences.

AORN's Patient Safety First web site at http://www.patientsafetyfirst.org is an up-to-date resource that contains the latest news about patient safety. The web site also provides extensive resources related to available educational products and services pertinent to promoting patient safety. For example, the site features reference lists, guidance statements, web site links, sample documents, and an opportunity to "ask an expert." Resources include information that can help nurses develop policies, procedures, and practices that promote patient safety. One such resource is the "Creutzfeldt-Jakob disease (CJD) information for protocol development," which provides guidance for best practices to prevent CJD infections in the OR.

The Anesthesia Patient Safety Foundation. The APSF has developed numerous resources specific to anesthesia safety, which can be found at http://www.gasnet.org. For example, this web site features a proposed guideline on providing anesthesia to patients infected with severe acute respiratory syndrome. The web site also includes a listing of safety videotapes available from the foundation. Another list includes web sites with resources related to anesthesia and perioperative settings, such as the US Food and Drug Administration (FDA) Safety Alerts or the Malignant Hyperthermia Association of the United States. Although the APSF focuses on anesthesia practice, many of the resources provide valuable information for other perioperative clinicians as well.

MEDICATION SAFETY RESOURCES

Two key resources for medication safety are the US Pharmacopeia (USP) at http://www.usp.ory, and the Institute for Safe Medication Practices (ISMP) at http://www.ismp.org.

The United States Pharmacopeia. The USP collaborates with the FDA, health professionals, and the pharmaceutical industry to establish authoritative information about medications. The USP annually publishes the USP NF (National Formulary), which provides end product standards for prescription and nonprescription medications and dosage forms. Standards related to botanical and non-botanical dietary supplements and ingredients also are provided.

The USP also operates two national medication error databases--the Medication Errors Reporting (MER) Program and MedMARx--that collect, track, and identify trends in medication error data. The MER program is a free, voluntary program for use by any clinician in any setting and is presented in cooperation with ISMP. This nationwide effort seeks to collect information from health care practitioners to provide data to regulatory agencies, professional organizations, and the pharmaceutical industry in an effort to educate these parties about adverse drug events and their prevention. The other program, MedMARx, an Internet-accessible, anonymous, medication error reporting database specific to hospitals and health systems is available through an annual subscription service.

The USP web site includes links to medication safety reporting programs, briefs, articles, reports, alerts, recommendations, patient safety presentations, journal articles, the MedMARx annual data summary, recommendations, resources, and information about news and events. Specific resources include summaries from committee meetings, conferences, and open meetings related to safe medication use. All example of the helpful resources available on this site is a series of tips to help older adults reduce medication errors and a free medication organizer. The USP's Center for the Advancement of Patient Safety focuses on reducing medication errors and providing safer patient care.

Institute for Safe Medication Practices. The ISMP provides valuable resources about safe medication practices for clinicians. This nonprofit organization collaborates closely with a variety of groups to provide education about adverse medication events and prevent them from occurring. The ISMP works closely with the USP by providing an independent review of medication errors reported to the MER database and also collaborates with the FDA and pharmaceutical companies mentioned in these error reports.

The wide variety of resources on this web site includes newsletters, medication safety alerts, and information about upcoming educational programs. The ISMP also provides a resource of particular interest to nurses--an online newsletter about medication safety offered free through 2004 that contains crucial information for nurses administering medications at the point of care.

CONCLUSION

These patient safety resources are representative of the vast number of quality resources available to clinicians. Nurses with an Internet connection at work or home can access these sites and review topics pertinent to the needs of their patients and the setting in which they work.

Knowledge and understanding of medical errors is advancing, and strategies to prevent errors are expanding; clinicians, therefore, must remain current and informed about the interventions that will reduce the risk of error. Explore one or more of these resources and review the information available at your fingertips. Resources such as these can help perioperative clinicians provide the highest quality of care and reduce the risks of error and injury.

Editor's Note: Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery is a trademark of the Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, III. MedMARx is a registered service mark of the United States Pharmacopeia, Rockville, Md.

SUZANNE C. BEYEA

RN, PHD, FAAN

DIRECTOR OF NURSING RESEARCH

DARTNOUTH-HITCHCOCK MEDICAL CENTER

LEBANON, NH

COPYRIGHT 2004 Association of Operating Room Nurses, Inc.
COPYRIGHT 2004 Gale Group