Weekly Must Reads in Patient Safety (Oct 3, 2014)

Patient monitoring seems to be the flavor of the day in this week’s articles and tweets … so, remember to monitor – Keep It On!

That said, better alarm management is needed to encourage more use of continuous electronic monitoring – could a woman’s death be due to alarm fatigue, as reported by Outpatient Surgery?

However, when adverse events occur (such as when an alarm is ignored), should the individual or the systems or lack of systems be blamed?

Monitoring to Improve Patient Safety and Outcomes

There are two recent studies to read on the benefits of patient monitoring.

The first is a study by Paul Niklewski, PhD, of University of Cincinnati and his colleagues, which suggests that the area under the curve of oxygen desaturation may provide “more complete information on the characteristics of desaturation episodes, [which] could be a useful new tool for monitoring patient risk during procedures”.

The second is a study from the Department of Respiratory Medicine, Shanghai Pudong New Area People’s Hospital which found that volumetric capnography may distinguish between chronic obstructive pulmonary disease patients and normal subjects.

The key takeaway – Keep It On!

Thanks to @joannasapida for tweeting about and supporting this effort!

Better Alarm Management is Needed

Hats off to @OutpatientSurg for this article – Patient codes on the OR table. Was distracted doctoring and alarm fatigue to blame?

Thanks to @stephanieO69 for pointing out our national survey that found hospitals rank alarm fatigue as top patient safety concern.

Are People or Systems at Fault?

Hats off to @MarkGraban for reminding us that firing people may not be the right patient safety fix.

As well, before we blame people, @StopErroresMed points out this study that shows that having enough nurses with the right workload is also a key to keeping patients safe.

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