Total Duration: 30 minutes

Presentation: 25 minutes

Question & Answer session: 5 minutes

Dr. Salma Azeez

To provide a multi-

disciplinary forum and

framework which

identifies and manages

environment of care

issues, thus promoting a

safety environment for

our patients, visitors and

staff.

1. To oversee, guide and ensure

the following aspects of

safety in the hospital:

Patient safety

Employee safety

Radiation safety

Environment /Facility safety

Disaster Management

2. To promote a culture of ‘ Do

not harm’ and report any

‘Near Misses”

3. To review the incident report

analysis & action taken

towards incidences reported.

4. Appropriate storage and safety practices with regard to all Hazardous materials including waste management.

5. Analyze the staff injuries reported and other illness caused at work.

6. Teaching and training programs conducted for all levels of staff for safety of patients and personnel.

A Risk management

program in hospitals is

imperative because:

•To treat patients in a

safe environment.

•We are constantly

exposed to external

and internal risks.

•To reduce errors that

are costly in terms of

damage.

Patient Safety

Employee

Safety

Laboratory

Safety

Emergency &

Disaster

Preparedness

Hazardous

Materials

Surgical

Safety

Facility safety

SET THE SAFETY

CULTURE……

•Non punitive

•Transparent

• Need to know

•Speak out

• If we don't know, how

can we correct it?

• It can happen to anyone

of us!

•Involvement of

Clinicians for clinical

safety issues

“ A sustained, proactive

process of

identifying, avoiding and

rapidly resolving

errors, omissions, mishaps

and miscommunications that

could affect patients well

being at any point of time”’

Accuracy of patient identification.

Safety of using medications.

Risk of Health care-associated infections.

Accuracy and complete reconciliation of

medications across the continuum of care.

Risk of patient harm resulting from falls.

Surgical safety.

Health care-associated Pressure ulcers

Emergency preparedness……

and many more !

(use of: safety bands, non skid slippers, markers on

surgery sites are helpful)

VERBAL ORDERS: ERROR

PREVENTION:

•Read back policy Avoid when

possible.

•Enunciate slowly and distinctly.

•State numbers like pilots

(i.e., “one-five mg” for 15 mg).

• Spell out difficult drug names

Specify concentrations

(10 Cohen MR. Medication Errors.

Causes, Prevention, and Risk

Management; 8.1-8.23.)

IDENTIFY PATIENTS

CORRECTLY

Use at least (2) ways to identify

patients while giving medicines, giving

blood or blood products, taking blood

samples or providing any other

treatments or procedures. The patients

Room No cannot be used to identify

patients.

(call patient name loud & clear and wait

for patient acknowledgement as well as

match wrist identification e.g. MR no.#)

Language should be simple and understood. A read back or narrate can help Increase health literacy of patients.

Standardize the handover process and allot sufficient time

Relevant information should be available to every one concerned.

Patients should be aware of the medicines, dosages and intervals of administration

Patient and families should be involved in the decision making.

(Comments: educate patient about: name of drug, dose, how-to-take, written instructions, & known side effects. Patient and relatives should sign consent for control drug therapies/surgeries)

Implementation of strategies that make

alcohol-based hand-rubs readily available at

points of patient care.

Access to a safe, continuous water supply at

all taps/faucets.

Staff education on correct hand hygiene

techniques; Use of hand hygiene reminders in

the workplace.

Measurement of hand hygiene compliance

through observational monitoring and other

techniques.

Patient Falls

Allergy assessment

Pressure Ulcers

Medication

Errors

Adverse drug reactions

Vulnerable patients

Risk assessment in different groups

of employees .

Pre Joining formalities: Medical

fitness

Periodic health check up policy

(„Periodicity‟ differs in different

groups of employees).

Medical Benefits

Post exposure prophylaxis… needs

to be streamlined.

•Installation of warning signals in appropriate areas - Bilingual

•Monitoring of Radiation safety & monitoring devices.

• Radiation safety data.

• Standardize the personal protective wearing for paramedics.

•Correct patient

identification.

•Correct sample

identification.

•Reduce typographical

errors.

•Safety in blood bank

•Transfusion transmitted

reactions.

•Set protocols in case

of a spill.

Know the emergencies/disasters relevant to

your institute/workplace.

Code system

Location of ramps, fire

extinguisher, evacuation plan etc.

Appropriate personal protective measures to

be procured for emergencies.

Training, training, training…

Do mock drills

CODE RED FIRE

CODE BLUE ADULT CARDIOPULMONARY ARREST

PEDIATRIC CODE

BLUE

PEDIATRIC CARDIOPULMONARY ARREST

CODE ORANGE HAZARDOUS MATERIAL SPILL / BIOLOGICAL

AGENT HAZARD

CODE YELLOW INFANT / CHILD MISSING

CODE GRAY SECURITY THREAT

CODE BLACK DISASTER

•Know the hazardous

material in relevant to

your area.

•Material safety data

sheets.

•Personal protective

equipment boxes.

•Training •Incident Reporting in

case of spills

•Incomplete Consent

forms.

•Marking of site pre

operatively.

• Pre anesthetic review

•Operative notes (to be

authenticated)

Nursing call bells

Checking and maintenance Safety

belts in stretchers/wheel chairs

Signage – danger/warning

Regular checking of alternative

sources of supply

CORDON off renovation sites

No lose wires/open electric circuits

Disabled friendly washrooms

Reactivation of fire detection

systems in new building

Emergency lights in staircases

To develop a culture of patient safety

To describe approach for measurement and reporting on patient safety

To find out frequent problems that our Institute encounters .

Identify accountabilities

To develop the solutions for patient safety

Safety

Reliability

Change

Data

Culture

Leadership

Pyramid

THANK YOU