Healthcare facilities

Manufacturers should also report incidents where user error resulted in death or a serious deterioration in the state of health, or created a serious threat to public health. The manufacturer is also obliged to monitor trends and report where a significant increase in the level of incidents is observed, even if individual incidents would not be reportable in isolation. Abnormal use events should be addressed to the healthcare facility where they occur. The manufacturer should endeavour to report incidents immediately, once they become aware of the suspected involvement of their device, but in any event the following time limits must be respected ... 

Isolation Procedures Once a victim of chemical or biological agents or weapons gets to the hospital or another healthcare facility, that person may have to abide by patient isolation procedures. These include Standard Precautions, Airborne Precautions, Droplet Precautions, and Contact Precautions. These precautions are spelled out in the third edition of Medical Management Of Biological Casualties Handbook published by the U.S. Army Medical Research Institute of Infectious Disease located at Fort Detrick in Frederick, Maryland. 

APIC Bioterrorism Task Force and CDC Hospital Infections Program Bioterrorism Working Group. Bioterrorism readiness plan a template for healthcare facilities. Available at http // www.cdc.gov/ncidod/hip/Bio/bio.htm. Accessed October 2001. 

Scott White s Center for Advanced Medicine in Temple, Texas, is the first comprehensive, all-digital healthcare facility in the United States and opened in 2005 with the assistance of MED, as well as many other Siemens divisions. A truly integrated hospital, Scott White will utilize Siemens healthcare information technology solutions for patient monitoring and for connecting all hospital departments to allow more... 

Nagamaik P, Batt A, Boulanger B (2011) Source characterization of nervous active pharmaceutical ingredients in healthcare facility wastewaters. J Environ Manage 92 872-877... 

Why is an understanding of the transient phenomenon important Large electromagnetic devices such as transformers and motors are practically impervious to the effects of transients. Problems arise because of the sensitivity of the microelectronic devices and circuits that make up the control elements of the power system. The microprocess controller is the nerve center of every present-day manufacturing or commercial facility. Medical electronic instruments used in healthcare facilities are becoming more sophisticated and at the same time increasingly susceptible to... 

Agency for Healthcare Research and Quality (AHRQ). (2002). Bioterrorism emergency planning and preparedness questionnaire for healthcare facilities. Retrieved from http // www.ahrq.gov/about/cpcr/bioterr.pdf... 

Center for the Study of Bioterrorism and Emerging Infections. (2001). Mass casualty disaster plan checklist A template for healthcare facilities. Retrieved from http //www.apic.org/ bioterror/checklist.doc... 

Richter, P. V. (1997). Hospital disaster preparedness Meeting a requirement or preparing for the worst Healthcare Facilities Management Series, 1-11. 

Intentional suicidal ingestion of large amounts of product conveys a greater risk for severe toxicity and increased mortality and should be referred to a healthcare facility for examination and treatment if needed (Ingels et al, 2002). 

In case of suspected terrorist act, misuse, intentional criminal, or any deliberate intentional suicidal ingestion, or when the amount ingested is either a large amount, or cannot be determined, the patient should be referred to a healthcare facility for clinical and laboratory assessment, and treatment if necessary (POISINDEX, 2007 Manoguerra and Cobaugh, 2005). 

CAD-related deaths occurring before 65 years of age. There are approximately 78 million 20- to 39-year-olds in the U.S. today compared with 72 million in 1980.2 More than 25% or 19.5 million have plasma LDL-C greater than 144 mg/dl, making this population a vast reservoir of futnre patients to bnrden healthcare facilities and resources as they age into their 50s and 60s. Effective prevention strategies focnsed on the yonng adult age group could potentially decrease the incidence of advanced atherosclerosis or considerably delay its onset, improve qnality of life at older ages, and ease the financial bnrden associated with atherosclerotic diseases, which is approximately 146.2 billion a year for coronary heart disease and stroke combined. ... 

Barker KN, Pl5mn EA, Pepper GA, Bates DW, Mikeal RL. Medication errors observed in 36 healthcare facilities. Arch Intern Med 2002 162 1897-1903. 

There are approximately 40,400 medicinal prescribers, 29,000 of which are physicians. Specialists comprise of 60 percent of this number. The number of pharmacists is 4,500, optimal for the country. By the end of 1995, apart from healthcare facilities run by the state, there were 10,230 physicians and 4,620 dentists in private practice. Approximately 403 wholesalers are licensed in Bulgaria, 381 of which are private and 22 that are in process of privatization. There are 2,300 pharmacies of which only 500 are still state-owned. About 6,000 drug dosage forms are registered in Bulgaria of which 15 percent are classified as over-the-counter (OTC). 

The Ministry of Health (MOH) is the central national health authority for healthcare, health protection, curative spas, curative centres, health education and pharmacy care. The state secretary has a function as a vice-minister. The MOH consists of the office sections and departments that are responsible for different MOH activities. The MOH directly governs more than 350 hospitals, institutions and healthcare facilities. 

Table 1. Healthcare facilities in government sector. Source Ministry of Public Health, 1997. ... 

An important component of responding to a significant chemical incident is to prepare and provide a Public Health Statement/Patient Information Sheet to the healthcare facility. The healthcare provider can then disseminate this objective toxicological information to all treated individuals and the community at large to both educate and allay fears within the local population. 

Healthcare facilities need to expect that in case of a chemical event, many people are likely to self-evacuate and present to medical facilities. In order to maintain some control, it is recommended that all access and egress at treatment facilities be controlled and monitored to prevent contamination of noncon-taminated individuals and facility areas. It is helpful to have law enforcement involved to provide security and crowd control. 

Decontamination with copious amounts of room temperature water for at least 15 min should be done. If irritation, pain, swelling, lacrimation, or photophobia persists, the patient should consult healthcare facility. 

Poisoning emergencies are a common occurrence. In 2002, The Toxic Exposure Surveillance System of the American Association of Poison Control Centers reported 2 380028 toxic exposures and 1153 resultant fatalities. Of these total exposures, 548 093 (22.2%) were managed in a healthcare facility and 72 877 were admitted to a critical care unit (3.1%). The mortality rate associated with these overdose patients was less than 1%. Thorough evaluation, adequate supportive care, and the use of a few specific antidotes have resulted in lowered morbidity and mortality if the poisoned patient arrives at the hospital in time for the healthcare team to intervene. In select cases, decreasing further toxin absorption by various decontamination procedures may be of benefit. 

Patients presenting to healthcare facilities with dermal contamination pose a potential risk to healthcare personnel. Contaminated patients should not gain entrance into the healthcare facility prior to decontamination. Personnel involved in the dermal decontamination may need to don personal protective equipment. Most chemical exposures do not pose a risk of secondary exposure. For exposures that occur in the workplace, Material Safety Data Sheets can be obtained and either the local poison center or the Agency for Toxic Substances and Disease Registry can be contacted to obtain advice on what level of protection is appropriate. Contaminated clothing and valuables should be placed in an impervious bag to avoid potential of gassing. 

The facts that the patient needs to know about the medication Patient education enables the patient to self-administer the medication and report adverse reactions after he or she leaves the healthcare facility. 

The availability of the medication Make sure that the healthcare facility stocks the medication. 

Easy Access Medication in a healthcare facility can be diverted from patients with little chance of being detected. 

Hint If an error occurs, assess the patient and then notify the nurse in charge and the physician. Follow the healthcare facility s policy for reporting error. Review the steps that caused the error to occur. 

Medication is measured using the metric system and the apothecaries system. The metric system is used to measure medication in a healthcare facility and used when prescribing and recording the medication in the patient s chart. The apothecaries (household) system is used by patients who self-administer medication. 

The dose prescribed by the healthcare provider may not be available in the healthcare facility. For example, the healthcare provider may order 15 mg tablets of Inderal and the healthcare facility has 10 mg tablets of Inderal. 

Replace the feeding bag every 24 hours (or per healthcare facility policy). 

Change the solution and tubing every 24 hours. Change the dressing every 48 to 72 hours or according to the healthcare facility s policy. 

Be aware of the healthcare facility s policy on stop orders and renewal orders. Typically antimicrobial medication orders are for 72 hours. A stop order is automatically enforced after 72 hours, requiring the healthcare provider to reassess the patient before renewing the medication order. This is to assure that the pathogen does not become resistant to the antimicrobial medication. 

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