Safe patient care

Alschuler, L. et al. Herbal medicine what works, what s safe. Patient Care 1997, (October), 49-68. 

Pennsylvania Patient Safety Authority Hemodialysis administration strategies to ensure safe patient care. PA Patient Saf Advis 2010 7 87-96. 

In medicine, not only are members of multidisciplinary teams rarely trained together, but they come from separate disciplines and diverse educational programs (1). Achieving safe patient care that results from the interaction of multidisciplinary teams is difficult to accomplish without adequate understanding of the contributions of each member and the mechanisms that enhance interaction among each other. 

Clinical outcomes measures can include morbidity and mortality, event rates, and symptom resolution (Ovretveit, 2001). These measures are a direct measure of quality but may be difficult to assess, especially in pharmacy, where their onset could be years following a treatment or intervention (Chassin and Galvin, 1998 Shane and Gouveia, 2000). In these cases, indicators or markers can be used to assess outcomes. These indicators can be condition-specific (e.g., HgAlc) or procedure-specific (e.g., rate of postoperative infection after hip surgery) or address an important issue of patient care. For example, blood pressure may be used as a marker to assess susceptibility to stroke because it is not practical, safe, or ethical to wait and measure the occurrence of stroke. 

Responsible for safe distribution and drug administration for patient care, supervising technicians, order entry, drug monitoring, and providing drug information to nurses and physicians. 

The only thing certain about the survey process is that the methods and areas surveyed will continue to change to reflect current standards of care in order to assure quality and safety of patient care provided by accredited organizations. Pharmacists can expect that the JCAHO views them as critical members of the patient care team and integral to ensuring safe and effective... 

Nurses should possess minimum core competencies In orderto provide safe, effective patient care at mass gatherings. 

The hospital became a safe haven for extended facility patients and home-bound patients that needed electricity for their care. Units that normally did not care for admitted patients became patient care areas such as the Cardiac Cath Lab and Same Day Surgery areas. SOMC opened their banquet facility as a respite area for staff and their families for sleeping and personal care. Electricity was restored at this location so staff could sleep or take a shower. 

Nurse responders must approach contaminated sites with great caution an6 be prepared to self-decontaminate. Nurse receivers need to have a solid understanding of how to stay safe while participating in decontamination procedures and patient care at the hospital. 

Tramadol Five reports describe the development of the serotonin syndrome in patients on fluoxetine, paroxetine, or sertraline when tramadol was added. Another patient developed hallucinations with tramadol and paroxetine. Other reports suggest that the SSRI/tramadol combination is therapeutically valuable and normally safe. Also, carefully monitor concomitant use with fluvoxamine. 

APhA programs, products, and services are built in recognition of the dual roles of contemporary pharmacists 1) to insure that the public has access to a safe, efficient, accurate, and patient-sensitive drug distribution system, and 2) that patients achieve optimal outcomes from medication use (prescription, nonprescription, and nontradi-tional therapies) with the assistance of pharmacists. Pharmacists may engage in one or both aspects of these roles, and APhA members practice in a wide variety of different settings, either directly or indirectly affecting patient care. 

Pharmacotherapy is the specialty responsible for ensuring the safe, appropriate, and economical use of drugs in patient care. The pharmacotherapy specialist has responsibility for direct patient care and often functions as a member of a multidisciplinary treatment team. These specialists may conduct clinical research and are frequently primary sources of drug information for other health care professionals. 

The term pharmacy and hospital services refers to departmental and institutional/organizational components of the infrastructure that support the pharmacist s activities. They consist of systems, operations, and personnel who facilitate and support the provision of patient care, teaching, and research to optimize safe and effective pharmaceutical care of the critically ill. 

Design, implement, monitor, evaluate, and modify or recommend modifications in drug therapy to ensure effective, safe, and economical patient care. 

The work of the Study Commission on Pharmacy has had an important impact on the development of clinical pharmacy and pharmaceutical education. It, coupled with other significant reports and individual and organizational leadership, have advanced the profession. As a result, pharmacists are now better educated and trained and play a more significant role in concert with other health providers to help ensure drugs are used safely and effectively in patient care. 

The practice of pharmaceutical care has a clearly articulated philosophy that defines values and explains what all practitioners must do. According to this philosophy, the practitioner performs the following 1) takes responsibility for meeting society s need to reduce drug-related morbidity and mortality 2) employs a patient-centered approach that addresses all the patient s drug-related needs 3) establishes a caring therapeutic relationship with individual patients and 4) assumes a clearly defined set of responsibilities that directs patient care activities. These responsibilities are to ensure that patients receive the most appropriate, effective, safe, convenient, and economical therapy to identify, resolve, and prevent drug therapy problems and to ensure that optimal patient outcomes are achieved. 

Further clinical experience and research fostered development of protocols that promoted better patient care and resulted in a decline in complications associated with parenteral nutrition (PN) therapy. The scope of practice for nutrition support clinicians has broadened as a result of increasing knowledge regarding the metabolic consequences associated with acute injury and chronic disease states. The pharmacist s role in providing safe and effective nutrition-support care requires knowledge of the principles of patient selection, initial therapy design, preparation and dispensing of the nutritional formu-... 

An accountable, systematic approach will ensure that cost-effective, efficacious, safe, and appropriate equipment is available to meet the demands of quality patient care. Such an approach requires that... 

In spite of increased attention to quality, and efforts to provide safe medical care, adverse outcomes are still frequent in clinical practice (Leape, 94). Although some of the risk is related to the imderlying complexity of care and severity of illness in the patient population, a significant portion may be related to the structure of the system - most notably, the operational policies, incentive structures, and constraints imposed by third-parties who finance care. Any efforts to redesign the system, however, must be preceded by careful modeling and analysis to demonstrate exactly how the policies and features of the system influence risk. In this paper, we attempt to build models that demonstrate these system-level influences and how they dynamically shape risk in the healthcare... 

Nelson, A., Safe Patient Handling and Movement A Guide for Nurses and Other Care Providers, Springer, New York, 2006. 

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