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Safety practices in hospitals may be “underused”

By Sun Advocate

Until now, patients haven’t been able to do much about the medical mistakes that result in an estimated 180,000 deaths each year in the U.S. That’s primarily because shortsighted medical care has been tough to recognize.
Enter a report commissioned by a small federal agency, the Agency for Healthcare Research and Quality (AHRQ), which takes a big step toward reducing deadly medical mistakes by alerting both health care professionals and the public to critical safety practices. Still, there’s a long way to go before such errors are significantly reduced, experts say.
The report “is a very good starting point, and it’s the cornerstone of our work,” says Laura Blum, project director with the National Quality Forum, a nonprofit membership organization focused on developing and implementing a national strategy for health care quality improvement. The forum, which counts AARP as a member, expects to release consumer-focused health safety practices next summer.
The AHRQ report, which ranked top safety practices after reviewing more than 70 hospital-related practices, is geared toward clinicians. However, “each item listed has relevancy for consumers,” Blum says. Many of the practices are associated with conditions or procedures common among older Americans.
Less than a third of high-risk patients undergoing vascular surgery receive beta-blockers.
What’s notable about the leading safety practices is the under-use of them by doctors and hospitals. Most are inexpensive strategies that would save lives, suffering and money if used more widely, and patients and their families should demand that health care providers follow these guidelines.
Dr. David Gaba, professor of anesthesia at Stanford University School of Medicine, recommends that “patients ask providers about what they are doing or what their institutions are doing to deal with their safety.”
Here are the critical safety practices to keep in mind:
•Prevent debilitating blood clots with fitted elastic stockings, aspirin and other blood-thinning agents that substantially decrease the risk of blood clots for patients undergoing total knee or hip replacements and for older patients facing general surgery. Blood clots commonly occur in hospitalized patients�particularly among older and high-risk patients�resulting in stroke, paralysis or even death. Ischemic stroke and acute spinal injury sufferers are also susceptible to dangerous clotting. Though blood clots occur frequently in hospitalized patients, low-cost measures to prevent clots remain under used or incorrectly used. Drugs such as warfarin or heparin also can reduce clotting.
•Reduce the risk of cardiac complication during surgery with beta blockers. Heart attacks and other cardiac problems are common complications for patients undergoing heart-related surgery, occurring in more than a quarter of such patients.
Almost 60 percent of those suffering such an event in surgery die, while survivors face prolonged hospitalization and higher medical costs. Beta-blockers, drugs that decrease the heart’s activity, can substantially reduce cardiac risk to high-risk patients when given to patients in conjunction with surgery.
Research suggests additional benefits to older patients, including a need for less pain medication. If you’re facing such surgery, ask your doctor about beta-blockers. Less than a third of high-risk patients undergoing vascular surgery receive beta-blockers.
•Prevent infections during catheter insertion. Here’s how: Insist that clinicians reduce the risk of infection by simply wearing sterile gloves, long-sleeved gowns, a full-size drape and non-sterile mask when inserting central line catheters. Problem is, catheter inserters usually wear only sterile gloves and small drapes.
Common and important devices in treating critically ill and other hospital patients, central venous catheters are associated with serious complications such as bloodstream infection, impacting more than 200,000 patients yearly.

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