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Search results for "Physicians"
Cases & Commentaries
- Spotlight Case
- Web M&M
C. Craig Blackmore, MD, MPH; March 2019
A woman with multiple myeloma required placement of a central venous catheter for apheresis. The outpatient oncologist intended to order a nontunneled catheter via computerized provider order entry but accidentally ordered a tunneled catheter. The interventional radiologist thought the order was unusual but didn't contact the oncologist. A tunneled catheter was placed without complications. When the patient presented for apheresis, providers recognized the wrong catheter had been placed, and the patient underwent an additional procedure.
Journal Article > Commentary
Gupta A, Jain S, Croft C. JAMA. 2019;321:504-505.
Journal Article > Review
Challen R, Denny J, Pitt M, Gompels L, Edwards T, Tsaneva-Atanasova K. BMJ Qual Saf. 2019;28:231-237.
Artificial intelligence (AI) has the potential to improve health care. This narrative review summarizes short-, medium-, and long-term safety concerns associated with AI implementation in medical care. The authors provide quality control questions to help those involved in developing AI systems detect areas of concern.
ISMP Medication Safety Alert! Acute Care. July 12, 2018;23:1-4.
Smart pumps are employed throughout health care, but their design can challenge safety. Reporting results of a national survey, this newsletter article outlines how smart pump data is being used to improve compliance and suggests ways organizations can enhance the value of analytics to inform frontline practice improvement. A previous WebM&M commentary discussed a smart infusion pump error that resulted in patient harm.
Journal Article > Commentary
Walroth TA, Smallwood S, Arthur K, et al. Am J Health Syst Pharm. 2018;75:893-900.
Nuisance drug alerts generated by smart infusion pumps can detract from safe care delivery by contributing to alert fatigue and interruptions. This commentary reviews a consensus initiative to decrease insignificant alerts across six health systems. The authors describe how the group standardized smart pump drug library management processes to refine dosage recommendations, policy development, alert review, and data usage to reduce alerts in acute care facilities. A past PSNet perspective discussed the importance of addressing hazards associated with smart pump utilization.
ISMP Medication Safety Alert! Acute Care Edition. April 5, 2018;23:1-5.
Smart pumps are considered an important tool to improve medication safety in the hospital environment. This newsletter article summarizes the results of two national surveys on smart infusion pump use to highlight current concerns and challenges to generating improvements. Irrelevant alarms and out-of-date drug libraries were among the problems identified by survey participants.
Journal Article > Study
Griffey RT, Wittels K, Gilboy N, McAfee AT. Ann Emerg Med. 2009;53:469-476.
Computerized reminders to renew orders for physical restraints were combined with a forcing function—denial of computer access until the order was completed—in this trial conducted in an emergency department. Although clinician ordering behavior improved, no significant improvement was found in the amount of time patients spent in restraints.