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Journal Article > Study
In situ simulated cardiac arrest exercises to detect system vulnerabilities.
Barbeito A, Bonifacio A, Holtschneider M, Segall N, Schroeder R, Mark J; Durham Veterans Affairs Medical Center Patient Safety Center of Inquiry. Simul Healthc. 2015;10:154-162.
Realistic in situ simulations of cardiac arrest scenarios, conducted in actual clinical settings without advance notification of participants, identified several latent errors in a hospital's emergency response system. Dr. David Gaba, a pioneer in simulation in health care, was interviewed for AHRQ WebM&M in 2013.
Journal Article > Study
A team-based approach to reducing cardiac monitor alarms.
Dandoy CE, Davies SM, Flesch L, et al. Pediatrics. 2014;134:e1686-e1694.
Improving alarm systems to mitigate the risks of alarm fatigue was added as a National Patient Safety Goal in the 2014 update. This study introduced a multifaceted cardiac monitor care process on a pediatric bone marrow transplant unit. The program included standardized steps for ordering and reassessing cardiac monitor parameters. In addition, physicians and nurses used a log to document the need for ongoing cardiac monitoring and created reliable systems for discontinuation of monitoring when it was no longer needed. Patients and families were actively engaged in these activities, helping sustain the program. As compliance with the process improved from 38% to 95%, the number of alarms per patient-day plummeted from 180 to 40. The hope is that reducing unnecessary alerts will address clinician desensitization to clinically important alarms.
Journal Article > Commentary
Developing an action plan for patient radiation safety in adult cardiovascular medicine.
Douglas PS, Carr JJ, Cerqueira MD, et al. Circ Cardiovasc Imaging. 2012;5:400-414.
This report reviews experts' recommendations to improve radiation safety in cardiology.
Journal Article > Study
Characteristics of medical professional liability claims in patients with cardiovascular diseases.
Oetgen WJ, Parikh PD, Cacchione JG, et al. Am J Cardiol. 2010;105:745-752.
This study of closed malpractice claims found that diagnostic error—particularly for missed diagnoses of coronary artery disease—was the most common allegation against cardiovascular physicians.
Journal Article > Study
Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention.
Tsai TT, Maddox TM, Roe MT, et al; National Cardiovascular Data Registry. JAMA. 2009;302:2458-2464.
Patients hospitalized for cardiac problems are vulnerable to experiencing medication errors, as they are commonly prescribed high-risk medications such as anticoagulants and antiplatelet agents. This analysis of more than 22,000 hemodialysis patients undergoing percutaneous coronary interventions (PCI) (for example, angioplasty) found that 22.3% were administered either enoxaparin or eptifibatide, medications that are contraindicated in dialysis patients due to excessive bleeding risk. This risk was borne out in the study, as patients who received the contraindicated medications did in fact have more major bleeding episodes. The high prevalence of serious medication errors in this study argues for education and use of forcing functions to prevent misuse of these medications.
Journal Article > Study
Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents during simulated cardiopulmonary arrests.
Hunt EA, Vera K, Diener-West M, et al. Resuscitation. 2009;80:819-825.
This study found that pediatric residents failed to consistently perform cardiopulmonary resuscitation according to established guidelines, mirroring results from a prior study in adult patients.