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‘Second Victim’ May Not Be the Best Approach to Adverse Events
In the effort to more effectively and humanely address adverse events in healthcare, one common method has been to consider the clinicians involved the “second victims.” But is it time to stop that practice? This terminology has been used to highlight the effects on clinicians who are part of a patient’s adverse outcome, signifying that in addition to the patient being a victim, the doctor or nurse also can be traumatized. While well meaning, the “second victim” terminology may produce detrimental effects.
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Legislation Aimed at Surprise Billing Could Bring Liabilities
States and Congress are working to address the “surprise billing” that can hit consumers after a hospital stay or other care in which they learn that they owe thousands of dollars for services they thought were covered by insurance. The legislation is popular among consumers but could create significant potential liabilities for hospitals and health systems. Reducing the risk of those penalties and other consequences will require the risk manager to work with multiple departments within the organization to prevent surprise bills from going out to patients.
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Patients Leaving AMA Require Good Communication to Avoid Liability
Patients who leave against medical advice can be frustrating to clinicians who want to provide the best care and to risk managers who worry that the patient will blame the hospital if the decision leads to a bad outcome. The best way to avoid potential liability is by ensuring that clinicians understand the need to communicate effectively and document thoroughly. Involving the patient’s family members may not always be a good idea, and the risk manager should be careful about intervening.
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Diagnostic Errors Tied to Specific Diseases, Showing Focus for Risk Managers
Despite several years of attention from the medical community, diagnostic errors remain one of the largest threats to patient safety. Three disease categories — vascular events, infections, and cancers — account for nearly three-quarters of all serious harm from diagnostic errors, according to recent research.
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Glucagon Nasal Powder (Baqsimi)
Glucagon nasal powder is indicated for the treatment of severe hypoglycemia in patients (≥ 4 years of age) with diabetes.
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Do Defibrillators Improve Mortality in Dialysis Patients?
In patients with left ventricular ejection fraction ≥ 35% undergoing dialysis, the insertion of a prophylactic implantable cardioverter defibrillator carries a relatively high risk for adverse events and does not significantly decrease sudden cardiac death or mortality.
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APIC Raises IP Profile on YouTube
For many years, patients, the public, and even some fellow healthcare workers were not fully aware of the critical role IPs played behind the scenes. The IP profile has been raised dramatically over the last decade by national efforts to reduce healthcare-associated infections, the rise of antibiotic resistance, and emerging infections like Ebola. As a result, APIC created a video that features IPs explaining what they do and what aspects of the job they particularly enjoy. The video can be used to raise awareness among the public, patients, medical personnel, and recruit new IPs into the profession.
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Infection Prevention Expertise Lacking on Water Management Teams
Water management plans to control Legionella and other waterborne pathogens in healthcare settings have become a priority since a CMS memo in 2017 ordered such measures to protect patients. Infection preventionists should be a key member of these water management teams, but almost half the facilities consulted by Legionella experts did not have an IP on the committee.
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Lower Systolic Blood Pressure Associated With Increased Mortality in Systolic Heart Failure Patients
Systolic blood pressure less than 130 mmHg was associated with increased mortality in a Medicare population with systolic heart failure.
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CMS Deadline Nears, But Infection Control in Long-Term Care a Challenge
The churn of staff turnover and administrative changes in long-term care may make it difficult for many facilities to meet an impending federal requirement to establish infection prevention programs. The CMS deadline for a designated and trained infection preventionist in long-term care facilities is Nov. 28, 2019. CMS and the CDC are offering free training to meet this requirement, but there are signs that some long-term care facilities will struggle to comply.