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Pennsylvania Patient Safety Authority Releases March Advisory Highlighting Communication Issues That Affect Patient Safety
Date:3/27/2008

ound on the Authority's website at http://www.psa.state.pa.us under "Tips for Consumers."

-- Treating Stroke Symptoms Quickly in the ED May Improve Outcomes: The Authority has received reports that show delays in treatment of a suspected stroke in the emergency department due to several factors including lack of staff awareness of stroke treatment protocols involving thrombolytic therapy -- a method of treatment proven to reduce the effects of stroke. Given the narrow therapeutic windows for treatment of a stroke, timely evaluation and diagnosis is critical to avoid significant harm or death. Challenges are outlined in confirming a stroke diagnosis quickly and risk reduction strategies are discussed.

-- Preventing the Retention of Foreign Objects: Several patients have been injured due to retained foreign objects during invasive radiology procedures performed outside the operating room setting. Interventional Radiology (IR) procedures allow physicians to use x-rays to perform certain procedures that usually involve a very small incision. However, despite the small incision, the risk of leaving behind foreign objects in the patient remains. Risk reduction strategies are discussed.

-- Lab Specimens at Risk: More than 600 reports submitted to the Authority show that misusing pneumatic tubes in material transport can present a patient safety concern. Some transport issues are because of mechanical breakdowns of the pneumatic tube systems but others are a result of staff misuse and breaks in communication. Many reports relate to specimen delivery, where samples are damaged, lost or delayed in transit. Also, cases mention having to redraw or recollect the specimen. Guidelines for proper use of pneumatic tube systems are given along with other considerations for improvement.

For a copy of the 2008 March Patient Safety Advisory go to

SOURCE Pennsylvania Patient Safety Authority
Copyright©2008 PR Newswire.
All rights reserved

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