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Patient-safety experts in North America and the U.K. systematically reviewed the growing evidence base for 158 patient-safety topics, including 41 strategies designated as most important to practitioners and patients. All reviews are published in the Agency for Healthcare Research and Quality (AHRQ) evidence report entitled “Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices” to update the original 2001 publication. After carefully analyzing each patient-safety problem and its related safety strategy, the authors strongly recommend immediate adoption of the following 10 strategies:
Preoperative and anesthesia checklists to prevent operative and postoperative events
Bundles (with checklists) to prevent central line–associated bloodstream infections
Interventions to reduce urinary catheter use
Bundles to prevent ventilator-associated pneumonia
Hand hygiene
Do-not-use list for hazardous abbreviations
Multicomponent interventions to prevent pressure ulcers
Barrier precautions to prevent healthcare-associated infections
Real-time ultrasonography for central line placement
Interventions to improve prophylaxis for venous thromboembolism
The authors also provide a list of 12 “encouraged” (rather than “strongly encouraged”) patient-safety practices.
Shekelle PG et al. The top patient safety strategies that can be encouraged for adoption now. Ann Intern Med 2013 Mar 5; 158:365. (http://annals.org/article.aspx?articleid=1657884)
Shine KI. Patient Safety Strategies: A call for physician leadership. Ann Intern Med 2013 Mar 5; 158:353. (http://annals.org/article.aspx?articleid=1656417)
Comment
To formally revisit patient safety makes sense after more than a dozen years following publication of the Institute of Medicine's report, “To Err Is Human: Building a Safer Health System.” Healthcare and policy experts have learned much during that time, including how to improve healthcare delivery to lower patient risk.