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Classification of the PSP |
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Type of Patient Safety Practice
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Not Evaluated
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Clinical Practice (CP)
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Related practices from PaSQ database
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| "Best fit" category of the reported practice |
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Medication / IV Fluids
Medical devices / Equipment
There is no specified text here
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| Topic of the reported practice |
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Patient safety system
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Aim and the benefit of the Patient Safety Practice
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This patient safety practice aims at reducing errors when using clear solutions on the operating theater. For example using antiseptic solutiion instead of local anesthetic (xylocaine).
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Description of the Patient Safety Practice
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Safe Clinical Practice: Differentiation of clear solutions in surgery. Reduce the risk of confusion of clear antiseptic solutions with local anaesthetic solutions in surgery.
Actions proposed to reduce risk:
Prevention:
-to differentiate products:
.mandatory:
.do not pepare products in advance. Keep them in their labelled packaging until you need to use them.
.use different type of containers (size,shape:sterile basin for skin disinfection and small sterile cup for local anesthetic) for different types of solutions.
.recommended:
.use coloured antiseptic for skin cleaning
.avoid deconditioning products and using unlabelled recipients. Anytime it is possible draw the product directly from its original packaging.
-double check:
.mandatory:
.when passing a medication to the licensed professional performing the procedure, the nurse who prepared the medication visually and verbally verify it by reading the medication label aloud (4 eyes principle).
.recommended:
.limit the number of HC professionals involved (the licensed professional performing the procedure is also preparing the medication)
-Discarding unused products:
.mandatory:
.Discarding unused solution from the surgical field immediately after the treatment is provided (here, the antiseptic solution)
.recommended:
.Modify preoperative process: site identification (drawing), alcohol based skin sterilisation and anesthetic injection before desinfection and sterile draping to avoid product errors and improve adrenergic effect.
Error recovery:
-stop injection in case of abnormal pain or any unexpected clinical sign
-product checking
-discarding products in case of doubt regarding their nature
Control of clinical consequences:
-patient disclosure and agreement for rapid surgical intervention on the area of necrosis.
-take pictures of the area of necrosis.
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| Attachment of relevant written information and/or photos, as appropriate |
81_WP4_SSP_confusion_injectable_9.pdf
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
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| Degree of implementation of reported practice |
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Yes, partly
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| Level of implementation of reported practice |
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Unit or ward level
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| Specific and measurable outcome for the reported practice were defined |
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Not known
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| A baseline measurement before implementation of the reported practice was obtained |
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Not known
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| A measurement after full implementation of the reported practice was obtained |
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Not known
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| Evaluation of a "positive" effect of the reported practice on Patient Safety |
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Effect not known or the intervention has not yet been evaluated
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| Type of before-and after evaluation |
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There is no specified text here
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| Enclosure of a reference or attachment in case of published evaluation's results |
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
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Hospital
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Transferability
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| Successful implementation of this Patient Safety Practice in other health care settings than above stated |
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Not known
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| Specification of implementation in another health care setting(s) |
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There is no specified text here
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| Successful implementation's level of this Patient Safety Practice across settings |
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There is no specified text here
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Involved health care staff
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Physicians
Nurses
Health care assistants
Risk manager
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Patient Involvement
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| Direct service user's involvement as integral part of this Patient Safety Practice |
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No
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| Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice |
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There is no specified text here
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| Point of time in which service user or their reprasentatives' involvement takes place |
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There is no specified text here
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| Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice |
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There is no specified text here
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| Short description of the service users' level of involvement |
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There is no specified text here
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| Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users |
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Not known
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| List of sources where public information is accessible |
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There is no specified text here
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Implementation of the Patient Safety Practice
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| Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice |
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No
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| Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc. |
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Not known or not relevant
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| List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice |
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There is no specified text here
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| List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice |
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There is no specified text here
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| Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice |
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No
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| Description of used incentives, if any. |
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There is no specified text here
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| Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice |
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Yes
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Costs of the Patient Safety Practices
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| Completion of cost calculation related to this Patient Safety Practice |
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No
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| Total number of person days required to implement this Patient Safety Practice |
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
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| Total number of person days required for training as preparation for implementation of this Patient Safety Practice |
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
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| Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice |
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There is no specified text here
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| Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice |
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There is no specified text here
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Contact information
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Name: Jean Bacou
Country: FRANCE
Organisation: HAS
E-mail: j.bacou@has-sante.fr
Phone: +33 1 55 93 73 37
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