Patient safety goals
The international patient safety goals , Engl. International Patient Safety Goals , abbreviated to IPSG, are an instrument for quality assurance in healthcare .
The goals were developed by the World Health Organization (WHO) and the US non-governmental organization Joint Commission International (JCI) to optimize patient safety in outpatient and inpatient treatment. These goals apply worldwide and should be implemented by all service providers . The focus is on the ongoing improvement of the quality of treatment and the primary goal of performing all medical services without treatment errors.
background
These goals were formulated because preventable problems have arisen in certain areas of health care worldwide, some of which have contributed to serious harm to patients. With regard to these particularly frequent dangers, the goals are intended to ensure patient safety and create a certain standard.
The goals
The six goals are:
- Correct identification of the patient
- Improving effectiveness in communication
- Improving the safety of high-risk drugs
- Improving the safety of operations
- Reducing the risk of HCA infections
- Reducing the risk of falls
Correct identification of the patient
The first patient safety goal is to correctly identify patients and avoid mix-ups. At least two ways should be used to identify the patient, the patient room number or other locations being unsuitable. The patient safety alliance found that technical aids such as patient wristbands, barcodes or radio frequency identification (RFID) can be helpful. The benefit of patient bracelets has not been proven in random studies, so further studies would be necessary to evaluate the use of these. The UK's National Patient Safety Agency (NPSA) recommended using patient wristbands to keep them on the patient's dominant arm during the entire inpatient stay. In addition, the patient's last name, first name, date of birth and insurance number should appear on the bracelet in this order. The font should be black on a white background for legibility and patients with risk factors such as B. Allergies are given a red bracelet.
Containers for blood or other samples should also be labeled in the presence of the patient to avoid confusion. The use of barcode printing or labeling systems significantly reduces the number of identification errors. Mixing up patients with blood transfusions, biopsy findings or the like can lead to serious consequences.
Improving effectiveness in communication
The second patient safety goal is to stimulate improved communication among service providers. Patient and shift transfers are a risk factor for errors and complications due to insufficient or incorrect information transfer. According to the Joint Commission International, 80% of serious adverse events in hospitals are caused by transfer errors.
The aim here is to improve patient safety in hospitals through open communication and teamwork. The transfer of information is also improved through technical aids such as checklists and protocols, the effectiveness of which has already been proven. Checklists ensure that necessary information is not overlooked and enable uniform information to be passed on. Handovers should always be carried out in a structured and organized manner. It is advisable to set up standardized documentation between the operating room, recovery room and ward in order to ensure consistent patient care. In addition, the dissemination of information should take place via at least two media, e.g. B. verbally and as a second medium in writing or electronically.
Improving the safety of high-risk drugs
Patient safety objective 3 addresses the safety of high risk drugs. Mix-ups and medication errors should be improved. However, it is not possible to state an exact number of medication errors, as medication errors without serious consequences are rarely reported. However, the number of unreported cases seems to be very high.
In order to improve the safety of medicines, the quality of the product labeling should be increased. This is intended to enable hospital staff to record the medication quickly and reliably. It is also advisable to label unlabeled syringes, cups, bowls or the like. Particular attention should be paid to patients taking blood-thinning medication. It is important to determine and note down which medicines the patient has taken so far. These drugs must be compared with the newly prescribed drugs. Then it must be ensured that the patient knows how to take their medication correctly. In order to further limit medication errors, computerized medication prescriptions are to be introduced. This can reduce the frequency of adverse drug incidents by more than 50%.
Improving the safety of operations
Patient safety goal 4 is concerned with improving the safety of operations, in detail it means that the planned operation is carried out in the right place and with the right procedure on the right patient. In order to achieve this goal, a universal protocol should be put in place to properly prepare for the operation. This should contain guidelines and procedures that ensure a uniform process. Among other things, it is recommended to actively involve the patient through medical education so that he can understand the course of the procedure. An additional marking of the intervention site on the awake patient is also helpful. Before the procedure, the patient should be identified again and the entire surgical team should also take a short break to avoid any mistakes. With this aim, it should be ensured that all the required documents are complete and that the equipment for the operation is both readily available and functional.
Reducing the risk of HCA infections
Patient safety goal 5 deals with reducing the risk of nosocomial infections, also known as HCA infections (Healthcare associated). They are only referred to as nosocomial if it is certain that the infection occurred during the hospital stay.
Continuous infection control is important here, which includes prevention, including properly trained hand disinfection by hospital staff. Learning takes place with the help of generally recognized guidelines on hand hygiene, which should be clearly visible in the hospital as a reminder. In addition, installing hand disinfection machines can be beneficial for patients and visitors. The reduction also includes following appropriate guidelines that can prevent blood infections, urinary tract infections, hard-to-treat infections, and post-surgery infections. In addition, when such an infection is detected, the focus should be on combating and preventing its spread.
Reducing the risk of falls
Patient safety goal 6 is concerned with reducing the risk of patient injury as a result of falls. In order to achieve this reduction, the risk of falling should be assessed for each patient and provision of aids (wheelchairs, crutches, assistance from the nursing staff) should be ensured for people at risk.
If the patient's conditions change after an operation under general anesthesia, a change in medication, or the like, they should be reassessed and, if necessary, appropriate changes made. A regular evaluation of the fall rate and the consequences of falls helps to eliminate dangers and to provide appropriate assistance at the required point.
implementation
In Germany, the service providers are legally obliged to ensure and further develop the quality of the services they provide ( Section 135a SGB V ). The Federal Joint Committee determines the mandatory quality assurance measures, including the minimum requirements for the quality of structure, processes and results ( Section 136 (1) SGB V) for statutory medical care and approved hospitals through guidelines . The Institute for Quality Assurance and Transparency in Health Care works on behalf of the Federal Joint Committee on measures for quality assurance and for the representation of the quality of care in the health system ( Section 137a SGB V).
In Austria, too, health care providers are obliged to adhere to quality standards in accordance with the Health Quality Act (GQG) and to participate in nationwide quality assurance measures.
In countries such as the United States, where there is no statutory quality management in medicine and guidelines for the hospital sector are primarily based on accreditations , compliance with the JCI's patient safety goals is particularly important in the voluntary quality control of hospitals.
Nevertheless, German hospitals can also be certified according to the JCI standards .
Web links
Individual evidence
- ↑ Patient safety goals ( memento of the original from January 10, 2018 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Website of the Bundeswehr Hospital Koblenz , accessed on January 10, 2018
- ↑ cf. Daniela Schriefl: The care documentation on chronic hemodialysis 2015, p. 23 f.
- ^ E. Sebastian Debus, Reinhart T. Grundmann, Julika Heilberger: Good Clinical Practice in Vascular Surgery. Springer-Verlag GmbH, 2017
- ↑ Promoting patient safety when using medical devices: Clear identification and any accompanying information that is available at all times ensure the recommendation for action by the Patient Safety Alliance , October 2017
- ↑ F. Reuther: Avoidance of mistakes in intervention. Springer-Verlag GmbH, 2009
- ↑ Peter Hensen: Quality Management in Health Care: Basics for Study and Practice. Springer Gabler 2016, p. 395 f.
- ↑ Section 3 of the Federal Act on the Quality of Health Services (Health Quality Act - GQG) RIS , accessed on July 26, 2020.
- ↑ Julia Alexandra Lex: Certification of hospitals as a guide to quality management. The development of the quality management system in compliance with the standards of the Joint Commission International using the example of the LKH Villach. Graz, January 2016
- ↑ Quality indicators relevant to planning: Concept for new and further development. Final report. Prepared on behalf of the Federal Joint Committee, status: December 21, 2018, p. 30.
- ↑ cf. DRK Kliniken Berlin again certified by the Joint Commission International Management & Hospital, December 21, 2011
