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Dome - Project Emerge: Preventable Harms and Ways to Avoid Them

Dome December 2013

Project Emerge: Preventable Harms and Ways to Avoid Them

Date: December 2, 2013

Delirium Limiting the use of sedating drugs and ensuring that patients get adequate sleep can help prevent delirium, a syndrome marked by severe confusion and hallucinations.

ICU-Acquired Weakness Introducing physical activity as soon as possible after surgery or a serious medical event prevents muscle wasting and weakness and hastens recovery.

Ventilator-Associated Harms Proper oral hygiene and other measures, such as elevating the head of the hospital bed, can prevent complications associated with the ventilator—a machine used to sustain patients’ breathing.

Venous Thromboembolism (Blood Clots) The formation of a blood clot in a deep vein—usually in the leg or pelvis—is a risk after any major surgery. Taking blood thinning medication before and after surgery can help prevent this condition.

Central-Line Associated Bloodstream Infections (CLABSIs) CLABSIs occur when thin plastic tubes, or central lines, are placed in ICU patients to administer medication or fluids, obtain blood for tests and directly gauge cardiovascular measurements. Because the tubes are easily contaminated, roughly 80,000 patients with central lines become infected each year. Following a standardized checklist that highlights cautionary and basic steps, from hand-washing to avoiding placement in the groin area, where infection rates are higher, can prevent these infections.

Loss of Respect and Dignity Integrating patients and their loved ones into the care team demonstrates respect for patients and preserves their dignity. Studies show that health outcomes improve when patients and their loved ones are engaged in their own care.

Care Unaligned with Patient Treatment Goals and Preferences Does the ICU team continue to recommend “cure-related, invasive interventions,” while the patient simply wants to have his or her pain controlled? Care providers need to verify a patient’s treatment preferences.

—Shannon Swiger