https://www.jenonline.org/article/S0099-1767(13)00015-9/pdf

The Evolution of ED Crowding

The WHO safer surgery checklist time out procedure revisited: Strategies to optimise compliance and safety.

Using Transformational Learning Principles to Change Behavior in the OR

There are more mobile phones in the world than there are people, and numbers are
increasing. Immediate access to technology has completely permeated everyday life, and
for many people their mobile devices are an indispensable accessory that accompanies them
everywhere, including the bathroom. Mobile devices can harbour pathogenic
microorganisms on their surfaces, that can survive for days, before potentially being
transferred onto hands or other objects that they come into contact with. These devices are
also rarely decontaminated. Whilst these microorganisms are generally not of concern to the healthy adult, they may be to the very young, the elderly, and those with reduced
immunity.

This study determined if mobile devices can be used in the healthcare setting and not be an
infection risk. A six-stage mixed methodology approach was employed, with laboratory
investigations into the contamination on mobile devices, the efficiency of transfer from
them, and the effectiveness of decontamination methods. Analysis of existing NHS mobile
device policy and application of the Hazard Analysis Critical Control Point process to
perioperative practice provided real-world perspective.

The findings from this study identified that current literature is under-reporting the
contamination on mobile devices, and determined that the bacterial presence is transient,
not constant. Transfer efficiency of up to 79% was recorded for Staphylococcus aureus from
a device onto a wet gloved hand, and observation of perioperative practice identified five
hazards specific to the presence of a device, that could become a risk to patient safety, but
could be managed through application of Critical Control Points. This study also found that
over 40% of NHS organisations in mainland UK do not have a mobile device policy, and only
11% make any reference to their infection prevention and control. Testing of
decontamination methods determined that a two-stage process of wiping with a dry lint-free
cloth, followed by exposure to UV-C, was the only approach that effectively reduced
contamination levels without contradicting manufacturers’ guidance and thus voiding the
device warranty. Optimum criteria for mobile device policy, and suggestions for in-context
application, are proposed.

Determination of the Infection Risks Posed by the Use of Mobile Technology in Healthcare Settings

Fur die Dokumentation der Notfallversorgung in deutschen Notaufnahmen existierte bislang kein einheitlicher Standard. Sowohl einrichtungsubergreifende Analysen der behandelten Patientenkollektive im Rahmen der Versorgungsforschung als auch krankenhausinterne Analysen des Qualitatsmanagements waren somit nur schwer moglich. Ziel der Sektion Notaufnahmeprotokoll der Deutschen Interdisziplinaren Vereinigung fur Intensivmedizin und Notfallmedizin (DIVI) war es, den 2010 konsentierten modularen Kerndatensatz „Notaufnahme“ fur eine standardisierte Dokumentation der fruhen innerklinischen Notfallversorgung zu entwickeln. Recherche und Auswertung aktueller Literatur, Expertentreffen, Delphiprozess. In interdisziplinaren Expertenrunden wurden zunachst die Anforderungen an die Dokumentation in einer Notaufnahme analysiert, bereits existierende Dokumentationssysteme ausgewertet und ein Kerndatensatz erarbeitet. Der so entwickelte Kerndatensatz ermoglicht die interdisziplinare und interprofessionelle Dokumentation der Notfallpatientenbehandlung in deutschsprachigen zentralen Notaufnahmen (ZNA) unter Berucksichtigung der Punkte Informationsweitergabe, Qualitatsmanagement, Benchmarking, medikolegaler Aspekte und Okonomie. Durch einheitliche Verwendung dieses Dokumentationsstandards kann die Vergleichbarkeit der Prozess- und Ergebnisqualitat in Notaufnahmen gesteigert werden. Mit der geplanten Integration des Datensatzes in EDV-gestutzte Dokumentationssysteme wird neben der Verbesserung der Dokumentationsqualitat auch die automatisierte Bedienung von bundesweiten Registern und Vermeidung von redundanter Dokumentation erreicht. Das vorliegende Update stellt den zuruckliegenden und zukunftigen Entwicklungsprozess des Kerndatensatz „Notaufnahme“ dar und erlautert die Moglichkeiten der Nutzung dieser Daten fur Zwecke des Qualitatsmanagements, eines nationalen Notaufnahmeregisters sowie der Versorgungsforschung anhand von 11 Aspekten der Kennzahlenanalyse. Erkannte Limitationen werden beschrieben und Wege, diese in zukunftigen Entwicklungsstufen zu verbessern, beleuchtet.

Susan K. Banschbach

Papers

Perioperative Nurse Leaders and Their Role in Patient Safety

Hand-held communication devices: friend or foe?

Development of consensus statement on definitions for consistent emergency department metrics.

Revisiting the Universal Protocol

Mutual accountability for the common goal of patient safety.