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Many readers of this website have asked, how often do errors with patient-controlled analgesia (PCA) occur? In a retrospective analysis lead by Rodney Hicks (who at the time of the study was Manager, Patient Safety Research and Practice, United States Pharmacopeia), the magnitude, frequency, and nature of non-harmful and harmful medication errors associated with PCA were studied. Over the five-year review period, of the 919,241 medication errors records from the 801 reporting healthcare facilities, just 1% (or 9,571) were associated with PCA.
Moreover, when the study looked at the number of events that caused harm, there were 624 records of PCA associated with harm, corresponding to 6.5% of the patients. However, this is clearly an area that standardization needs to occur and organizations need to invest in training and policies and procedures as well as equipment – all areas to promote safety.
Moreover, although elimination of error is critical, studies have shown even a correctly programmed PCA pump poses patient safety risks.
Even correctly programmed, appropriate doses of opiates can suppress respiration and decrease heart rate and blood pressure.
Capnographic monitoring—measurements of ventilation using respiration and exhaled carbon dioxide (EtCO2)—is particularly important because it can provide an earlier warning of respiratory depression than pulse oximetry (SpO2) in some patient populations.
I don’t know of other studies, but my anecdotal experience suggests that you are probably looking at a significant safety issue. Enter your email address to subscribe to this blog and receive notifications of new posts by email. PPAHS reserves the right to decline comments and articles submitted that, in its opinion, are not in accordance with the above principles. The opinions expressed in each article in this blog are solely those of the article’s author and of any health experts quoted therein.
About UsPhysician-Patient Alliance for Health & Safety (PPAHS) is an advocacy group dedicated to improving patient health and safety. PPAHS is engaged in the following key initiatives for improving patient safety and health outcomes: opioid safety, venous thromboembolism, and alarm management.
When you are sick and injured the last thing you want to worry about is the safety, quality and effectiveness of medical equipment and products. We need international standards to protect the health and safety of patients and healthcare providers. We have over 1200 standards focusing on health in many sectors, from dentistry to medical devices, and health informatics to traditional medicines. We need to set up an environment that ensures the best possible conditions for healthcare professionals to do their job. An important role of international standards is making it easier for healthcare professionals to focus on whata€™s important - their patients. Medication errors and adverse drug events can occur in nearly half of all surgical procedures, according to one study. Medical experts from nearly 60 countries are working to develop five International Standards for the identification of medicinal products. From healing herbs to pain-reducing acupuncture, Traditional Chinese Medicine takes a holistic approach to health and wellness, focusing as much on prevention as it does on treatment.
The 2015 Nobel Prize in Medicine took many by surprise, when it was awarded to a Traditional Chinese Medicine (TCM) expert for her landmark discovery of anti-malarial Artemisinin.

There is currently a great risk of inferior practitioners and treatments in poorly regulated markets that can undermine public safety, and the reputation of TCM.
Despite being in existence for so long, Traditional Chinese Medicine is still clouded in mystery and myths. What are the five elements of Chinese medicine and how do they manifest themselves in our bodies?
Marrying TCM to modern medicine faces numerous challenges, but South Africa is taking a bold step forward in this direction. Medical devices refer to the products used in the diagnosis, prevention and treatment of medical conditions, from wound dressings to life-support machines. ISO 13485 sets out the requirements for a quality management system specific to the medical devices industry. With medical devices ranging from simple needles to life-saving high-tech implants, how can we ensure the highest possible level of safety?
All you need to know about the revised ISO 13485, a key standard for organizations working in the design, production, installation and servicing of medical devices and related services. Goal 3 of the United Nations Sustainable Development Goals focuses on good health and well-being. For example, there are ISO guidelines for the delivery of telehealth services that ensure consistent, quality remote medical assistance, while safeguarding a clienta€™s data. ItE?s midnight and youE?re burning with fever and you would like a medical consultation right here at home. All ISO publications and materials are protected by copyright and are subject to the usera€™s acceptance of ISOa€™s conditions of copyright. Although 1% may seem insignificant, this analysis was based on the voluntary medication error reporting program, MedMarx. On an annualized basis, this would mean that about 600,000 to 2 million events per year could involve PCA. Many studies have shown the benefits of using PCA, including improved pain management, better utilization of nursing resources, increased patient satisfaction, and improved pulmonary function.
Episodes of bradypnea and desaturation can escalate to respiratory depression (RD) requiring rescue.
Of 12,000 root cause analyses conducted within the VA system over a 10 year period, 129 involved infusion pumps and 69 of the 129 involved PCA pumps. As a result you may not receive email notifications, particularly if you received them on the old web platform. PPAHS seeks to advance key patient health and safety initiatives that significantly impact patient lives and to do so in a prescriptive and practical manner.
They give us confidence that medical equipment, laboratory testing and evaluations are reliable and that our patient data is safe. For governments, standards are a fundamental technical basis for healthcare legislation, that ensures communities receive the quality of care they deserve. Standards ensure things work, from keeping bugs at bay of our medical devices to making sure all the important medical information is clearly labelled. They do this by ensuring that medical devices are up to speed, that laboratory results are reliable and comparable, and much more.

Standardized graphical symbols, for example, help professionals understand important information across language barriers. This award was a huge leap for the industry, raising hopes of more mainstream recognition of traditional therapies. An ISO committee developing TCM standards is poised to bring confidence and reliability to the field. The standard has recently been updated with improvements that broaden its applicability to all organizations involved in the life cycle of medical products, ensure greater alignment with regulatory requirements, and place more focus on post-market surveillance, including complaint handling, infrastructure and risk management. ISO standards contribute in many ways to this important milestone, not least by ensuring the devices and products we need to keep healthy, or recover from illness, work as intended. Similarly, standards can help regulate the effect on our body of light from electronic devices, shown in recent studies to have an adverse impact on sleep. With telehealth you can, all it takes is a computer and you can soon back in bed resting with a prescription waiting to be filled.
The success rate for in-hospital cardiopulmonary resuscitation remains less than one in five patients. Based on these findings, the VA’s integrated product team recommended that PCA pumps with an integrated end tidal CO2 monitor is the pump of choice, because use of this technology could have prevented more than 60 percent of adverse events related to PCA pumps.
Respiratory depression was detected at a significantly higher rate in the capnography group. For healthcare organizations, standards are a harmonizing force that helps increase the effectiveness and reliability of medical care across countries.
A new set of standards to unambiguously identify medicines across regions will improve transparency of medical product information and reduce medical error.
These are just a few examples of how standards are looking out for us, but there are many more.
If detected early, most cases of opioid-induced respiratory depression can be treated with naloxone. In total, 146 episodes of respiratory depression were detected during the 36 hours on the general care nursing unit: 140 in the capnography group and six in the control group. All of these episodes were detected because the patient either took six or fewer breaths per minute or had an episode of apnea lasting longer than 20 seconds. These include cost of implementation of the system, resistance to the system by ICU physicians and nurses, and integration of data systems and clinical information into the remote electronic ICU model.
Seventeen patients (15 in the capnography group and two in the control group) accounted for all episodes of respiratory depression. In this chapter, we will provide background information on error reduction theory and the role of the remote ICU model, review current data supporting use of the remote ICU system, address the current obstacles to effective implementation, and look to the future of the field for solutions to these challenges.
Pauses in breathing while sleeping, an indicator of OSA risk, were detected in the capnography group at twice the rate as in the control group (48% and 24%, respectively).

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