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ECRI Unveils Top 10 Health Technology Hazards

John Commins, for HealthLeaders Media, November 14, 2011

The incessant beeping, chirping, whirring, flashing and whooping of any number of patient monitors continues to be a top hazard in hospitals, as bedside providers either struggle to prioritize the noisy demands of the machines, or tune them out completely.

That's according to a study, Top 10 Health Technology Hazards for 2012, from the nonprofit ECRI Institute.  The organization is designated an Evidence-Based Practice Center by the U.S. Agency for Healthcare Research and Quality.

The report notes that bedside providers increasingly are showing signs of "alarm fatigue" as they deal with the constant demands of ventilators, infusion pumps, physiologic monitors, dialysis units, and other technology.

Repeated exposure to the alarms, the report says, can desensitize providers, which can lead to missed alarms or delayed responses, or a failure to make distinctions between the levels of urgency. In addition, the report suggests that some providers improperly adjust monitors to limit alarms, or simply turn down the volume so that the alarms can no longer be heard.

Among its recommendations, ECRI says that healthcare providers should establish institution-wide alarm management programs that examine all equipment being used, and establish protocols for alarm-system settings and notifications.

ECRI's annual report ranks hazards by the harmful impact they could have on patients, how often the hazards occur, how widespread the hazards appear to be, and whether or not the hazards are considered "high-profile" problems that have been covered in the news media, or that providers are pressured to correct.

Here's a brief synopsis of the remaining Top 10 Healthcare Technology Hazards for 2012.

2. Exposure hazards from radiation therapy and CT scans

Radiation exposure, the top healthcare technology hazard in 2011, continues to be a top threat to patient safety. "It isn't clear how many patients are affected by radiation therapy errors – for one thing, there isn't an unambiguous definition of a reportable event – and there is a good chance that incidents are being significantly underreported," the report warns.  

With CT scans, the report notes, higher dose levels improve image quality which creates "a natural tendency to use higher doses." In addition, most healthcare facilities do not audit CT doses, so there is a wide variation in the dosages used for the same treatments.

ECRI says there are no simple solutions to correcting the problem, but they recommended in general terms that healthcare providers: ensure proper staffing; install and verify quality control measures; and acquire national accreditation for their radiology an CT services.

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