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Diagnostic Errors Found in 1 of 4 ICU Patient Deaths

Cheryl Clark, for HealthLeaders Media, August 28, 2012

Likewise, better blood and imaging tests that aren't yet ready for acute care use could reduce false positives and false negatives. But there are many types of improvements that hospitals can make now that will improve diagnostic accuracy that may reduce mortality.

For starters, Winters says, hospitals should consider employing intensivists to monitor their ICUs, but only 7,000 in the U.S. are board-certified, far fewer than are needed to meet the demand. 

Second is the nurse-to-patient ratio in the ICU, which more often than not should be 1 to 1 but may frequently slip to 1 to 2.

Checklists or "goal sheets," something Johns Hopkins is well known for, are extremely helpful in the ICU, but not all hospitals use them, Winters says. 

"These are a list of considerations that every single patient in the ICU should have made for them every day, asking such questions as "Is the patient on a ventilator, is the patient appropriate for a sedation hold to take them off the ventilator, is the patient appropriate for deep vein thrombosis prophylaxis.

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