1. Alarm hazards. Alarms on devices ranging from patient monitoring equipment to ventilators and dialysis units are intended to improve clinical practice and protect patients. But ECRI says alarm issues are among the most commonly reported concerns it receives. Such problems include devices that issue too many nuisance alarms (causing hospital staffers to tune them out), nurses and other staffers that improperly set alarms to medically unrealistic levels, and clinical layouts that make it difficult to hear and respond to alarms.
2. Needlesticks and sharps injuries. Despite protective devices on many needles and IV sets, ECRI argues that these injuries keep happening, putting medical staff, patients and waste-disposal workers at risk of wounds or contracting diseases such as HIV and hepatitis. The institute recommends properly training staff in the handling of sharps and carefully evaluating protective features, since some are better than others.
3. Air embolisms from contrast-dye injectors. Dye injectors are commonly used in angiography to image the heart and its blood-vessel system, but they can sometimes also inject air bubbles into the blood, with potentially fatal consequences. Safety systems on these devices aren’t fullproof, so ECRI suggests — you guessed it — proper staff training and regular inspections of the embolism-prevention features.
4. Retained devices and unretrieved fragments. Yes, surgeons sometimes leave sponges and even instruments inside patients, and doctors sometimes unknowingly break off the tips of instruments like catheters. ECRI recommends more training and inspections, although it also notes the emergence of new systems designed to help track surgical sponges, which may also eventually be used for other devices.
5. Surgical fires. Yikes! Electorsurgical devices, cauterization systems and lasers can sometimes cause operating-room fires, particularly when patients are receiving supplemental oxygen. Recommendation: Ensure proper handling of still-hot disposable components, limit the pooling of oxygen and keep potential fuel such as alcohol swabs and hospital gowns well away from “ignition sources.”