Programa Seguridad del Paciente - Inducción Corporativa - Promedan S.A.

Patient Safety Program Overview

Historical Context of Patient Safety in Colombia

• Colombia has been promoting quality health services for several years, leading to the creation of an obligatory system for guaranteeing health quality in 2006.

• In 2008, the National Patient Safety Policy was established, aligning with global strategies to minimize risks associated with healthcare services.

• The Sector Normalization Unit defined safe practices known as instructional packages in 2010, aimed at creating secure institutional processes based on scientific evidence.

Current Practices and Guidelines

• An updated technical guide on good patient safety practices (version 2) was released in 2014, which is currently utilized. This encompasses structural elements and methodologies proven by scientific evidence to reduce adverse events during healthcare visits.

• The average implementation of a patient safety program provides clear guidelines for directing safety policies within institutions, focusing on promoting and managing safe practices in healthcare settings.

Goals and Strategies for Patient Safety

• The policy emphasizes educating patients about self-care while complying with current regulations that foster a culture of patient safety through awareness and training initiatives.

• Key patient safety goals include:

• Correctly identifying patients.

• Enhancing medication management security.

• Reducing infection risks associated with healthcare.

• Ensuring correct surgical procedures are performed on the right patients.

• Minimizing fall-related injuries.

• Preventing injuries related to dependency issues. These goals apply across both hospital and outpatient components.

Management Model for Patient Safety

Strategic Direction and Commitment

• The organization's general direction is committed to the patient safety program through its mission statement emphasizing safe and humane care delivery, which informs the patient safety policy structure.

Event Management Process

• The event management process consists of three stages:

• Identification: Collaborators are trained to identify and report incidents using an established reporting system.

• Analysis: Data from reports are transformed into actionable information using tools like the London Protocol for cause analysis alongside evidence-based protocols for support during evaluations.

• Intervention: Action plans are developed based on identified issues, including establishing security barriers, training staff according to errors or incidents reported, and providing support systems for affected parties (tertiary victims).

Continuous Training Initiatives

• Ongoing training programs focus on instilling a culture of safety among collaborators by mandating adherence to ten essential safe practices as per national standards while also implementing additional best practices through local initiatives (PAMI). This aims at fostering a humanized approach towards care delivery.

Monitoring Tools for Patient Safety

Measurement and Vigilance Programs

• Various tools are employed to ensure patient safety during care delivery by measuring adherence to established safe practice indicators through regular monitoring rounds across services. Additionally, there are structured programs dedicated to surveillance concerning patient safety events that initiate reporting mechanisms when risks arise during care provision.

Application for Reporting Health-Related Events

Overview of the Application

• The application is crucial for reporting and notifying health-related events, including incidents, adverse events, non-compliant services, and complications. Access is through the Bojayá platform.

Notification Process

• Collaborators can select the date of the event, enter patient details (name and ID), specify the service location, and describe immediate actions taken. This information is saved to create records.

Analysis Line Tool

• The organization uses a tool suggested by the Ministry of Health called the London Protocol for investigating health-related events. It employs a fishbone diagram for systematic reflection beyond merely identifying blame.

Non-Punitive Approach

• The protocol aims to make staff feel less threatened as it focuses on non-punitive measures when validating that errors were not intentional. This approach does not relate to disciplinary procedures but identifies unsafe actions and contributing factors instead.

Infection Prevention Guidelines

Safe Practices in Healthcare

• Emphasis on safe practices to detect, prevent, and reduce infections associated with healthcare delivery through established protocols and guidelines during patient treatment stays. These include hygiene protocols and antibiotic use policies.

Established Protocols

• Various manuals have been created to mitigate infection risks:

• Human hygiene protocol

• Daily inspection manual

• Rational antibiotic use policy

• Good sterilization practices manual

• Biosecurity manual

These are essential in both outpatient and inpatient settings.

Standard Precautions in Patient Care

Classification of Precautions

• Two main classifications exist: standard precautions applicable regardless of diagnosis, and transmission-based precautions tailored to specific mechanisms of disease spread. Standard precautions include handwashing techniques critical for infection control.

Hand Hygiene Techniques

• Proper handwashing requires at least 40–60 seconds:

• Wet hands, apply soap.

• Rub palms together followed by back-and-forth rubbing between palms.

• Rotate fingers against palms.

• Clean thumbs individually.

• Rinse thoroughly with water using paper towels for drying which should also be used to turn off taps afterward.

When to Perform Hand Hygiene

Key Moments for Hand Hygiene

• There are five critical moments identified for hand hygiene:

• Before touching a patient.

• Before performing an aseptic procedure.

• After potential exposure to bodily fluids.

• After touching a patient.

• After contact with the patient's environment or surroundings.

Hand Hygiene and Personal Protective Equipment

Importance of Hand Care

• Emphasizes the need for regular hand washing and alcohol-based disinfection, while also highlighting the importance of using creams to maintain skin health.

• Advises against washing hands with hot water immediately after alcohol disinfection to prevent skin damage.

Guidelines for Nail Care

• Recommends keeping nails short and free from polish to easily check for dirt underneath, which is crucial in a healthcare setting. Avoiding artificial nails is also advised.

Personal Protective Equipment (PPE) Usage

• Discusses essential PPE including long-sleeve gowns, disposable masks, N95 high-flow masks, and protective eyewear based on patient care needs. Clean gloves are necessary for direct contact procedures while sterile gloves are reserved for invasive tasks.

• Highlights that clean gloves should not be used when handling items like pens or phones during patient interactions to avoid contamination.

Transmission-Based Precautions

• Introduces transmission-based precautions that apply specifically to patients requiring isolation due to their diagnosis, emphasizing communication among healthcare teams about these protocols.

• Describes different types of isolation:

• Contact Isolation (yellow): For patients needing contact precautions.

• Airborne Isolation (green): Requires high-efficiency masks and closed rooms with open windows.

• Droplet Isolation (blue): Involves standard hand hygiene and disposable masks in closed rooms.

• Protective Environment Isolation (purple): Similar hygiene practices as above but focuses on protecting immunocompromised patients.

Infection Control Protocol

• Stresses the importance of adhering to both standard precautions and isolation protocols to protect both healthcare workers and patients' families from infections. Regular monitoring of specific hospital-acquired infections is also mentioned as part of ongoing vigilance efforts within healthcare settings.

Patient Safety Initiatives

• Introduces the concept of being a "captain" of patient safety, encouraging all staff members to take responsibility for improving medication safety through established guidelines and monitoring systems such as pharmacovigilance committees. This includes ensuring correct medication administration practices across various routes.

Medication Administration and Patient Safety

Correct Medication Administration Practices

• Emphasizes the importance of verifying medication expiration dates before administration.

• Highlights the need for patient education regarding medications being administered, including potential allergies.

• Stresses understanding drug interactions with other medications prior to administration.

• Advocates for accurate documentation of medication in the patient's clinical history.

Ensuring Patient Identification

• Discusses strategies for confirming patient identity, such as double verification methods.

• Introduces identification bracelets and additional identification boards as tools for ensuring correct patient identification.

• Mentions educating patients and families on proper identification during healthcare processes.

Effective Communication with Patients

• Suggests asking open-ended questions to confirm a patient's identity rather than leading questions that may confuse them.

• Recommends confirming identity through family members or physical ID if the patient is unable to respond.

Patient Identification Tools and Alerts

Identification Boards and Bracelets

• Describes how identification boards can include comprehensive patient information like name, ID number, allergies, and admission date.

• Details the use of identification bracelets containing essential information about the patient’s identity and alerts.

Color-Coded Alert System

• Explains color-coded alerts: orange for known allergies, purple/violet for medical devices present, yellow for disabilities affecting communication, and fuchsia for risk of elopement.

Surgical Safety Practices

Importance of Surgical Procedures

• Acknowledges that surgeries carry inherent risks which can lead to complications if not managed properly.

Implementation of Safe Surgery Checklists

• Introduces a surgical safety checklist aimed at monitoring pre-operative, intra-operative, and post-operative phases to enhance safety.

Fall Prevention Strategies

Risk Assessment Scales

• Utilizes Morse scale in hospital settings and another scale in outpatient settings to assess fall risk among patients.

Education on Fall Prevention

• Focuses on educating patients and families about preventing falls both in healthcare facilities and at home.

Preventing Pressure Injuries

Risk Assessment Tools

• Implements Braden scale specifically designed to evaluate pressure injury risk among patients.

Care Strategies

• Discusses moisture management, nutritional care, reducing pressure points through various strategies under a "Healthy Skin" program.

Blood Management Safety Measures

Hemovigilance Program

• Outlines actions taken under hemovigilance aimed at monitoring adverse events related to blood donation and transfusion processes.

Conclusion on Informed Consent

• Notes that informed consent is treated as a clinical act requiring thorough understanding by patients before procedures are performed.

Informed Consent and Patient Safety Protocols

Importance of Informed Consent

• The law mandates that healthcare professionals inform patients about the risks, benefits, and relevant circumstances regarding their health situation and proposed interventions. This allows patients to make informed decisions based on their personal beliefs and preferences.

• Patients have the right to choose whether or not to undergo suggested interventions or procedures. This emphasizes the importance of clear communication between healthcare providers and patients.

Accessing Resources for Patient Safety

• Healthcare professionals can access patient safety information, protocols, guidelines, instructions, procedures, and forms through the corporate intranet. This resource is crucial for ensuring compliance with safety standards in medical practice.

• To access these resources, users must navigate to the Promed website and enter the "Colaboradores" section within the applications portal. This highlights the structured approach to maintaining patient safety through accessible information.