1 - Technology & Safety IDC Flashcards
What are the two broad categories of Safety?
Occupational Safety and Patient Safety
Refers to Safety of the anesthesia and OR personnel
Occupational Safety
Refers to Avoidance of adverse incidents and
Increased safety
Patient Safety
The 5 Regulatory agencies that deal with occupational safety
ANSI (or ASTM) OSHA NIOSH FDA JCAHO
Replaced by the ASTM (American Society for Testing and Materials).
American National Standards Institute (ANSI)
The Agency that reviews standards every 8 years for applicability and updating.
Cover equipment used in many industries.
For anesthesia, it sets standards for anesthesia machines, ETT, bronchoscopes, vaporizers etc.
ANSI
International committees that standardize equipment across manufactures of equipment world wide.
ANSI/ASTM
It ensures equipment is interchangeable and that the same piece from one device will fit another. An example of this is the ETT, fits the anesthesia machine and also the ventilators in the ICU. (It is why the metric system is used).
Why Standardization is used with equipment
OSHA Stands for?
Occupational Safety Health Administration
NIOSH Stands for?
National Institute for Occupational Safety and Health
FDA Stands for?
Food and Drug Admnistration
JCAHO Stands for?
Joint Commission on the Accreditation of Health Organizations
True or False: JCAHO is a private entity, that sets standards and have no law making authority.
TRUE
The AANA Position Statement that covers surgical and anesthesia safety.
Position Statement 2.15
The AANA Position statement that provides information regarding transfer of care and techniques for mitigating and evaluating adverse events (ex: using checklists, preprocedure briefings, transfer of care and communication)
AANA Position Statement 2.15
The AANA Advisory Opinion that covers Patient Safety: Fatigue, Stress and Work Schedule Effects
Advisory Opinion 5.1
The AANA Advisory Opinion that is concerned with minimizing and managing behaviors with significant potential for harm to patients and workers. More specifically, how to deal with fatigue and sleep deprivation when scheduling anesthesia providers for surgical and obstetrical coverage.
Advisory Opinion 5.1
As of 2000, how many deaths per anesthesia cases have been identified?
1 death per 200,000-300,000
What was the occurrence of deaths per anesthesia cases In the 1970s and 80s.
1 death per 10,000
Human or equipment failure that could have, if not discovered and corrected in time, or lead to an undesirable outcome ranging from extended stay or death.
Critical Incident
This study revealed that 2% of Claims were attributed to Equipment failure. Of that 2%,
76% resulted from equipment misuse and
24% resulted from true equipment failure
ASA closed claims study
Most common sources (2) of errors in the operating room:
Human and Equipment
Breathing circuit disconnections
Breathing circuit leaks or defective valves
Breathing circuit misconnection
Breathing circuit control error (e.g., failure to adjust APL valve)
Inadvertent gas low control errorsGas supply problems
Vaporizer control errors (under-dose/over-dose)
Intravenous drug dose errors (including infusion and syringe pumps)
Intravenous drug/fluid delivery system problems
Ventilator missetting or malfunction
Misuse of monitors
Laryngoscope malfunction
Scavenging system problems
Other (e.g., soda lime exhaustion, sensor failure, blood warmer malfunction, etc.)
Common sources of equipment errors in the OR
Human error occurrence (responsible for)
70%-80% of errors
