1 - Technology & Safety IDC

Question 1

What are the two broad categories of Safety?

Answer 1

Occupational Safety and Patient Safety

Question 2

Refers to Safety of the anesthesia and OR personnel

Answer 2

Occupational Safety

Question 3

Refers to Avoidance of adverse incidents and

Increased safety

Answer 3

Patient Safety

Question 4

The 5 Regulatory agencies that deal with occupational safety

Answer 4

ANSI (or ASTM)
OSHA
NIOSH
FDA
JCAHO

Question 5

Replaced by the ASTM (American Society for Testing and Materials).

Answer 5

American National Standards Institute (ANSI)

Question 6

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.

Answer 6

ANSI

Question 7

International committees that standardize equipment across manufactures of equipment world wide.

Answer 7

ANSI/ASTM

Question 8

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).

Answer 8

Why Standardization is used with equipment

Question 9

OSHA Stands for?

Answer 9

Occupational Safety Health Administration

Question 10

NIOSH Stands for?

Answer 10

National Institute for Occupational Safety and Health

Question 11

FDA Stands for?

Answer 11

Food and Drug Admnistration

Question 12

JCAHO Stands for?

Answer 12

Joint Commission on the Accreditation of Health Organizations

Question 13

True or False: JCAHO is a private entity, that sets standards and have no law making authority.

Answer 13

TRUE

Question 14

The AANA Position Statement that covers surgical and anesthesia safety.

Answer 14

Position Statement 2.15

Question 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)

Answer 15

AANA Position Statement 2.15

Question 16

The AANA Advisory Opinion that covers Patient Safety: Fatigue, Stress and Work Schedule Effects

Answer 16

Advisory Opinion 5.1

Question 17

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.

Answer 17

Advisory Opinion 5.1

Question 18

As of 2000, how many deaths per anesthesia cases have been identified?

Answer 18

1 death per 200,000-300,000

Question 19

What was the occurrence of deaths per anesthesia cases In the 1970s and 80s.

Answer 19

1 death per 10,000

Question 20

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.

Answer 20

Critical Incident

Question 21

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

Answer 21

ASA closed claims study

Question 22

Most common sources (2) of errors in the operating room:

Answer 22

Human and Equipment

Question 23

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.)

Answer 23

Common sources of equipment errors in the OR

Question 24

Human error occurrence (responsible for)

Answer 24

70%-80% of errors

Question 25

Two types of human errors

Answer 25

Rules based and Knowledge based.

Question 26

Types of human errors that occur with when rules are deviated from.

Answer 26

Rules-based Errors

Question 27

Type of human error that occur when an event is outside of the experience of the provider. Fixation with the wrong diagnostic algorithm; being “closed minded.”

Answer 27

Knowledge-based errors

Question 28

The SI unit of electrical resistance, expressing the resistance in a circuit transmitting a current of one ampere when subjected to a potential difference of one volt

Answer 28

Ohm (expression: R = E/I)

Question 29

The SI Unit derived unit of Energy. The energy dissipated as heat when an electric current of one ampere passes through a resistance of one ohm for one second.

Answer 29

A Joule

Question 30

An electric current that reverses its direction many times a second at regular intervals, typically used in power supplies.

Answer 30

Alternating Current