Patient Safety

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Patient Safety

• In an era of centralisation and de-centralisation

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Better Health, Better Care

• http//www.scotland.gov.uk/Publications/2007/08/13
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• 7. Ensure continuous improvement in services,
  with a determined focus on patient safety

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Guarantees of safety 1

• Quality system
• Audit
• Training
• SOPs
• Continuous improvement
• Doesnt extend far outside the laboratory

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What increases risks to patient safety?

• Decentralisation
• Point of Care Testing (POCT)
• Laboratory controls training SOPs
• Laboratory conducts audit
• Limited control over availability of the
  information

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Protocol for RSV Near patient testing ward

• Procedure
• Collect Nasopharyngeal Aspirate (NPA ) in virus
  transport medium
• Generate HISS laboratory request form
• Perform assay as per instructions - write
  patients name on test card
• Record result on a data collection sheet and on
  lab request form
• Send request form and NPA to laboratory.

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Protocol for RSV Near patient testing -
Microbiology Dept.

• NPA is booked in and given a lab. No.
• All negative RSV near patient NPA are tested by
  Direct Immunofluorescence (DIF) for 6 respiratory
  viruses including RSV
• Some RSV near patient NPA are tested by Direct
  Immunofluorescence (DIF) for 6 respiratory
  viruses including RSV (clinical reasons)
• Selection of RSV near patient positive NPA tested
  by DIF for RSV only (audit)

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RSV Hospital Acquired Infection (HAI )

• 2000/01 - 26
• 2001/02 - 8
• 2002/03 - 7
• 2003/04 - 12
• 2004/05 - 4
• 2005/06 - 1.3

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Guarantees of safety 2

• Patient identifier
• CHI number
• Electronic ordering
• Single data entry
• Electronic reporting

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CHI number compliance
Electronic Orders
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CHI number compliance
Manual orders
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What increases risks to patient safety?

• Decentralisation
• Further from the laboratory

• Centralisation
• Further from the patient

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What decreases risks to patient safety?

• Decentralisation
• Recording of results on laboratory system
• Electronic ordering

• Centralisation
• Results available where required
• Electronic reporting

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How electronic ordering/ reporting contributes to
patient safety

• Improved CHI number compliance
• Single patient record (for the discipline)
• Availability of results
• Information for audit