Health tech hazards
Infusion errors and faulty cleaning of medical devices are among the many potentially unsafe issues involving technology in healthcare.
Infusion errors and faulty cleaning of medical devices are among the many potentially unsafe issues involving technology in healthcare.
WHILE technology has improved many aspects of daily life, it also comes with some drawbacks.
Hospitals, power grids, airports, railway and road transport systems are increasingly dependent on technology. Rather than saving us time, however, new technology means we have to process more information and work more intensively. But, if technology were to be taken away, humans might find themselves at a loss.
Last week, we featured eight health and fitness technologies that are expected to impact us in 2017.
This week, we list five health technology hazards, as listed by the United States-based ECRI Institute, a not-for-profit organisation focused on improving health care quality and safety.
The list, which was developed by ECRI engineers, scientists, clinicians and safety experts, identifies problems that can be avoided through careful technology ma- nagement.
Infusion pumps
Most large-volume medication infusion pumps incorporate safety mechanisms for reducing the risks of potentially deadly intravenous (IV) infusion errors.
These pumps can be particularly dangerous when malfunctions lead to the release of too much medication into a patient.
“Although today’s pumps incorporate features that reduce the risks of infusion errors, these safety mechanisms cannot eliminate all potential errors, and the mechanisms themselves have been known to fail,” ECRI states.
However, it adds that a few simple steps can help guard against errors, such as training staff to look for equipment damage, making appropriate use of the roller clamp on IV tubing and periodically checking drip chambers for unexpected flow.
Cleaning reusable medical instruments
One of the top hazards relates to reusable medical instruments, which have been a high-profile source of infections in recent years.
Outbreaks associated with the use of contaminated duodenoscopes illustrate the severity of this issue.
According to ECRI, complex, reusable instruments such as endoscopes, cannulated drills and arthroscopic shavers, are particularly hard to clean and prone to contamination.
The use of contaminated medical instruments can lead to disabling or deadly patient infections, or instrument malfunctions.
Medical staff should be careful to follow cleaning protocols provided by device manufacturers and to pre-clean devices at the point of use, the report advises.
And provider organisations should also pressure manufacturers to provide detailed, up-to-date guidance about how to properly clean medical devices.
Software management gaps
Inadequate medical device software management can delay a facility’s responses to safety alerts, allow cybersecurity vulnerabilities to be exploited and compromise patient safety.
Maintaining a central repository of up-to-date and easily retrievable information about the software versions used in a healthcare facility’s medical devices is challenging.
But failure to do so leaves the facility ill-prepared to effectively manage software updates and alerts.
For example, ECRI says mismanagement of software updates could cause downtime or otherwise affect the performance of medical devices or interconnected systems, delay identification and implementation of key software updates, including those that address safety concerns and allow cybersecurity vulnerabilities to persist, possibly leading to lost, stolen or inaccessible data.
To address this hazard, ECRI suggests the healthcare facility verify that its computerised maintenance management system provides the capabilities needed to effectively track software versions for its medical devices and systems.
In addition, the facility should establish practices for keeping the software version information current and complete.
Heater-cooler devices
Heater-cooler systems have been identified as a potential source of non-tuberculous mycobacteria (NTM) infections in heart surgery, which can be life-threatening or lead to patient deaths.
The ECRI says these systems are used in cardiothoracic surgeries to warm or cool the patient through extracorporeal heat exchange with the patient’s blood during heartlung bypass procedures.
The devices circulate warm or cold water through a closed circuit.
“Water in the circuit is not intended to come into direct con- tact with the patient or the patient’s circulating blood. However, aerosolised water carried by air from the exhaust vents of contaminated heater-coolers has been suggested as a cause of NTM infections.”
Initial reports focused on one specific model of heater-cooler, but models from other suppliers could likewise become contaminated under certain circumstances and if appropriate precautions are not taken.
Surgical stapler misuse and malfunctions
Problems associated with the use and functioning of surgical staplers can lead to intraoperative haemorrhaging, tissue damage, unexpected post-operative bleeding, failed anastomoses, and other forms of patient harm.
Surgical staplers require meticulous technique to operate, and problems during use are not uncommon. Although severe injuries are infrequent, they do occur, says ECRI.
Commonly reported problems include misfiring or difficulty in firing, misapplied staples, unusual sounds during firing (which can indicate a damaged or malfunctioning mechanism), and tissue becoming “jammed” in the mechanism.
“To prevent patient harm, users must be familiar with device operation; they must carefully select the appropriate staple size for the patient and tissue type; and they must be alert to the signs that the stapler may not be functioning as intended,” advises ECRI.