The independent nonprofit research organization ECRI Institute recently announced its Top 10 Health Technology Hazards list for 2014, which is distributed to raise awareness of the potential dangers associated with the use of medical devices and to help health care providers minimize the risk of technology-related adverse events.
New topics this year include hazards related to radiation exposure in hybrid operating rooms and complications arising from insufficient training in the application of robotic surgery.
The list also includes two hazards that are risks to pediatric patients: computed tomography (CT) radiation dose and the use of technologies designed for adults.
Among the other hazards on the list are data integrity failures in electronic health records (EHRs) and other health IT systems, as well as neglecting change management for networked devices and systems. To develop the annual list, ECRI Institute and ECRI Institute PSO engineers, scientists, nurses, physicians and patient safety analysts draw on the resources of the institute’s 45-year history, as well as their own expertise and insight gained through analyzing health care technologies.
This includes examining health technology-related problem reports from hospitals and health systems worldwide, as well as those received through ECRI Institute PSO, a federally designated patient safety organization.
Here’s a look at the top 10 health IT hazards for the coming year.
Data Integrity, Networked Devices Among Top Health IT Hazards for 2014
By Nathan Eddy
Alarm Hazards Lead the List
Ventilators, infusion pumps and many other devices generate clinical alarms to help caregivers keep patients safe, but excessive numbers of alarms can lead to fatigue, and patients could be put at risk if an alarm does not activate when it should.
Alarms can also distract caregivers from paying attention to more important patient care activities.
Infusion Pump Medication Errors Place Second
Although invaluable, these devices also represent a large technology management burden, as a hospital may have hundreds or even thousands of these devices in its inventory, and device failures—or failures to use the devices properly—are not uncommon and can cause significant patient harm, the report noted. Infusion pump integration—that is, connecting the servers for the infusion pumps with other information systems—can provide additional protections.
CT Radiation Exposures a Concern for Pediatric Patients
CT practices that can place children needlessly at risk include the inappropriate use of any technology that uses ionizing radiation, as well as the failure to properly control the radiation dose during such procedures.
The report said efforts should be made to minimize a child’s exposure to high doses of ionizing radiation.
EHRs Can Be Helpful or Harmful for Patients
The presence of incorrect data in EHRs and health IT systems can lead to incorrect treatment, potentially resulting in patient harm.
The report points out the myriad ways that the integrity of the data in an EHR or other health IT system can be compromised.
Occupational Radiation Hazards Could Impact Hybrid ORs
Knowledge of the risks and experience in executing precautions may be lacking—a situation that could lead to unnecessary radiation exposures to clinicians working in a hybrid operating room (OR) on a daily basis, the report warned.
Inadequate Reprocessing of Endoscopes and Surgical Instruments
The report warned that successful reprocessing of any device requires consistent adherence to a multistep procedure. Failure to properly perform any step, including some necessary manual tasks, could compromise the integrity of the process and lead to significant patient harm. Staff should be trained in these protocols, and they need adequate space, equipment and instructional materials.
Neglect of Change Management for Networked Devices and Systems
One underappreciated consequence of system interoperability is that updates, upgrades or modifications made to one device or system can have unintended effects on other connected devices or systems, like a facilitywide PC operating system upgrade that causes the loss of remote-display capability for a hospital’s fetal monitoring device.
Risks to Pediatric Patients From ‘Adult’ Technologies
Due to their smaller size and ongoing physiologic changes, children may suffer adverse effects when subjected to adult-oriented health care techniques.
The report warns that medication dosing errors can be particularly harmful to children because of the patient’s small size.
Robotic Surgery Complications Due to Insufficient Training
Initial training provided by the supplier of a robotic system can help users become familiar with it, but it does not teach trainees how to perform specific surgical procedures. Thus, it is up to the hospital to verify that surgical staff members have the necessary procedure-specific skills.
Retained Devices and Unretrieved Fragments
Last appearing on the list in 2010, a string of incidents prompted the organization to include retained surgical items (RSIs) as a 2014 top risk. Risks to patients can include prolonged or additional surgery, as would occur when an RSI is discovered and its removal is deemed appropriate, or future complications, some potentially serious, as could occur when an RSI leads to infection or causes damage to the surrounding tissue.
Nathan Eddy is Associate Editor, Midmarket, at eWEEK.com. Before joining eWEEK.com, Nate was a writer with ChannelWeb and he served as an editor at FierceMarkets.
He is a graduate of the Medill School of Journalism at Northwestern University.