Most hospitalized patients have placement of a peripheral venous access device, either a short peripheral catheter or a peripherally inserted central catheter. Compared with central venous catheters that are not peripherally inserted, the other 2 types are generally perceived by health care providers as safer and less complicated to manage, and less emphasis is placed on the prevention and management of complications. Expertise of nurses in inserting, managing, and removing these devices may reduce the likelihood of complications, and increased recognition of complications associated with use of the devices is important to ensure continued improvements in the safety, quality, and efficiency of health care. Complications associated with short peripheral catheters and peripherally inserted central catheters include tourniquet retention, tubing and catheter misconnections, phlebitis, air embolism, device fragment embolization, and inadvertent discharge with a retained peripheral venous access device. Integration of prevention, detection, and recovery strategies into personal nursing practice promotes the quality and safety of health care delivery.
Errors related to health care devices are not well understood. Nurses in intensive care and progressive care environments can benefit from understanding manufacturer-related error and device-use error, the principles of human factors engineering, and the steps that can be taken to reduce risk of errors related to health care devices.
Negative-pressure wound therapy represents a relatively new strategy for wound management. Significant, life-threatening complications (bleeding, infection, and retained dressing material) have been associated with negative-pressure wound therapy. As a result, the Food and Drug Administration published several warnings to negative-pressure wound therapy users and recommended that clinicians ordering, managing, and/or monitoring negative-pressure wound therapy be aware of the potential complications and be prepared to take prompt action to reduce patients' risk for harm. This article reviews and organizes published consensus, expert opinion, research, and manufacturer guidelines about patient safety during negative-pressure wound therapy relevant to nurses practicing in acute and critical care settings, including in advanced practice roles.
This article reviews the connection between task type (skill based, rule based and knowledge based) and human error. Using real-life examples, each task type and error type is described in detail. Understanding how task type contributes to medical error enhances the ability of nurses to make meaningful changes in health care systems. Through error wisdom, nurses and other health care providers can more successfully navigate health care delivery and ultimately provide safer care to patients.
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