Top 10 Health Tech Hazards for 2020

·      Using healthcare technologies safely requires identifying and addressing possible sources of danger from these technologies.

·      To help institutions and providers do that, ECRI Institute’s Health Devices Group compiles an annual list of top 10 health technology hazards.

·       The list, which follows, is based on investigations, tests, observations and literature reviews conducted by ECRI engineers, scientists and clinicians.   

#10 Loose or missing fasteners in medical devices

·      The nuts, bolts and screws holding together medical devices may not be exciting, but failing to maintain or replace them can have severe consequences.

·       Devices can tip, fall, or collapse during use and cause injury or even death to patients, staff, and bystanders.

#9 Medication errors caused by dose timing discrepancies in EHRs

·      Delayed or missed medication dosages can occur when the intended dose administration time differs from the time listed in the EHR-generated worklist used by the nurse.

·      These errors can be reduced if the EHR’s order entry system prominently displays scheduled medication administration times, allows prescribers to easily modify that time, and includes a “now” option for medications that need to be administered right away. 

#8 Performing MRI scans with incomplete patient implant data

·      Patients undergoing MRI studies must be screened for implanted devices, since some implants can heat, move, or malfunction when exposed to an MRI’s magnetic field.

·      However, information about patient implants is often scattered and hard to locate

·      Healthcare facilities need to work with EHR vendors to create a place in the patient record where an implant list can be stored and easily accessed.

#7 Cybersecurity risks from connected home healthcare devices

·      Network-enabled monitoring devices used in patients’ homes create cybersecurity risks, such as data flow interruptions and data breaches, with a resulting need to address them.

·      Reducing these risks requires assessing a device’s security, both at the patient’s home and in the provider’s network, when the device is purchased and/or installed.

#6 Alarm/alert fatigue

·      As the number of devices generating alarms and alerts grows, so too does the risk that a doctor will ignore them and not respond to a genuine emergency.

·      Healthcare institutions need solutions that address all sources of distractions that create the potential for desensitizing doctors and cause them to miss truly important notifications that can lead to patient harm.

#5 Using surgical robotics in new procedures

·      Surgical robots’ mechanical wrists offer surgeons benefits, such as improved dexterity and tremor reduction.

·       But these systems also have drawbacks, such as possibly not providing tactile feedback on forces exerted on tissue, that can produce adverse outcomes.

·      Healthcare institutions need to develop processes for approving the use of surgical robots in new procedures, and programs for training surgeons and OR staff for those procedures. 

#4 Hemodialysis risks from home use of central venous catheters (CVCs)

·      Many hemodialysis patients are treated via CVCs for longer than the recommended time period. Meanwhile, the federal government is encouraging increased home treatment for patients with kidney disease.

·      In a home setting and without the presence of trained staff, the consequences of CVC problems such as clotting, infection, and air embolism can be severe.

#3 Infection risks from sterilization errors

·      Insufficient attention to proper sterilization, especially in ambulatory care settings can expose patients to dangerous pathogens from contaminated instruments, implants, or other items.

·      Prevention measures include designating a qualified staff member or contractor to support office infection prevention and control practices, and providing appropriate training for benchtop sterilizer operators.

#2 Insufficient safeguards for using point-of-care ultrasound (POCUS) equipment

·      Many healthcare facilities lack proper safeguards for ensuring that POCUS users have the requisite training, experience, and skill to use it, leading to misdiagnoses and overreliance on POCUS when an examination by an imaging specialist is indicated.

·      Solutions include proper training and credentialing for POCUS users, exam documentation, data archiving, and developing user protocols that conform to established exam guidelines.

#1 Misuse of surgical staplers

·      While the rate of adverse events involving surgical staplers is low relative to their frequency of use, the consequences of misapplied staples or a staple line failing can be severe. They include intraoperative hemorrhaging, tissue damage, and unexpected postoperative bleeding, among others.