Medical Errors in NICU - For Nurses & RMO

Category: Others/ Misc

Presentation Description

What mistakes and errors can occur in NICU and what to do to prevent them


Presentation Transcript

Medical Errors in NICU:

Medical Errors in NICU Dr Manan Parikh

WHY My Doctor is ALWAYS upset with me?:

WHY My Doctor is ALWAYS upset with me? Interested in giving BEST treatment to the Pt Can not execute all work Has to rely on Nursing Staff / RMOs Small mistake can take LIFE Avoidable… if understood properly

Errors in NICU :

Errors in NICU Patient related Equipment related Charting related Investigation related Treatment related Handover related

Patient Related:

Patient Related Monitoring.. Sensorium , abnormal movements Heartrate – good ECG, Pulse-ox trace Saturations – good wave, perfusion BP – Proper size cuff Temperature -- Probe

Patient Related:

Bed side care Positioning – VAP, raised ICP, shock Eyes, Mouth, Skin, Joints IV site – Patent, Extra vasation Lines – Position, Patency Patient Related

Equipment related:

Equipment related Ventilator Disconnect Humidifier Tubing Change of mode – N/P, CPAP/ SIMV HME Positioning of Circuit ET Tube – Fixing, Kink, disconnect

Equipment related:

Multi para Monitor ECG – No proper leads Pulse Ox – Cold Extremities BP – Wrong size Cuff Alarm Limits Battery Backup Maintenance Equipment related

Equipment related:

Warmers Servo mode / Manual mode Improper temperature probe Over Warming Skin Burns Alarms After X ray Equipment related

Equipment related:

Infusion Pump Battery Status Pressure Alarm Air in line Proper syringe fixation Labeling Ensure Rate Equipment related

Equipment related:

Photo Therapy Tube light / LED – Hours, Working condition Over covered Under covered Temperature Hydration Sense of security Pulse Ox probe Equipment related

Charting related:

Charting related Hourly V ital Monitoring Periodic variation Intake Output Balance Units + / - Procedure Charting

Investigation related:

Investigation related Labeling Wrong vaccutainer Wrong Sample Wrong telephonic report – PLT 70000 / 17000 Improper collection techniques Less Quantity Improper storage Delayed Transport Blood Gas -- Heparin

Investigation related:

X ray – Centralization, Venti tubings , Probes, Exposure, Labeling USG – Improper technique EEG – Improper electrodes, moving baby, Sedation CT / MRI – Improper sedation Investigation related

Treatment Related:

Treatment Related Wrong patient Wrong Medication Wrong dose Wrong dilution Wrong route Wrong Infusion rate Blocked Infusion Lines IV out Drug Drug interaction

Handover related:

Handover related Don’t Handover your errors Handover without understanding orders Drug indent Investigation Plan for infusion and ventilators Remaining work Transfer out

WHY My Doctor is ALWAYS upset with me?:

WHY My Doctor is ALWAYS upset with me?

To Summarize:

To Summarize Most Errors are avoidable Common sense and Presence of mind is very important in NICU Avoid gross errors – Especially related to Emergency medication, inotropes , Ventilation Accept your mistake Tell others their mistakes in proper way

Don’t Handover ERROR Don’t take ERROR in Handover:

Don’t Handover ERROR Don’t take ERROR in Handover

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