The San Diego Patient Safety Council consists of county-wide representatives from acute care facilities across multiple disciplines including physicians, nurses, pharmacists and respiratory therapists. Council members review literature, apply process improvement tools, and share best practices to obtain consensus in building a comprehensive set of recommendations on specific topics. The Council has developed three tool kits – ICU Sedation Guidelines of Care, PCA Guidelines of Care and Safe Administration of High-Risk IV Medications. Current efforts focus on sepsis - helping to decrease the death rate with early recognition and aggressive treatment.
An evidence-based standard for safe and effective management of pain, sedation, and delirium in the adult ICU ventilated patient. The Tool Kit contains clinical guidelines for adult, sedated ICU patients and a plan for implementing the guidelines in your institution.
The objectives are to:
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Tool Kit: Patient-Controlled Analgesia (PCA) Guidelines of Care (December 2008)
Managing post-operative pain has been a focus of the Joint Commission and is associated with some of the highest incidence of adverse drug reactions. It is also associated with wide variation in prescribing, administration, and monitoring.
Tool Kit: Safe Administration of High-Risk IV Medications (November 2006)
Standardization of intravenous (IV) infusion medication concentrations and dosage units with and across hospitals in San Diego County was identified as a significant opportunity to reduce morbidity and mortality due to preventable, high-risk IV-related adverse drug events. The 2006 Institute of Medicine (IOM) report, "Preventing Medication Errors," urges hospitals to take action to reduce the potential for errors.
In 2009, the IV task force published a follow up report in Hospital Pharmacy. The results showed that area-wide standardization of high-risk IV drug concentrations and dosage units significantly reduced variability in IV therapy, helping promote safer and more consistent practices in administering high-risk IV medications to patients.
- "If every hospital adopted the recommended standards fully, variation in concentration and dosing units would be reduced by 94% and 100%, respectively."
- "It is expected that standardization will decrease the potential for medication errors within hospitals and on patient transfer to other health care facilities."
Hospital Pharmacy - Reduction in Variation of Intravenous Drug Administration in Seventeen San Diego Hospitals with Standardized Drug Concentrations and Dosage Units
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