Introduction to health care management

Author: Janet Peter

Patient suicide, self-harm or attempted suicide resulting in serious disability in a health care facility

Policy

  • Improve systems of assessment and management intentional self-harming behaviors. Patient suicide, self-harm or attempted suicide in health service settings may indicate a catastrophic system failure. Although suicides may not be always preventable, an appropriate system can reduce suicides and suicide attempts. A systems-oriented approach is required, along with a non-punitive culture that supports continuous quality improvement and rewards incident reporting.
  • Identify and disseminate best practices in suicide risk assessment and management.
  • Review existing clinical guidelines and protocols of health services. This will include examining risk assessment and outcomes measurement.
  • Implement and utilize incident monitoring systems for monitoring cases of deliberate self-harm, suicides, and suicide attempts.
  • When a sentinel event of suicide occurs, the relevant service policy on open disclosure should be followed. Post-suicide bereavement information resources should be available to the patient’s families. Appropriate processes should be put in place to support staff.
  • Investigate all suicides that occur in the healthcare facility using tools such as root cause analysis.
  • Develop training strategies for staff and other support services to enable effective use of tools of investigation.
  • Develop measures for reporting, classifying and recording all suicides in the care of health facility.
  • Identify where and when mishaps occur in the care process. Change processes of care to reduce chances of harm.
  • Implement current clinical practice guidelines for the management of suicide and self-harm.
  • Ensure that systems are adjusted according to findings by ensuring appropriate changes are made.
  • Regularly evaluate changes, practice, and outcomes.

Death or serious injury of a patient or staff in the MRI area due to introduction of a metallic object

Policy

  • Conventional metal detectors should be used in the MRI area to

help in identifying metal objects in and on patients.

  • Ferromagnetic Detectors should also be in place as conventional metal detectors can give false-positives and false-negatives. Furthermore, they do not alert personnel to all objects that are subject to malfunction, heating, or failure during an MRI scan.. Availability of ferromagnetic detectors may also help in screening individuals in MRI area for objects left on them.
  • A safety officer whose role will be to implement and enforce safety procedures in the MRI suite should be appointed. A safety officer should also be involved in implementing systems to support safe MRI practice including written protocols and checklists, assessing compliance with MRI policies and conducting periodical reviews of procedures, policies, and protocols.
  • Restrict access to all MRI areas by implementing the four zone concept according to ACR Guidance Document for Safe MR Practices. The purpose of the four zone concept is to put in place some progressive restrictions in access to the MRI area. The four zones should include: General public, Unscreened MRI patients, Screened MRI patients and personnel and Screened patients under the supervision of MR personnel.
  • Use of competent personnel in the MRI environment.
  • Patients should be accompanied by specially trained staff person familiar with the MRI environment at all times.
  • Precautions should be taken to prevent patient burns during scanning. Only tested and approved equipment should be present in the MRI area.
  • There should be a proactive plan for managing critically ill patients requiring the continuous infusion of life-sustaining drugs and physiologic monitoring while in the MRI area.
  • MRI safety policies and procedures should be routinely assessed and reviewed.
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References

Hickey, L., Hawton, K., Fagg, J., & Weitzel, H. (2001). Deliberate self-harm patients: a neglected population at risk of suicide. Journal of psychosomatic research, 50(2), 87-93.

Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A.,... & Mehlum, L. (2005). Suicide prevention strategies: a systematic review. Jama, 294(16), 2064-2074.

Shellock, F. G., & Crues, J. V. (2004). MR Procedures: Biologic Effects, Safety, and Patient Care 1. Radiology, 232(3), 635-652.

Sherry Roberts is the author of this paper. A senior editor at Melda Research in nursing paper writing service if you need a similar paper you can place your order for a custom research paper from custom research paper writing.