Reporting Medical Errors
Historically, reporting medical errors has been associated with punitive action for the individuals involved, thereby discouraging its practice. Hospitals that take a non-punitive approach in such reporting improve their odds of capturing errors and avoid repeating them in the future. This includes ventilator problems caused by equipment malfunction or clinician error. The hospital should encourage the reporting of actual errors as well as near misses or close calls. This open reporting may help ensure operational defects are identified and corrected.
Evidence-Based Practice
Evidence-based medicine (EBM) is the utilization of the best evidence when making clinical decisions in the care of individual patients. Evidence-based medicine has gained popularity in recent years because many physicians do not practice according to the best available evidence. Today’s technology makes these data current and readily available. Evidence-based medicine includes results from clinical trials as well as outcomes from clinical practice. The IHI(3) and other groups have included evidence-based practice as one of their initiatives in improving ICU outcomes. These groups collect data from research and best clinical practice and make the information available to clinicians around the world.
ARDSNetwork Recommendations. The ARDSNet study was conducted from 1996 to 1999 and randomized more than 800 patients to receive either a low tidal volume or high tidal volume strategy. The results showed a 25% increase in survivability when low tidal volumes were used.(4) Evidence-based strategies for ARDS ventilator management today include: