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The Joint Commission disseminates "sentinel event alerts" identifying specific sentinel events, their underlying causes, and steps to prevent recurrence. [5] Further nursing research is ongoing at a number of "magnet" hospitals in the United States, especially to reduce the number of patient falls that may lead to sentinel events.
In addition, the Joint Commission created a "do not use" list of abbreviations [52] in 2004 to avoid acronyms and symbols that lead to misinterpretation. Identifying sentinel events and analyzing the root causes has been a focus of TJC since 1996; the first eight alerts were published in 1998. The Commission defines a sentinel event as "any ...
On April 18, 2013, the Joint Commission issued a sentinel event alert that highlighted the widespread problem of alarm fatigue in hospitals. Their recommendations included establishing guidelines to tailor alarm settings, training all members of the clinical team on safe use of alarms, and sharing information about alarm-related incidents. [ 4 ]
A sentinel surveillance system is used to obtain data about a particular disease that cannot be obtained through a passive system such as summarizing standard public health reports. Data collected in a well-designed sentinel system can be used to signal trends, identify outbreaks and monitor disease burden, providing a rapid, economical ...
The FDA Adverse Event Reporting System (FAERS or AERS) is a computerized information database designed to support the U.S. Food and Drug Administration's (FDA) postmarketing safety surveillance program for all approved drug and therapeutic biologic products.
A list of events was compiled by the National Quality Forum and updated in 2012. [3] The NQF’s report recommends a national state-based event reporting system to improve the quality of patient care. Artificial insemination with the wrong donor sperm or donor egg; Unintended retention of a foreign body in a patient after surgery or other procedure
Volunteers report a twitching sensation when exposed to rapidly switched fields, particularly in their extremities. [ 34 ] [ 35 ] The reason the peripheral nerves are stimulated is that the changing field increases with distance from the center of the gradient coils (which more or less coincides with the center of the magnet). [ 36 ]
Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides is a U.S. state-based surveillance program that monitors pesticide-related illness and injury. It is administered by the National Institute for Occupational Safety and Health (NIOSH), twelve state health agencies participate. NIOSH provides technical support to all ...