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[Tweet](https://twitter.com/share) [![Stethescope](https://www.myknowledgebroker.com/hs-fs/file-3840041829-jpg/blog-files/stethescope.jpg?width=250&height=168&name=stethescope.jpg)](https://www.myknowledgebroker.com/hs-fs/file-3840041829-jpg/blog-files/stethescope.jpg)Great article on improving patient safety for care giving facilities such as hospitals and nursing homes. [Read full article in Amednews.com](http://www.amednews.com/article/20130415/profession/130419969/4/), by Kevin B. O'Reilly. These are things hospitals and nursing homes should be doing to protect patients. 1. **Improve Hand Hygiene** Rates of hand washing are low, averaging 39%, with many doctors and nurses underestimating the activity's safety value. Research shows that effective hand hygiene initiatives improve knowledge of when to clean and how to clean, require demonstration of the knowledge, ensure that alcohol-based rub and gloves are available at the bedside, and guarantee that compliance is monitored continuously 2. **Use barrier precautions to stop the spread of infections** Along with hand hygiene, barrier precautions are key to reducing the 1.7 million health care-associated infections that occur in the U.S. each year, which the CDC says kill about 99,000 patients annually. 3. **Implement care bundles to prevent central-line associated bloodstream infections** About 250,000 bloodstream infections occur each year in the U.S., and these infections can triple hospital stays from seven to 21 days. Bloodstream infection rates in ICUs fell by nearly 60% between 2001 and 2009 thanks to wider use of a prevention protocol bundle. 4. **Use real-time ultrasonography when placing central lines** Using portable ultrasound machines to get a real-time, two-dimensional view while placing the catheter has been shown in randomized trials to lower infection rates and improve other outcomes. For every 1,000 patients, ultrasonography-guided central-line placement helps avoid 90 complications, research shows. 5. **Use protocols to reduce catheter-associated urinary tract infections** The most important step in preventing catheter-associated UTIs is to reduce use of indwelling urinary catheters. At least 21% of catheters are placed in patients inappropriately — for example, as a substitute for extra nursing care — and they often are left in long after they are needed. 6. **Employ preoperative checklists to reduce surgical complications** The most well-known surgical safety checklist is one devised in 2008 by WHO, which cut mortality rates from 1.5% to 0.8% at sites in industrialized nations and developing countries. The checklist also helped reduce the surgical complications rate from 11% to 7% over six months involving nearly 4,000 procedures. 7. **Improve venous thromboembolism prophylaxis** Between 350,000 and 600,000 Americans develop deep vein thrombosis each year. One key to improving use of these prophylactic interventions is health information technology that helps identify patients at higher risk for VTE. Medical and mechanical interventions can prevent VTE, Dr. Haut says. Low-dose unfractionated heparin and low-molecular weight heparins such as enoxaparin and warfarin are effective. So are compression stockings and pneumatic compressing devices. 8. **Use preventive intervention care bundles to cut rates of ventilator-associated pneumonia** Pneumonia linked to endotracheal intubation accounts for 25% of ICU infections and is responsible for half of intensive care antibiotic use. Research shows that preventive intervention care bundles can cut rates of ventilator-associated pneumonia by as much as 40% among adults and children. 9. **Avoid hazardous drug abbreviations** About 15,000 medication errors a year have been linked to using abbreviations such as “u” for “unit” and “q.d.” instead of “once daily.” Implementation of computerized physician order entry systems also can help eliminate the vestiges of this problem. 10. **Use multi-component interventions to prevent pressure ulcers** About 2.5 million Americans develop bedsores each year, and about 60,000 patients will die from complications related to pressure ulcers acquired in U.S. hospitals. One bundle of preventive care measures has reduced pressure ulcers by 90% at a large health system, from a rate of 5.7% of patients to less than 0.5%. The bundle, dubbed SKIN, calls for continual assessment of the skin of at-risk patients, regular turning of these patients, management of incontinence to prevent soiling that can contribute to bedsores, and nutritional assessment for malnourishment that can enable the ulcers. Health care organizations in Wisconsin wanting to know more about how to reduce their risk and liability exposures, contact knowledgebroker [Jeff Thiel](mailto:jeff.thiel@rrins.com). Topics: [Safety](https://www.myknowledgebroker.com/blog/topic/safety), [Practice Management](https://www.myknowledgebroker.com/blog/topic/practice-management), [Healthcare](https://www.myknowledgebroker.com/blog/topic/healthcare), [Business Insurance](https://www.myknowledgebroker.com/blog/topic/business-insurance) ## [Are you in violation of Title I of ERISA?](https://www.myknowledgebroker.com/blog/are-you-in-violation-of-title-i-of-erisa) Posted by [Jane Shevey](https://www.myknowledgebroker.com/blog/author/jane-shevey) - [Tweet](https://twitter.com/share) Most employers - and you may be one of them - don't completely understand Employee Retirement Income Securtity Act (ERISA), how it impacts business and employees, and the possible risks it presents. Ask yourself the following questions: 1. If you have over 100 enrolled participants in any benefit, have you ever filed a Form 5500 with applicable schedules? *ERISA imposes an **$1100 day penalty for each day** this filing is late up to amximum penalty for large employer (over 100) of $30,000 annually.* 2. If yes, have you ever completed and distributed a SAR (Summary Annual Report)? 3. Have you ever been subject to a DOL audit? *Audits can be triggered through a DOL investigation reproted through other agencies (IRS), through review of form 5500 filings and most often through Employee reporting or lawsuits.* 4. Do you have other ERISA plans such as a 125 plan with FSAs (flexible spending accounts) or HRAs (helaht reimbursement accounts)? *Health FSAs and HRAs are also ERISA plans and must meet the same documentation and filing requirements.* Did you answer No to questions 1 or 2? Did you answer yes to questions 3 or 4? If so, you may be in violation of Title I of ERISA that governs health and Welfare Benefit plans. If you have any questions regarding your ERISA compliance, obligations or anything regarding your health insurance or benefits packages; R&R knowledge broker [Jane Shevey](mailto:jane.shevey@rrins.com) can help! Topics: [Employee Benefits](https://www.myknowledgebroker.com/blog/topic/employee-benefits), [Practice Management](https://www.myknowledgebroker.com/blog/topic/practice-management), [Health Reform](https://www.myknowledgebroker.com/blog/topic/health-reform), [Healthcare](https://www.myknowledgebroker.com/blog/topic/healthcare), [Business Insurance](https://www.myknowledgebroker.com/blog/topic/business-insurance) ## [Patient Safety Awareness Week – March 3-9, 2013](https://www.myknowledgebroker.com/blog/business-insurance/patient-safety-awareness-week-march-3-9-2013/) Posted by [Maureen Joy](https://www.myknowledgebroker.com/blog/author/maureen-joy) - [Tweet](https://twitter.com/share) [![ladywithwalker](https://www.myknowledgebroker.com/hs-fs/file-3903048958-jpg/blog-files/ladywithwalker1.jpg?width=250&height=168&name=ladywithwalker1.jpg)](https://www.myknowledgebroker.com/hs-fs/file-3903048958-jpg/blog-files/ladywithwalker1.jpg)Safely caring for others is a full-time commitment. R&R Insurance Services always recognizes the expertise and commitment of our health care customers and their employees, especially during **Patient Safety Awareness Week** – **March 3-9, 2013**. Here are some ways to promote **patient safety** in your organization: - [**Patient Safety Get Involved:**](http://www.patientsafety.gov/patients.html#intro) available from Department of Veterans Affairs - **[Medication Errors - Tips to Help Prevent Them:](http://familydoctor.org/familydoctor/en/healthcare-management/self-care/medical-errors-tips-to-help-prevent-them.printerview.all.html)** available from American Academy of Family Physicians - [**Hand Hygiene Project**](http://www.centerfortransforminghealthcare.org/projects/detail.aspx?Project=3): available Joint Commission Center for Transforming Health Care - [**Fall Prevention:**](http://www.ncoa.org/improve-health/center-for-healthy-aging/falls-prevention/) available National Council on Aging - Video: **[Keeping Patients Safe From Falls](http://www.centerfortransforminghealthcare.org/multimedia/keeping-patients-safe-from-falls/)** Information on [Health Care Workers and Patient Safety](http://www.myknowledgecenter.com/business-insurance/healthcare-worker-fatigue-and-patient-safety/) For any help with understanding Patient Transfer Safety, or the implementation of proven wellness and work comp techniques, please contact me, [Maureen Joy](mailto:maureen.joy@rrins.com), OTR, knowledgebroker, Occupational Therapist and Health Care Specialist at R&R Insurance Services. Topics: [Safety](https://www.myknowledgebroker.com/blog/topic/safety), [Wellness](https://www.myknowledgebroker.com/blog/topic/wellness), [Practice Management](https://www.myknowledgebroker.com/blog/topic/practice-management), [Healthcare](https://www.myknowledgebroker.com/blog/topic/healthcare), [Business Insurance](https://www.myknowledgebroker.com/blog/topic/business-insurance) ## [Health Care Practices Should Have Disaster Plan in Place](https://www.myknowledgebroker.com/blog/business-insurance/physician-practices-should-have-disaster-plan-in-place/) Posted by [the knowledge brokers](https://www.myknowledgebroker.com/blog/author/the-knowledge-brokers) - [Tweet](https://twitter.com/share) [![Tornado_Flood_Poweroutage](https://www.myknowledgebroker.com/hs-fs/file-3840044864-jpg/blog-files/tornado_flood_poweroutage.jpg?width=250&height=168&name=tornado_flood_poweroutage.jpg)](https://www.myknowledgebroker.com/hs-fs/file-3840044864-jpg/blog-files/tornado_flood_poweroutage.jpg)I found a great article about disaster planning for physician practices, and an even better comment at the bottom of the article I felt worth sharing. It's from Bear Rock Electric located in Maryland. They sum up some concerns that practice managers should think about in a nice, concise way. I am also including a link to the whole article from [MDNews.com](http://www.mdnews.com/news/2013_02/tornado-flood-power-outage.aspx) about power outages and it's affect on practice management: [Small practices and clinics have to prepare, too](http://www.mdnews.com/news/2013_02/tornado-flood-power-outage.aspx). This really applies to all health care facilities - not just small physician practices. Assisted Living, Nursing homes, Urgent Care Centers, CBRF. **Here's the comment from [Bear Rock Electric](http://bearrockelectric.com/):** Bear Rock Electric services the Maryland community for emergency preparedness and power outages and we thank you for such an insightful article. Medical processionals do face very unique situations during storms and power outages and we couldn't agree more that a plan should be in place. Not only do they have the same problems as anyone else, but they also face the tremendous disruptions caused by hours or even days of long nuisance outages. We ask them to think about the following questions: •What if you're in the middle of an office procedure? •What happens to the day's schedule and the rest of the week? •What about your refrigerated supplies? •Where will your patients go? Does the ER have your specialty or dental facilities? Standby power solves all these problems and if they own their building, it also protects that building from a devastating mold infection that could render it uninhabitable or require expensive remediation. It only takes 72 hours for black mold to get started behind sheet rock. 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