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Top 10 health technology hazards for 2019
Health technology—ranging from simple devices to complex information systems—poses unanticipated risks for healthcare organizations. It’s important to identify these risks, understand them and try and correct them. Each year, the ECRI Institute’s Health Devices Group produces a list of the top 10 health technology hazards, identifying potential sources of danger that warrant the most attention for the coming year. “All the items on our list represent problems that can be avoided or risks that can be minimized through the careful management of technologies,” ECRI reports.

Here are the ECRI Institute’s selections for 2019.
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Hackers exploiting remote access to systems
Cybersecurity attacks that infiltrate a network by exploiting remote access functionality on connected devices and systems—or by any other means—remain a significant threat to healthcare operations. Attacks can render devices or systems inoperative, degrade their performance or expose or compromise the data they hold. Remote access systems are a common target because they are publicly accessible.

Safeguarding assets requires identifying, protecting, and monitoring all remote access points, as well as adhering to recommended cybersecurity practices, such as instituting a strong password policy, maintaining and patching systems, and logging system access.
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Mattresses contaminated with patients’ body fluids
Blood and other body fluids that remain on, or within, mattresses or mattress covers after cleaning can contact subsequent patients, posing an infection risk. Reported incidents include patients lying on an apparently clean bed or stretcher when blood from a previous patient oozed out of the surface onto the patient.

Healthcare facilities must take care to use appropriate products and procedures for cleaning and disinfecting mattress covers, and they should regularly inspect mattresses and covers for signs of damage or contamination.
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Surgical sponges that are left in patients
Surgical sponges that are unintentionally left inside the patient after the surgical site is closed can lead to infection and other serious complications, including the need for secondary operations. Manual counts—in which the surgical team verifies that all sponges are accounted for before concluding the procedure—are standard practice, but they are prone to error.

Technologies that supplement manual counting are available and have been found to be effective when used correctly. ECRI Institute contends that broader adoption of these technologies could further reduce the risk that a surgical sponge will be unintentionally retained during a procedure.
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Ventilator alarms that are not set correctly
Mechanically ventilated patients are at risk if user-adjustable ventilator alarms are not tailored to the patient’s respiratory parameters. Leaks, disconnections, and other failures associated with a ventilator’s consumable components can lead to harm if the condition is not identified and rectified promptly.

Properly set alarms can prevent such consequences. Healthcare facilities need policies on setting user-adjustable ventilator alarms and protocols for verifying that the policies are being followed and that component connections are secure.
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Sloppy handling can infect flexible endoscopes
Cleaning and disinfecting flexible endoscopes between uses is known to be a challenging process, and failing precisely to follow a robust reprocessing protocol can lead to debilitating or even fatal infections. Less well known is that improper handling and storage practices can recontaminate previously disinfected scopes, heightening the risk of patient infections.

Recontamination can also occur when transporting and storing endoscopes. Disinfected and dried endoscopes should be transported in a clean enclosed container dedicated to that purpose, and they should be prevented from contacting potentially unclean surfaces.
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Confusing dose rates with flow rates on infusion pumps
Mistakes such as entering the intended flow rate into an infusion pump’s dose rate field can lead to dangerous medication administration errors, and such wrong-field programming errors occur relatively frequently. Even “smart pumps” that incorporate a dose error reduction system can be misprogrammed in a way that could lead to patient harm.

The surest way to eliminate manual-entry errors is to implement auto-programming of infusion pumps. Other recommendations include configuring the MAR to match the sequence in which infusion parameters will be entered into the pump and instituting appropriate double-checks to verify pump programming.
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Improperly setting physiologic monitor alarms may cause issues
Improper customization of the alarms on a physiologic monitoring system could prevent staff from learning about significant changes in the patient’s physiologic status or about problems with the medical device or system. Failure to recognize and respond to such conditions in a timely manner can result in serious patient injury or death.

Establishing thoughtful policies and educating staff about optimal alarm-customization practices can help reduce the risks. Additionally, monitoring system vendors offer tools to support customization efforts.
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Injury risk from patient lift systems
Overhead patient lift systems are fixed structures designed to lift and transfer patients, such as from a bed to a wheelchair. During use, the patient is placed in a sling suspended from a lifting mechanism. Most overhead lifts use a motorized trolley that travels along an overhead track that is mounted to the ceiling or wall or that is part of a freestanding frame built around a patient bed or other location.

Risks can be reduced by having qualified personnel install the system, thoroughly testing the system after installation, assessing the condition of the lift before and during each use, and performing regular preventive maintenance.
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Cleaning fluids causing fires in electrical components
Improper cleaning of electrical equipment can result in equipment malfunction, damage or fire. Medical devices and other electrical equipment used in healthcare facilities must be cleaned and disinfected to prevent cross-contamination between patients and curtail the spread of infectious organisms. However, some cleaning practices can present risks—fluids may enter electrical components such as plugs, sockets or power supplies.

Staff should follow manufacturer instructions when cleaning electrical equipment; they should avoid spraying fluids directly onto the equipment, and they should use appropriate cloths, wipes and sponges, squeezing out excess liquid before use.
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Flawed battery charging systems can affect device operation
Insufficiently charged batteries can affect the readiness and operation of medical devices that rely on rechargeable batteries to temporarily power the device. If no alternative device or source of power is readily available, serious injury or death could result, particularly if the equipment is needed for life-saving or life-sustaining therapy. Staff failing to properly charge or maintain batteries is one concern, but often, the fault lies with the equipment: A device’s battery status indicators may not be sufficiently accurate or clear.

Adhering to appropriate battery use and maintenance practices is essential. Equally important, but often overlooked, is assessing battery systems before purchase.