If you've made your career in the healthcare industry, you may think you know what works and what doesn't. This may make you think again. Here are five common hospital practices that might not be as useful as you initially believed.
1. Hand sanitizers.
Many hospitals have installed hand sanitizer dispensers in patient rooms and in key areas throughout the hospital in an attempt to improve hand hygiene. But these hand sanitizers may not be as effective as you think. The Centers for Disease Control and Prevention (CDC) says that alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but they do not eliminate all types of germs (for example, they are not as effective against Cryptosporidium, norovirus, or Clostridium difficile). Another concern raised by the CDC with regard to hand sanitizers is that although alcohol-based hand sanitizers can effectively inactivate many types of microbes when used correctly, people may not always use enough of the sanitizer or they may wipe it off before it dries. In most situations, hand washing with soap and water is a superior method of removing microbes.
2. Sliding scale insulin
According to an article in American Family Physician, the use of sliding scale insulin (SSI) is still common in US hospitals despite persistent expert recommendations that the practice be discontinued. Multiple studies have been conducted to test the effectiveness of SSI. Results of the largest cohort study to date showed that SSI not only failed to control hyperglycemia, but also resulted in higher rates of hypoglycemia and was associated with longer hospital stays.
3. Repetitive lab testing
Patients who are hospitalized generally have blood drawn multiple times over a brief hospital stay. According to the Society of Hospital Medicine, this practice should be eliminated in patients whose clinical conditions and labs are stable. Their reasoning behind this stance is that phlebotomy can contribute to anemia, which can, in turn, have significant consequences, especially for patients with cardiorespiratory diseases. Additionally, reducing the frequency of unnecessary blood draws can add up to significant cost savings for the hospital.
4. Patient handling practices
An article in the Online Journal of Issues in Nursing reports that the most common patient handling approaches in US hospitals include manual patient lifting, classes in body mechanics, training in safe lifting techniques and back belts. However, there is strong evidence to suggest that none of these approaches is effective in reducing caregiver injuries. More recent evidence suggests that patient handling equipment/devices, patient care ergonomic assessment protocols, no lift policies, training on proper use of patient handling equipment/devices and patient lift teams are more effective practices.
5. Quality improvement (QI) programs
Without follow-up, that is. The US Health Resources and Services Administration says on its website that once a QI initiative is launched, it is important to regularly communicate progress to all staff. This would include periodic updates on how the QI plan is being implemented, training activities being conducted, and improvement charting. In a recent global survey conducted by the American Nurses Association and GE Healthcare, only 57% of survey respondents said they believed the patient safety programs at their hospitals were effective. Of those surveyed, 59% of the nurses agreed that although patient safety data is collected and reported in their hospitals, there is no follow-up or feedback given to the nurses.