Over the past few centuries, tourniquets have been associated with the battlefield, a device that has been either harmful or lifesaving. Soldiers were given tourniquets in their pockets with very little training on their use, particularly when they were to be used. In a hospital setting, tourniquets are often used for venipuncture, and much like the battlefield, guidelines are unclear on safe use. Phlebotomists may use unconventional materials for tourniquets (e.g., gloves) and procedures usually lack safeguards against forgetting tourniquet removal.
Ensuring discharged patients have access to and take their medications affects readmissions and patient safety significantly. Medication reconciliation is a key component of this. Medication adverse events have been estimated to occur in approximately 20 percent of patients following discharge, and of those, two-thirds were determined to be either preventable or ameliorable.(1,2) Given the number of US discharges, this represents 4 million patients a year having an ameliorable or preventable drug related adverse event.
Since many of its members are outside California, CHPSO in 2015
changed its name from the California Hospital Patient Safety
Organization to CHPSO. CHPSO
members currently include healthcare organizations in nine
states: Arizona, California, Colorado, Hawaii, Nevada, New
Mexico, Oregon, Texas, and Washington. As one of the first
federally-listed PSOs through the Agency for Healthcare Research
and Quality (AHRQ), CHPSO welcomes members from all states and US
For the past three years, CHPSO has produced hospital-specific
reports to member hospitals that have submitted patient safety
events through the PSO. The hospital specific reports include
data submitted to CHPSO for the 2016 calendar year, January 1 –
December 31. A dashboard will include the following: