Risk Management Tips for Device-Related Events

As continuing care facility managers may know from experience, staff sometimes do not preserve all equipment involved in an event involving healthcare devices, especially disposable devices and associated packaging. Staff may not understand the need to preserve the equipment or may be concerned about time constraints involved in securing the equipment. In addition, staff often fail to record all relevant device-related information in the event report, such as the device's manufacturer and model number, date of application, placement, lot and/or serialnumber, and date used on or removed from the resident. As a result, information necessary to an investigation of an event that may involve resident injury or death is often lost or unavailable to the continuing care manager and investigators.

This Risk Analysis describes procedures for handling healthcare devices involved in events or accidents, including documentation and securing of devices, and maintaining a chain of custody. A sample letter to send to manufacturers to obtain their cooperation in preserving devices when they must be returned is also included.

Long-term care facilities or home care agencies should maintain a master list of device-identifying information (e.g., serial, control, or lot number) for all devices used in resident/patient care. Continuing Care Risk Management(CCRM)recommends that identifying...