Bill Levinson

Bill Levinson

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All Content by Bill Levinson

  1. Live and learn...my med error!

    Bill Levinson replied to Antikigirl's topic in General Nursing

    I've never seen a PCA pump but a relatively-obvious solution comes to mind. I assume there is some kind of fixture through which the syringe is attached to the pump. The syringe's front could...

  2. Live and learn...my med error!

    Bill Levinson replied to Antikigirl's topic in General Nursing

    So have the geniuses who run this hospital ever heard of Computer Physician Entry Order (CPEO) systems? Just from what you have told me here (assuming this is the whole picture), this is probably not...

  3. 7000 fatal med errors last year-where are theses nurses?

    Bill Levinson replied to supportneeded's topic in General Nursing

    In other words, the hospitals do not have anything that resembles the kind of quality systems we use in industry, where errors like this are pretty much impossible. (If they happen, they don't happen...

  4. 7000 fatal med errors last year-where are theses nurses?

    Bill Levinson replied to supportneeded's topic in General Nursing

    This was not your fault. Speaking as a quality engineer (I am not a medical professional), it is evident to me from what you have written that unreliable equipment was to blame. I am surprised that...

  5. Is JCAHO just a way to make money?

    Bill Levinson replied to Cheyenne RN,BSHS's topic in Patient Safety Issues

    As I see it, JCAHO is part of the problem and not the solution. http://www.wjla.com/news/stories/0704/160613.html Note especially the fourth paragraph. "A California hospital lacked "a sanitary...

  6. Med error,I'm suspended,I need advice,please!

    Bill Levinson replied to Mama2-3's topic in Patient Safety Issues

    From what I can see here, the fault is not really yours or the other nurse's but the hospital's. The procedure that allows medications to be transferred from labeled containers into unlabeled cups is,...

  7. Healthy 22 y/o mom with DNR

    Bill Levinson replied to cabbage patch rn's topic in General Nursing

    Is a DNR order legal if the patient is not terminally ill? In Pennsylvania, a living will goes into effect only if the patient has less than six months to live, as I

  8. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    No one at my father's nursing home (or his doctors) ever explained this to me. It is probably a good thing that Dad died before I could have a tube put in "to keep him from being hungry and thirsty"...

  9. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    Did Terri Schaivo ever sign an advance directive? If so, did it say she did not want to be tube-fed? There is also the issue that brain activity can be detected (from what I last read) so she is not...

  10. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    I am now very disappointed that the doctor (who rarely spoke with me anyway) did not explain these things to me. My father was opposed explicitly to anything that would merely prolong the dying...

  11. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    Yes, Dad had several cases of aspiration pneumonia, and they wanted to put a feeding tube into him several months before I agreed it was necessary. I thought a tube would prevent him from eating (he...

  12. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    That was indeed my perception but, based on what I have seen here, it is probably better that Dad passed on before a tube could be inserted. I was actually trying to get the doctor to certify that he...

  13. state is threatening to go after license over precharting

    Bill Levinson replied to oramar's topic in Patient Safety Issues

    This is known as non-value adding WASTE in industry. Anything that does not provide care to the patient is WASTE and management should be looking for ways to eliminate or minimize it. E.g. barcode...

  14. Must we all die with a feeding tube?

    Bill Levinson replied to URO-RN's topic in Patient Safety Issues

    This is interesting; I was actually going to have a feeding tube put into my father when he stopped taking fluids and nutrition but he died (perhaps fortunately) before this could be done. I actually...

  15. state is threatening to go after license over precharting

    Bill Levinson replied to oramar's topic in Patient Safety Issues

    Does your state have an anonymous tip line where you can report your hospital for pressuring RNs to prechart? It seems to me that RNs don't prechart because they want to do the job wrong, but because...

  16. state is threatening to go after license over precharting

    Bill Levinson replied to oramar's topic in Patient Safety Issues

    In industrial situations, lot travelers (documents on parts that show which operations have been performed on them) are checked off exactly when the operation is performed. If someone pre-checks them...

  17. state is threatening to go after license over precharting

    Bill Levinson replied to oramar's topic in Patient Safety Issues

    This is prima facie evidence of deficient management systems. If the hospital's management team designs a system in which RNs must cut corners to get the job done, the management team is ignorant...

  18. learning from mistakes...too many?

    Bill Levinson replied to miss.bandaid's topic in Patient Safety Issues

    try http://qualitypress.asq.org/perl/catalog.cgi?item=h0987, "iso 9000 at the front line." (i do not have a commercial interest in this book, by the way, as i wrote it for my former employer, which...

  19. state is threatening to go after license over precharting

    Bill Levinson replied to oramar's topic in Patient Safety Issues

    I like the computer charting idea from a quality management standpoint. Precharting would definitely not be acceptable in an ISO 9000-compliant workplace, and your computer system seems to prevent...

  20. learning from mistakes...too many?

    Bill Levinson replied to miss.bandaid's topic in Patient Safety Issues

    Here is an example of how an equipment change prevents "mistakes" that can endanger patients (or medical staff). I recall having blood drawn during blood drives with lancets that the nurse then...

  21. learning from mistakes...too many?

    Bill Levinson replied to miss.bandaid's topic in Patient Safety Issues

    no, that is not how a quality management system works. if you make a med error you shouldn't feel bad but "blame management" is not the answer. the idea is not to blame people but to fix the problem...

  22. learning from mistakes...too many?

    Bill Levinson replied to miss.bandaid's topic in Patient Safety Issues

    The problem is definitely with the system in which you work, especially since others have made the same error. In an ISO 9000-compliant workplace, the following procedure is followed whenever there...

  23. learning from mistakes...too many?

    Bill Levinson replied to miss.bandaid's topic in Patient Safety Issues

    Can you tell me how this happened? I will lay six to one odds that the basic problem is in the system in which you work. What I mean is that, if it is possible for you to administer the wrong dose, it...

  24. bar coding

    Bill Levinson replied to pa-tricia's topic in Patient Safety Issues

    On general principles, YES. :) Bar-coding is an error-proofing technique that is commonly used in industry. It sounds like your hospital is investigating error-proofing techniques, which is good....

  25. ISO 9000 and patient safety

    Bill Levinson posted a topic in Patient Safety Issues

    I found this forum by searching for discussions of Pennsylvania's Blue Cross surplus. I am working with a legislator to protect the interests of Blue Cross ratepayers...