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Difficulty: MediumPatient Safety and Quality Improvement

Match each clinical safety intervention implemented by a healthcare facility to its corresponding category in the hierarchy of intervention effectiveness.

  • Procuring specialized enteral feeding tubes that physically cannot be connected to standard intravenous ports.Forcing function
  • Installing an electronic health record prompt that alerts the physician of a potential drug-allergy interaction before an order can be finalized.Automation and computerization
  • Implementing a hospital-wide, pre-printed order set to manage acute asthma exacerbations in the emergency department.Standardization and simplification
  • Distributing a memorandum to all nursing staff outlining the updated policy for two-identifier patient verification.Education and policy
  • Assigning an additional pharmacist to conduct independent double-checks on all high-alert medication preparations.Redundancy

Answer

The interventions map to the hierarchy of effectiveness from most effective (forcing functions) to least effective (education and policy).
The hierarchy of intervention effectiveness categorizes safety strategies from most to least reliable based on human factors engineering. System-level interventions like forcing functions are highly effective because they remove reliance on human memory by physically preventing an error. Automation and standardization are moderately effective as they streamline processes and provide warnings, but they can still be bypassed. Person-level interventions, such as redundancy (double-checks) and education (memorandums), are the least reliable because they depend on human vigilance, which is easily compromised by fatigue and distraction.

Step-by-Step Solution

1
Analyze the intervention describing the enteral feeding tubes.
This physically prevents an incorrect connection.
Physical constraints that prevent an error are known as forcing functions.
2
Evaluate the electronic health record prompt.
This provides a computerized warning before order completion.
Alerts fall under automation and computerization in human factors engineering.
3
Assess the pre-printed order set.
This creates uniform clinical management for asthma exacerbations.
Using identical protocols to reduce variation defines standardization.
4
Analyze the memorandum distribution.
This relies on staff reading and remembering the newly outlined policy.
Information dissemination directly corresponds to education and policy.
5
Evaluate the independent pharmacist check.
This adds a second layer of manual verification to the process.
Adding backup checks or secondary reviews is the definition of redundancy.

Key Concept

Hierarchy of Intervention Effectiveness / Human Factors Engineering
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Topics

Patient Safety and Quality Improvement

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