Becker's Clinical Quality & Infection Control

18 PATIENT SAFETY & OUTCOMES Pennsylvania saw 1.4 wrong-site surgeries weekly from 2015-19, study finds By Mackenzie Bean P ennsylvania healthcare facilities reported more than 350 wrong-site surgeries between 2015 and 2019, nearly three-fourths of which result- ed in patient harm, according to a study published in Patient Safety. Pennsylvania is in the minority of states that require healthcare organiza- tions to report wrong-site surgery events to a state database. Researchers used this database to identify and analyze all wrong-site surgery events reported in the state between 2015 and 2019. Six report findings: 1. In total, 178 healthcare facilities reported 368 wrong-site surgeries, which averages out to 1.42 a week. 2. Seventy-six percent of wrong-site surgery events resulted in temporary or permanent harm to the patient. 3. Healthcare facilities reported the most wrong-site surgeries (83) in 2015 and the fewest in 2019 (58). 4. Overall, hospitals accounted for 79 percent of all wrong-site surgery events, and ambulatory surgical facilities accounted for 21 percent. 5. When sorted by bed size, hospitals with more than 300 beds reported the largest share of wrong-site surgeries at 43 percent. 6. The most common body region involved in wrong-site surgeries was the spine (43 percent), followed by the head/neck (17 percent) and lower extremities (14 percent). n COVID-19 might be triggering new-onset diabetes, researchers say By Erica Carbajal N ew-onset diabetes could be another complication added to the list of health problems associated with COVID-19, e Washington Post reported Feb. 1. Before the pandemic, Bethesda, Md.-based Suburban Hospital managed about 18 pa- tients with new-onset diabetes per day. As of January, the hospital was caring for as many as 30 per day, according to Mihail Zilbermint, MD, a diabetes specialist at the hospital. "We've definitely seen an uptick in pa- tients who are newly diagnosed," Dr. Zil- bermint told the Post, adding that many of the patients had no diabetes history. While some hospitalized COVID-19 patients de- veloped elevated blood sugar that subsided by the time they were discharged, others left with diabetes. e Post cited a number of studies indicat- ing a possible link between diabetes and COVID-19, including a study from late November that reported as many as 14.4 percent of patients hospitalized with severe COVID-19 developed diabetes. Some patients who've developed Type 1 or Type 2 diabetes during or aer a COVID-19 infection had existing risk factors such as obe- sity, while others had no prior health concerns. Scientists are unsure whether a COVID-19 in- fection can trigger existing diabetes symptoms that are already developing, or whether the infection itself can cause them. Among other unanswered questions include whether newly diagnosed diabetes following a COVID-19 infection is temporary or permanent. In London, researchers are evaluating whether COVID-19 has spurred an entirely new type of diabetes that evolves differently than tradition- al forms aer reports of cases where patients don't fit the usual profile of existing types of diabetes, according to the Post. While researchers have observed an associ- ation between viral infections such as SARS and the onset of diabetes, they're not sure what the reasoning is, according to the Post. Now, researchers are diving into whether viral infections may damage beta cells, which are responsible for producing insulin. n Leapfrog launches national effort to prevent diagnostic errors By Mackenzie Bean T he Leapfrog Group is launching a national program to publicly report hospitals that are preventing harm from diagnostic errors, the organization said Jan. 28. Leapfrog developed the program, called Recognizing Excellence in Diagnosis, with the Society to Improve Diagnosis in Medicine. The initiative is funded by a two-year, $1.2 million grant from the Gordon and Betty Moore Foundation. In the program's first year, Leapfrog and the society will convene a group of ex- perts to identify diagnosis best practices and create a road map for healthcare organizations. In year two, Leapfrog will pilot a national survey and collect data from up to 100 hospitals and health systems about their adoption of the best practices. n

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