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May 2010, Volume 40 Number 5 , p 21 - 23



Based on practice recommendations from the American Society for Parenteral and Enteral Nutrition (ASPEN), the Be A.W.A.R.E. initiative includes posters for display in nursing stations and other prominent places. The posters remind nurses of simple but essential practices for safe medication delivery via enteral feeding tubes, including: * administer only one drug at a time—don't mix drugs together * don't add medication directly to enteral feeding formula * use water only to dilute medications and flush the tube * flush the tube before and after each drug administered, using an amount appropriate for the patient's age and condition * establish and follow evidence-based protocolsThe poster also reminds nurses to ask the pharmacist about drug-nutrient interactions and other drug-related factors affecting patient care and safety.This safety campaign builds on ASPEN's 2009 Be A.L.E.R.T. initiative to promote safer enteral practices. For more information, visit .Compared with physicians, risk managers are more likely to support disclosing errors to patients. But risk managers are less likely to support offering a full apology, according to findings from anonymous surveys of about 3, 000 healthcare facility–based risk managers and 1, 300 physicians published by The Joint Commission.Risk managers also have more favorable attitudes about the systems in place at their facilities to inform physicians about errors, but both groups agree that improvement is needed.The study authors recommend that hospital policies clearly state who has final authority over whether and how errors should be disclosed to patients.Source: Loren DJ, Garbutt J, Dunagan W, et al. Risk managers, physicians, and disclosure of harmful medical errors. Joint Comm J Qual Patient Safety 2010;36(3):1–108.Remote ischemic preconditioning is a simple, noninvasive technique based on a natural process that helps protect tissue from ischemic injury

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