Notre dame university fremantle

1Pleural Drainsin AdultsNSW Consensus GuidelinePurpose To provide appropriate and safe strategies to reduce the risks associated with the use of pleural drains in adults. The recommendations contained within this document may also be suitable for older adolescents requiring pleural drain insertion. The strategies and processes outlined in this consensus guideline are to be incorporated into health facility procedures in relation to pleural drains in adults.Roles and responsibilitiesEvery health professional has responsibility for the health and welfare of our patients.Chief ExecutivesTo assign responsibility and resources that will promote the provision of safe care in relation to pleural drains in adults.Directors of Clinical GovernancePromote safe pleural drain insertion and post insertion care.Promotethe consensus guideline for pleural drains in adults within health facilities.Ensure successful implementation of the consensus guideline recommendations within their facilities.Director of Clinical Operations, Local Health District and Clinical Stream ManagersDistribute Pleural Drains in Adults Consensus Guideline and decision support tools to all clinicians.Support/provide education and training on the correct and safe insertion, management and removal of pleural drains in adults.Ensure timely and appropriate access to CXR/CT scans as recommended in the consensus guideline.Ensure that any incorrect insertion or incidents related to the management of pleural drains are discussed at appropriate patient safety and clinical review meetings.Ensure and document competency of staff who will perform and supervise drain insertion within their facilities.
2CliniciansComplete education and training to ensure that they attain both the knowledge and the practical skills required for pleural drain insertion and care.Assess every patient for their increased risk of pleural drain complications.Correctly insert pleural drain according to clinical indication and patient risk.Assess and re assess pleural drain placement as outlined in consensus guideline.Document the correct insertion, ongoing management, observations, removal and complications of pleural drains in the patient’s health record. Be Aware of the RisksPleural procedures which involve the insertion of inter costal catheters into the pleural cavity incur a high risk of adverse outcomes including death.The NSW Clinical Excellence Commission has identified 185 reported incidents related to pleural procedures in NSW from January 2010 to October 2011. Of the 185 pleural procedure incidents there were Sac 1 (6) and Sac 2 (5) adverse events.Clinical management was attributed as the principal incident type in 69% of all the incidents reported.