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Physician Assistants: Clarity is Key When Writing Prescriptions

Medical DocumentationWhen a PA has the authorization to write prescriptions for controlled medications, it can lead to a more effective physician-physician assistant team by allowing the physician to spend more time with patients with fewer interruptions. It can also limit unnecessary visits to the emergency department or return office visits for the patient. All of these benefits result in lower costs to both physicians and patients.

However, along with the benefits of PA’s being able to write prescriptions comes the potential risk of medication errors. Medication errors can leave the PA opened to litigation. One way to help mitigate the chance of medication error is by ensuring accurate prescription writing. The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) has developed the following suggestions to improve the clarity of prescription orders in order to prevent medication errors:

  1. All prescription documents should be legible and verbal orders should be minimized.
  2. Prescription orders should include a brief notation of purpose (e.g., for sore throat) to help further assure that the proper medication is given and to add an extra safety check in the process.
  3. All prescriptions should be written in the metric system except for therapies that use standard units.
  4. Prescribers should include age and weight of the patient on the prescription order.
  5. Prescriptions should include name of drug, exact metric weight or concentration and dosage form.
  6. A leading zero should always precede a decimal expression of less than one. A trailing zero should NEVER be used after a decimal.
  7. Prescribers should avoid the use of abbreviations including those for drug names and Latin directions for use.
  8. Prescribers should avoid using vague instructions.

National Coordinating Council for Medication Error Reporting and Prevention

These suggestions, when applied by a PA, will decrease the chance of a medication error happening. A decreased chance of an error occurring will naturally decrease the risk of a claim being brought against a PA for medical malpractice.

For more information on risk management and personal medical malpractice insurance, visit www.MedEdge.com.

Structural Considerations for Greenhouses to Prevent Snow Damage

GreenhouseImage Credit:
extension.org

A significant problem for nurseries during the winter season is the damaged caused to greenhouses and equipment during snow storms. As snow builds up on a greenhouse, it begins to put tremendous pressure and weight on the structure. Eventually, if the structure is not set up properly, this weight will take its toll and crush the greenhouse leaving the business owner to deal with the costly task of fixing the damage to equipment, the structure, and the plants inside the structure

Take the following real life case from 2009 as an example of the high costs snow damage can cause:

Oregon nurseries say winter storms have done a number on some greenhouses, and the damage to plants wont be known fully until spring.

The Oregon Association of Nurseries says that at a seedling operation in Molalla, more than a foot of snow and ice crushed 72 of 84 greenhouses. Another operator estimated structure and equipment loss at more than $1 million.

Claims Journal

Preventive measures can be taken when designing a greenhouse to help manage this risk. When building a greenhouse, be sure that foundation posts are large enough to support the weight of the building and that the greenhouse has diagonal bracing. All post connections should have the proper bolts and screws reinforcing them. When building individual greenhouses next to each other, be sure toleave around one foot of space between individual greenhouses. This will help prevent the sidewalls from collapsing in as snow accumulates.

After the greenhouse is properly built, there are still preventive measures to put into action. Any cracked or broken glass that is noticed should be replaced immediately. The heating system should be turned on and should maintain 60 degrees Fahrenheit and energy screens should be retracted in order to melt the snow away. It is also critical to have a standby generator available in case of a power outage occurring during the snow storm.

Designing a greenhouse properly and taking the correct steps prevent snow damage will reduce business risk for the business owner and save them from some financial trouble.

For more information on greenhouse growers insurance and risk management, visit GrowPro..

Plumbing Risks: Gas Explosions

Gas ExplosionImage Credit:
abclocal.com

Common practice used by plumbers when purging gas lines has always been to open the gas valve and, once they smell the familiar scent of gas, shut the valve off. But what if the gas has lost its odor? Then simply relying on the ability to recognize the smell of gas proves to be a dangerous and risky practice.

In 1937, after a deadly explosion at a Texas school, a law was passed to add a chemical to natural gas that would give it that rotten egg smell that has become the tell tale sign that there is gas present in the air. What is not common knowledge is that this odor can fade and even disappear because the steel and plastic piping can absorb the odor. This is known as “natural gas odor fade”. Without the ability to smell the gas, a plumber may purge a gas line before connecting a fixture allowing odorless gas to fill up an enclosed space and mix with the air. This mixture has the potential to cause a serious explosion.
To help mitigate the risk of a gas explosion occurring, remember:

  • NEVER rely on your sense of smell alone to detect the presence of natural gas.
  • ALWAYS use gas detection equipment during purging or when working on or around gas piping systems, i.e., combustible gas detector.
  • Be aware of other signs of a gas leak besides the smell: a hissing, whistling or roaring sound near a gas appliance or pipeline; a damaged connection to a gas appliance.
  • Make sure to purge gas lines in a well ventilated area, never into an enclosed space.

Pacific Gas and Electric Company

Outside of the obvious risk of injury to the plumber that a gas explosion would cause, explosions can cause serious injury to the customer and serious structural damage to the building or house, leaving a business owner opened to some severe claims being filed against them. Following the above guidelines and understanding that using only the sense of smell to detect gas is a dangerous practice, will reduce the chance of a gas explosion occurring which will result in less business risk for the business owner.

For more information on plumbing insurance and risk management, please visit PlumbingPro.

Reducing Veterinarian Risk: Handling, Lifting, and Restraining Dogs

Dog
A large part of the day-to-day business of a veterinary hospital is the physical handling of dogs. These animals may be calm and docile, or they may be angry and irritated. In either case, the level of risk is high and the opportunity for an accident that leaves the veterinarian opened to litigation is always present. This is why it is so important to train staff on the proper way to handle animals that are brought into the hospital. The entire humane handling process requires an appraisal of each animal’s behavior, an adequate number of properly trained staff, an appropriate choice of location for the procedures, and proper equipment that is readily available

Handling
Always observe the animal behavior before approaching and get their attention by calling the pet by name and encouraging him to come to you. If the animal does not come to you, slowly approach him from the front. Approaching the animal from behind can cause the animal to be surprised and raise the chances of an accident occurring. If the owner is holding the pet, let them place the animal down on the table, instead of taking the pet from the owner’s arms. Otherwise, the animal may become protective of the owner when you reach out to them.

Lifting
To lift a dog from the floor to the examination table, put one arm in front of the animal’s chest and the other behind the rear legs or under the stomach and lift in a scooping motion. A larger dog may require 2 people to lift with one person lifting behind the front legs and the other under the stomach.

Restraint
When it is determined that restraint is necessary, always remember that less is more. Excessive restraint may cause the animal to become irritated, aggressive, and/or uncooperative. The least amount of restraint needed to allow the Vet to do their job should be applied. Talk to the dog in a soft, soothing tone. The owner can be within sight of the animal and talk to it try to calm it down but should NEVER be the one to restrain the animal. This would leave the business opened to serious lawsuits if an accident were to happen. If the animal attempts to bite or has a history of biting, than the use of a muzzle is necessary.

www.vetmed.wsu.edu

Proper handling, lifting and restraint of dogs during a physical examination will lead to happier customers and a lower chance of a claim being filed against a Vet. But even with a well trained staff and a properly equipped facility at a veterinarian’s disposal, claims can still be filed against a business owner. In this event, veterinarians deserve to have a defense with their needs in mind through a coverage program like PetPro.

For more information about pet care insurance and risk management, visit PetPro.

Risk Management for Landscapers: Equipment Transportation

Trailer
Most landscapers are aware of the risks involved with landscaping work while on the job site. Employee injury and property damage tend to be the most common risks involved in the landscaping line of business. While landscapers recognized these as potential liabilities inherent with this type of work, they often ignore a major part of the process that can cause some serious business risks: traveling to and from the worksite. Traveling with all the necessary, often heavy, equipment needed to perform a job can lead to accidents leaving the business owner opened to claims being filed against them.

Take this real world example:

A Philadelphia man is suing a Maryland business over claims he sustained head injuries and completely lost his sense of smell following a chain reaction accident triggered by items that fell off of the back of a landscaping truck.

The lawsuit says that the defendant failed to adequately secure its load of wheelbarrows and other landscaping tools, causing the items to be ejected from the bed of the truck and land on the highway, which triggered the multi-vehicle accident.

The Pennsylvania Record

Accidents like this can be avoided if the time is taken to make sure that all equipment is properly and safely loaded into the truck. To help mitigate the risk, make sure to do the following:

  • Be sure to properly balance the cargo load in the trailer. Unbalanced cargo can cause the trailer to sway.
  • NEVER overload the trailer or pick-up bed.
  • For large equipment, use chains or straps with ratchet load binders to secure.
  • Double check that all straps and chains are fastened properly before driving.
  • When driving, make sure stop gradually to prevent cargo from shifting and avoid exceeding the speed limit.

The points above may seem like common sense, but it’s surprising how many landscapers forget these simple steps when they are in a rush or just following their daily routine on auto-pilot. It is important for landscapers to find a way to remind themselves and their employees to properly load and secure their vehicle; as it goes a long way in preventing accidents.

For more information on landscaping insurance and risk management, visit LandProTreePro.