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1. Two common diabetes drugs may cause heart failure 2. More adults with asthma need to receive flu vaccines 3. Pay per view: Reduce errors through Failure Modes and Effects Analysis

Patient Safety Monitor Alert, September 12, 2003

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1. TWO COMMON DIABETES DRUGS MAY CAUSE HEART FAILURE
Researchers at the University of Texas at Dallas Southwestern Medical Center discovered that two popular diabetes medications may cause congestive heart failure and pulmonary edema in some patients. More than six million Americans take Pioglitazone and Rosiglitazone, but patients with Type 2 diabetes who also have left ventricular dysfunction or chronic renal insufficiency should avoid these drugs, according to researchers.

Both drugs are relatively new and researchers should study potential side effects in more depth, says Abhimanyu Garg, PhD, the study's lead author. The researchers studied six patients with Type 2 diabetes who were all admitted to the hospital with signs of congestive heart failure. Each patient took one of the drugs for one to 16 months. When the patients received diuretics and stopped taking the drugs, they no longer had any symptoms of congestive heart failure, says Garg.

2. MORE ADULTS WITH ASTHMA NEED TO RECEIVE FLU VACCINES
A majority of adults who suffer from asthma don't receive annual flu vaccines, even though they are at risk for developing complications if they contract the virus, according to a new study published in the September issue of CHEST. According to the study, only one-fifth of asthmatic adults under 50 years old receive a flu vaccine annually. The Centers for Disease Control and Prevention (CDC) and the 1997 National Asthma Education and Prevention Program recommend annual vaccines for these adults.

The influenza virus and other upper respiratory infections can trigger asthma attacks, and the vaccine can help limit the impact of the infections, according to the study. The infections can turn into pneumonia or acute respiratory diseases in asthmatic patients, according to the American College of Chest Physicians. One reason more asthmatics don't receive vaccinations could be that health care workers may not be familiar with the CDC recommendations, says study author Seymour Williams, MD. The study suggests both patients and physicians need education on the benefits of the vaccine for asthmatics.

3. PAY PER VIEW: REDUCE ERRORS THROUGH FAILURE MODES AND EFFECTS ANALYSIS
If your facility conducts a Failure Modes and Effects Analysis (FMEA) just to comply with the JCAHO's standards, it isn't looking at how the tool can help you improve patient care and safety.

FMEAs can help your facility correct potential problems, says Craig Clapper, PE, CQM, chief operating officer of Performance Improvement International of San Clemente, CA. To benefit from the tool, conduct FMEAs on a regular basis. That means you need to convince leaders in your hospital that it is a valuable part of your quality program, according to Clapper. Click here to read more about how to make the most of FMEAs. The cost is $10. Briefings on Patient Safety subscribers received this article in the September 2003 issue of the newsletter.

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