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Protocol Drift

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Kimball Pomeroy

on 4 June 2012

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Transcript of Protocol Drift

Martin B-10
Douglas B-18
Boeing Model 299
Martin 146
Central Line Checklist
Wash Hands With Soap
Clean Skin With Chlorhexidine
Cover Body With Sterile Drape
Wear Mask, Hat, Sterile Gown and Gloves
Put Sterile Dressing Over Insertion Site
My Checklist for Visual Checklists
1. Show Critical Steps
2. Show Steps That Are Prone to Errors
3. Use Shapes to Differentiate
4. Use Colors on the Checklist to Differentiate
5. Be Consistent in Style
6. Have a Time Box
8. Modify After Use
Woman Implannted With the Wrong Embryo.
Plan to say "hello and goodbye" when she plans to deliver the baby soon.

It is supposed to the happiest news a couple can get, especially a couple who have difficulty conceiving and carrying babies. The in vitro fertilization procedure had been a success: Carolyn Savage was pregnant.

And then came the horrible news: It wasn’t her baby. The fertility clinic they had used had made an all but inconceivable mistake and had implanted another couple’s embryos into Carolyn.
by Kimball O Pomeroy, PhD, HCLD
The World Egg Bank
Full transcript