New Sentinel Event Alert warns about tubing misconnections

The Joint Commission has released a new Sentinel Event Alert that warns healthcare providers to be vigilant while new International Organization for Standardization (ISO) tubing connector standards are being developed for manufacturers. A phased implementation of redesigned tubing connectors is underway.

Under the new standards, small-bore (less than 8.5 mm inner diameter) connectors will be developed to make it almost impossible to connect one delivery system to another system that serves a different function, such as connecting a feeding administration set to a tracheostomy tube.

The first new ISO connector standard (ANSI/AAMI/ISO 80369-1) has been adopted and more are expected to be adopted in 2014 and 2015. The Joint Commission doesn’t expect to introduce new accreditation or certification tubing connection standards at this time, according to the alert.

Read the Sentinel Event Alert here.