9. Incomplete anesthesia pre-check

Making sure anesthesia equipment is in working order before use -- checking that gas cylinders are full and breathing circuits are properly hooked up -- is so critical for safety, in the early 1990s, anesthesiologists got together and developed a "pre-checkout" list providers were encouraged to use. However, while widely adopted, ECRI says that, in practice, inspections can be "inconsistent and incomplete." Sometimes, safety steps are skipped altogether as staff can mistakenly think someone else has already performed them or that they're covered by the equipment's own semi-automated "self-check." Among ECRI's recommendations: delegate clear responsibility for who should perform what.

8. Needlestick injuries

Holding the same rank as on last year's list, sharps injuries remain a significant health care challenge. According to the Centers for Disease Control and Prevention, about 385,000 such injuries occur to health care workers every year, usually nurses, exposing them to blood-borne pathogens like HIV and hepatitis C. And a 2009 Massachusetts public health survey estimated an annual rate of 28 sharps injuries per 100 occupied beds. Thanks to federal legislation, the introduction of safer devices and aggressive publicity campaigns, including most recently "Stop Sticks" by the National Institute for Occupational Safety and Health, the injury rate has been falling in nonsurgical hospital settings -- dropping about one-third from 2001 to 2006. But it's still climbing in surgeries, rising almost 6.5 percent over the same period, the CDC said.

7. Surgical fires

Up two spots from 2011, surgical conflagrations are rare, but not as rare as you might think. According to ECRI, between 550 and 650 such fires occur every year, and they generally get reports of one to two fires a week. These fires, often happening in oxygen-rich environments, such as surgeries using open oxygen delivery systems, can cause horrific, even deadly burns. According to ECRI, about 20-30 fires a year cause serious injury, and one or two are fatal. In response, ECRI and the Anesthesia Patient Safety Foundation have come up with a number of recommendations. For instance, the groups urge providers to discontinue open oxygen delivery in surgeries involving the head, face and upper chest, where possible.

6. Feeding-tube tragedies

Inserting an enteral feeding tube -- meant to deliver foodstuffs to the gut -- into the wrong connector can have fatal consequences, in this hazard, also making a reappearance from last year. To prevent misconnections, the FDA has urged manufacturers to make tubes with safeguards like color-coding and "design incompatibility." The International Organization for Standardization is also working on a standardized enteral connector to prevent such mishaps, ECRI said, but as it will be some time before that's finished, the institute recommends a number of precautions, such as always tracing lines to their source before plugging anything in.

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