The Epidemiology, Causes and Patient Risk Factors for Medical Errors - Coursework Example

MEDICAL ERRORS By In the recent past, there has been increased concern on the alarming rates of medical errors in the health system. Statistics reveal that about 98000 people face their death because of errors in the health system. It only saddens to note that many medical errors prove to be preventable if certain steps are taken in an effort to reduce the occurrence. Tully and colleagues (2009) asserts that medical errors denote the use of wrong strategies with the aim of achieving a certain objective. Moreover, medical errors refer to the failure to complete a planned action. Research has revealed that medical errors are becoming more prevalent, especially in the intensive care units, emergency departments, and the operating rooms. Considering the criticality of patients’ condition in these departments, it becomes evident that medical errors may prove to be deadly. This explains why a minimum of 44,000 people lose their lives each year because of medical errors and their adverse effects. History of Medical Errors Donchin and colleagues (2003) assert that the Institute of Medicine published a compelling report in 1999 concerning the prevalence of medical errors and their consequences. The report presented statistics on the number of people affected by errors in the health care systems, the costs involved, and other alarming statistics that highlighted the epidemiology of medical errors, which surpassed other known causes of death. This report indicates that medical errors caused more deaths in the United States compared to the cumulative death rate from road accidents, HIV aids, and cancer. The report also estimated the rising cost of health care resulting from increasing medical errors. The release of the report triggered the need for advanced research on the rates of medical error and their potential adverse effects as well as the financial cost involved. Dodek (2010) also highlights that in the United States, the occurrence of medical errors proved to be a problem that needed prompt addressing. Therefore, the then president Bill Clinton ensured that the federal government took measures of reducing medical errors in accordance with recommendations from the Institute of Medicine. Moreover, there was a salient need for further research on related issues in an effort to establish the primary causes of medical errors. The Clinton’s government sought to develop a comprehensive strategy that could help in the reduction of medical errors. This strategy involved a national reporting an\d disclosure of medical errors. The strategy developed by the Clinton government aimed at reducing medical errors by 50% in a period of 5 years. The Institute of Medicine of medicine highlighted that different types of medical errors were prevalent. Diagnostic errors, which resulted from delayed or wrong diagnosis as well as failure to conduct the necessary tests before administering drugs, registered a leading occurrence. In other cases, diagnostic errors resulted from the reliance on outdated tests and diagnostic procedures. Other diagnostic errors resulted from the failure of health care providers to monitor the results of diagnostic tests effectively. A second type of medical errors was highlighted as treatment errors, which occurred during a medical procedure test or operation. In some cases, health care providers administered as a required treatment in the wrong way. Dhillon (2003) asserts that some health care providers registered errors when prescribing dosages of drugs. In more serious cases, health care providers registered delay before responding to the health needs of patients or failure to exhibit efforts of reversing wrong procedures as highlighted by David and colleagues (2013). Preventive medical errors are also common, especially when health care providers do not consider it a priority to provide patients with prophylactic preventive errors also resulted from the lack of proper monitoring of treatment. According to Beladi, Seifollah, and Hayati (2013), other medical errors result from poor communication channels within the health care system. Health care providers who fail to communicate effectively concerning critical issues regarding a patient’s health or medical procedures are more likely to report medical errors. Bucknall (2010) highlights that the failure of equipment in health care facilities is also known to trigger numerous errors. according to Bohomol and colleagues (2009) types of errors are classified as follows: The classification of consequences was based on the Ohio State University Severity Scale (Schneider & Gift 1998). This describes seven levels of severity to the patient: zero, errors intercepted before they reached the patient; one, no change in clinical outcome; two, increased monitoring required; three, additional laboratory tests required, or change in vital signs; four, treatment or procedure required, increased length of stay, or hospital (re)admission; five, transfer to ICU, invasive procedure, or permanent harmful results and six, contributed to a fatal outcome. Epidemiology of Medical Errors Causes of Medical Errors Research has indicated that different factors contribute to the occurrence of medical errors. Moreover, different theories have been developed to describe circumstances that lead to medical errors. It is critical to understand the causes of medical errors if the efforts of reducing these types of errors are to prove successful. Health care centers need to adopt effective management. Bedevian (2010) highlights that poor management systems in hospitals are a leading contributor to the occurrence of medical errors. This is because poor management strategies do not cater for the measures required to ensure that all the systems promote the patients’ safety. According to Giard (2014), some management systems do not carry out research on the levels of patient safety within the health care facility. In addition, poor management promotes negligence, a factor that increases the medical errors. Increased occurrences of adverse drug events have been identified as leading causes of medical errors. Adverse drug events refer to negative effects triggered by administering drugs. Zineldin, Zineldin, and Vasicheva (2014) highlight that although there are usual adverse effects of drugs that may result even after proper administration of drugs, there is evidence that wrong prescription leads to critical adverse events which may include kidney failure, diarrhea, vomiting, bleeding, body rashes, low/ high blood pressure, and mental confusion. Adverse drug events may be either physiological or biochemical or a combination of both effects as highlighted by Weingart and colleagues (2000). The occurrence of adverse drug events usually compels health care providers to develop prompt intervention strategies in an effort to alleviate the adverse effects. It is possible to prevent adverse drug events if the proper prescription of drugs occurs. There is a salient need for health care providers administering any type of drug to a patient to be cautious of its potential adverse effects. This will help in the prevention of critical adverse drug events that may lead to death or serious complications. Other studies have highlighted that, medical errors may occur as health care providers prepare drug solutions or dispense the solutions. Some drugs need dilution, a factor that needs the health care providers to have adequate knowledge on the proper ratios of dilution. However, there is evidence that health care providers usually make mistakes in the dilution process and when transferring drug solutions for large to small containers. This places emphasis on the need for management systems to ensure that these processes are properly monitored in an effort to ensure that there are minimal errors. Olden and William (2007) have highlighted that human errors have been described as having a great potential of causing medical errors. Health care systems rely on the skills of health care providers in different levels. In accordance with the institute of medicine report released in 1999, it is only for human beings to err. This highlights that it may prove impossible for human beings to exhibit perfect performance. In one way or another, they are prone to making errors. Some human errors pose serious consequences while others are easily overlooked because of their nature. Human negligence contributes to many of the human errors that often lead to medical errors. In other cases, lack of the required vigilance while delivering health care or treatment contributes to medical errors. Some researchers have indicated that that 80% of medical errors result from human errors. Bohomol and colleagues (2009) highlight that this only serves to place emphasis on the need for health care providers to be much more vigilant and cautious in an effort to reduce medical errors. Different theories have been developed in an effort to describe how human errors are leading contributors to increasing medical errors. One of the theories used is that of bad versus good apples. Bad apples denote health care providers who are prone to negligence and lack of vigilance resulting to increased medical errors. On the other hand, competent health care providers are highly regarded and referred to as good apples. Studies that are more recent have identified that the bad versus the good apple theory is inefficient in explaining how human errors lead to increasing medical errors. These studies have identified that dysfunctional health systems are the main cause for the increasing medical error rates. This is because the dysfunction of health systems presents loopholes, which facilitate the occurrence of medical errors. For example, dysfunctional health systems exhibit poor communication channels. Poor communication contributes to a range of medical errors because health care providers are unable to update each other on the level of care needed for specific patients. Moreover, the dysfunction of many healthcare systems results from fragmentation. According to Boettger (2012), such fragmentation lacks an outline of proper designation of authorities and responsibilities. Therefore, many responsibilities are left pending because each health care provider assumes that someone else should handle them. Some health care facilities have tried to implement automated systems in an effort to minimize human error. However, automated systems have failed because they lack proper management. Notably, automated systems need individuals who can keep the functioning. In addition, cognitive errors also occur among some doctors. These are closely linked to errors resulting from poor judgments and unclear thinking processes. Worth noting is the fact that some health care providers lack the relevant skills and knowledge as well as the expertise required for their job. This also contributes to the occurrence of medical errors. Incompetent heath care providers are more prone to improper diagnosis, wrong prescription of drugs, and negligence especially when handling critical responsibilities as highlighted by Imhof and Blondel (2013). Patient Risk Factors for Medical Errors Research has identified numerous factors that surround patients and which prove to be risk factors for medical errors within the hospital. One of these factors is the severity of the illness. Usually, patients present different health complication. Whereas some of them are straightforward and understood by health care providers, others are complex and require more attention from health care providers. Tourgeman-Bashkin and Zmora (2008) highlight that it has been identified that medical errors are more likely to occur in a situation whereby a patient presents a complex situation. This explains why the intensive care unit records the highest number of medical errors because patients admitted in this department require critical care. Moreover, emergency patients are also more prone to medical errors than usual outpatients are. As asserted by Marik (2010), in a case whereby the severity of illness necessitates hospitalization, the chances of medical errors increase. Patients with complicated medical conditions bear the high cost of medical errors because their conditions demand critical care and treatment. Health care providers make errors as they strive to offer the relevant care and treatment. Taib and colleagues (2011) argue that the age of patients, determine their susceptibility to medical errors. For example, Pediatric patients who are majorly children are more prone to a high risk of medical errors. Health care providers register an increased level of medical errors as they strive to address the health needs of children. This is because the development of children physically and mentally brings about new health care needs necessitating the health care providers to offer different services. It is easy to confuse the type of service a child requires hence making an error, as highlighted by Rathert and Phillips (2011). Moreover, children exhibit a high level of dependency, especially when hospitalized. Since they are unable to address any of their needs, caregivers have to obtain the relevant information and provide the required care to children. Nguyen and Nguyen (2005) assert that this dependency serves as an additional risk because it increases the chances of medical errors. Moreover, children present different epidemiology of certain diseases compared to adults. This places them in need of special care and increases their risk for suffering adverse effects of medical errors. The demographics of children, especially factors related to poverty and racial disparities in health care may serve to increase their risk of suffering medical errors. Naylor (2002) indicates that the fact that they rely entirely on public insurance and seeks services in government hospitals is considered a risk factor for medical errors. On the other hand, older adults are also more prone to medical errors than other people. The fact that advancing age increases their need to seek medical care makes them more likely to be admitted to the intensive care unit or in the emergency department. These sections of the hospital register the highest number of medical errors. According to Valiee (2014), diseases associated with older adults, such as diabetes, dementia, and heart attacks require critical care. As health care providers strive to provide to provide such critical care, they are more likely to register medical errors. Mattox (2010) argues that the risk is higher for hospitalized elders who rely on care from nurses to manage their health conditions. This increases their dependency and serves as an additional risk factor that triggers medical errors. Being elderly people limits their understanding and synthesis of information regarding the use of drugs and other instructions presented to them. Failure to understand and synthesize the information correctly leads to more medical errors. Research has identified that elderly patients register poor cognitive abilities. This means that they are more prone to medical errors related to dosage regimes. Therefore, they are more likely to omit dosages or overdose. Research has also identified that older adults present narrow therapeutic windows, a factor that compels health care providers to monitor them constantly. Failure to do so only triggers the occurrence of medical errors. Shanley, Derek, and Wong (2007) highlight that the literacy level of patients is also a critical risk factor, which makes some patients more prone to medical errors. Patients with limited literacy levels find it difficult to evaluate information critically, understand dosages, and even locate critical health information. Since they have such disadvantages, they are more prone to suffering the effects of medical errors. On the other hand, literate patients present a lower risk of medical errors. Research has identified that populations that register a high level of illiteracy include older adults, minority populations, immigrant populations, and those from low-income families. These factors contribute immensely to the occurrence of medical errors. Compensation Payments in Medical Errors In the United States, the tort law that focuses on liability resulting from negligence comes into place in the case of medical errors. As highlighted above, many of the medical errors occur due to human causes and prove to be preventable, if the health care providers involved take the necessary measures. Therefore, when patients suffer out of their negligence, the health care providers are liable for any injury or pain caused by their errors. Patients can press charges against those health care providers requiring the court to decide on the rate of compensation required. The court has a critical role of ensuring that there is evidence of negligence and malpractice exhibited by the health care provider. There is a need for the court to establish whether any injury was caused because of an evident medical error. Usually, claims that lack evidence of injury, malpractice by the health care provider or substandard care offered to the patient are usually rejected by the court and patients do not receive any form of compensation. However, if there is evidence that injury resulted from the negligence of health care providers, compensation is provided. Compensation rates vary according to the level of negligence identified. In some cases, patients are held partly liable for the injuries and health care providers are only required to compensate for their 50% liability. Manasse and Kasey (2005) highlight that a percentage of the compensation paid is directed to administrative expenses. A closer analysis of different cases in the United States reveals that a considerable amount of money is spent in compensation payment. Hospitals are compelled to pay compensation if any of their staff is proven guilty of negligence in the line of duty causing either injury or death. In the case of death, compensation rates are higher. Rates of Medical reported Medical Error The institute of Medicine identified that different types of errors presented varying prevalence. Some medical errors are more likely to occur compared to the rest. The general statistics presented in 1999 by the Institute of Medicine indicated that about 98,000 people were affected by medical errors causing death. The Institute of Medicine also identified that a percentage of 3-7 of patients who are hospitalized were more prone to medical errors. It has been determined that medication errors account for about 11% of all medication errors. These errors occur during the dispensing of drugs. Despite this remarkable percentage of medication errors, only about 3% of the errors resulted in a form of injury. Without doubt, reporting of medication errors is still relatively low with many health care providers not practicing self-reporting when such errors occur. Keers and colleagues (2013) highlights that poor communication contributes to the death of approximately 7000 people each year. This happens when health care systems are fragmented and they exhibit poor communication channels. The United States registers over 7.5 million unnecessary and unwanted medical and surgical procedures. Moreover, technical errors have been contributing to over 44% of the total medical errors each year. This was according to statistics presented in 1997. During that time, the research team also identified a 12% occurrence of medical errors because of the failure of medical errors to undertake preventive measures in an effort to minimize errors. In the modern day, medical errors have increased by alarming rates and become a leading killer of many Americans as asserted by Kale and colleagues (2012). An approximated 400,000 errors, which are related to drugs, are registered on an annual basis. Healey and Michele (2010) highlight that the reported rates of medical errors have been changing over time. The statistics presented above have changed immensely in the modern day. Since medical errors contribute to the death of the greatest percentage of the Americans, there is a salient need for detailed statistics on the prevalence of each type of error. There is evidence suggesting that faulty health care systems are more likely to register medical errors compared to highly functioning health care systems. This is because dysfunctional systems present more risks related to medical errors. Understanding the prevalence of each type of medical error in the modern day requires extensive research and the emphasis on strict reporting of all errors. Unless there is a clear understanding of the evidentiary prevalence of the different types of errors, proper intervention proves to be impossible. Huston (2014) argues that it is possible to estimate the rates of reported medical errors because 27 states have successfully adopted the disclosure laws that require individuals working in the health care system to record all the errors that they make. Using data from the 27 states, it is possible to compute the reported rate on an annual basis. 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