Medical Errors in Nursing Practice and Healthcare - Article Example

? Medical errors in nursing practice and health care Lecturer: Medical errors have for so long being a huge contributor to deaths and other fatal injuries. As a result, there are a number of solutions to the various medical errors that need to be implemented by both the practitioners and the patient. With that vividly stated, this paper will seek to focus on medical errors, their causes, challenges, possible solutions as well as the ethical principles that guide every aspect of medical errors in the health care facility. According to the Agency for Healthcare Research and Quality (AHRQ), medical errors are mistakes which are committed while disbursing patient care and they can be very harmful to the patient (Freisen, Farquhar and Hughes, n.d). Medical errors are inclusive of errors which are committed by medical care individuals as well as any other form of system errors. According to the Institute of Medicine (IOM), other definitions put forward on the description of medical errors include: “error of execution”, “error of planning” (Freisen, Farquhar and Hughes, n.d). The causes for medical errors are quite a number. Medical errors that are caused by medical personnel could be as a result of: lack of proper communication between the health care personnel; lack of proper communication between the patient (s) and the health care personnel; irresponsibility by the medical personnel in terms of prescriptions and dosages; handing out drugs over the counter without a sound doctor analysis; wrong drug administration; lack of following the mandated patient care policies. Communication is quite essential in a health care facility. In the event that there is a communication gap between the health care personnel, then problems are likely to occur. Lack of proper communication is likely to happen while writing out patients’ results or even while packaging or labelling drugs by their names and dosages. That is; a drug could be labelled wrongly and this could be interpreted differently by another medical personnel. A communication deficit could also occur between a patient (s) and the health care personnel. An example of such a situation is when the patient is describing their symptoms to the health care personnel. As a result, the words and expressions being used by the medical care expert could not actually be exactly what the patient is referring to. At that instance, a communication error occurs and this will in turn lead to wrong drug and dosage administration. Over the counter drugs (OTC) and prescriptions have also been known to cause fatal medical errors – this is due to the reason that the personnel responsible could be lacking adequate knowledge and experience in providing ample analysis of the symptoms that the patient has. As a result, they could either give the wrong drugs to the patient or provide an under-dose or an over-dose of the medicine. Following the mandated hospital policies and procedures is very essential. These policies and procedures include: providing organisation orientation to new medical staff, providing medical education to patients and ensuring that medical training is done effectively. The benefit of carrying out all these tasks is that they will reduce the total numbers of medical errors that occur. For example, if the health care facility acquires new equipment, the staff should be trained on how to properly use the equipment so as to alienate the possibility of system errors. In addition to that, patient education should be provided so as to educate them with information on how they could also avoid being victims of unwanted medical errors. In a 1993 to 1998 medical study that was conducted by FDA (2013), the results revealed that the most regular form of medical error was as a result of recklessness while giving out prescriptions and medical dosages - This accounted for 41%. The same study revealed that the other forms of personnel medical errors included: wrong drug administration that answered for 16% while the use of wrong drug channels answered for 16%. The study concluded that these errors were majorly caused as a result of lack of proper communication between the medical personnel which accounted for 16% and a shortfall in personnel knowledge which accounted for 44%. Freisen, Farquhar and Hughes (n.d) also suggested that a majority of the medical errors were as a result of improper communication between the medical staff in the health care facility. Medical errors can also be caused through the health care information systems that are in use. Due to the fact that these systems are used to collect, store, manipulate and provide patients’ information. In the event that the respective medical personnel does not key in the right data or information, errors are likely to occur. The same errors could lead to improper drug administration, wrong drug dosages and even wrong analysis of the patients’ general health. The results/consequences of medical errors can either be harmful or fatal. In most cases, patients could either get: adverse drug reactions (ADRs) such as nausea, vomiting, fever and blood pressure; major or minor forms of medicinal errors which could be related to recklessness of the medical personnel. In worst case scenario, errors could lead to disabilities, long term illnesses or death. Medical errors can occurs in various stages in the medical process. They can occur while ordering, transcribing, dispensing, administration and monitoring. Lisby, Nielsen and Mainz (2005) conducted a research study and revealed that out of 2467 cases, 1065 were erroneous (43%). In addition to that, 20% – 30% of the reported cases were as a result of adverse drug events/ reactions. Other errors occurred in: ordering which constituted for 39% (167/433 cases), transcription that totalled to 56% (310/558 cases), dispensing which equated to 4% (22/538 cases), administration which constituted for 41% (166/412 cases) and wrong sum-ups in discharge information which totalled to 76% (401/526 cases). In a study conducted by IOM (1999), the consequences of medical errors resulted to annual deaths of approximately 44,000 to 98,000. Medical errors can also lead to financial losses and lack of trust in the existing health care system as well as the practitioners. Challenges are prone to be faced in a bid to prevent higher frequencies of medical errors. With that, the biggest challenge lies in error reporting. This is because, in the event that a medical practitioner reports that a medical error has occurred, they are prone to undergo a series of personal challenges. These include: legal action by the patient or the hospital, fear of losing their medical practice certificate and fear of being blamed for the occurrence. As a result, some of the potential solutions to these challenges include: Efficient reporting tools: Better strategies and tools should be put in place to not only collect data related to medical errors but to also determine all the possible causes of the medical errors. From such information, better strategic solutions could be sought for. Patient education: Patients could be educated on how they could prevent medical errors. For example, they could be educated on OTC drugs, prescription and pharmaceutical drugs. In addition to that, they could also be included in the reporting process. That is; allowing the patient to have a look at their medical report and confirm it with another practitioner. Improper communication: Errors caused as a result of improper communication between the health care personnel could be solved by eliminating the use of abbreviations and using the full names of the medicine. For example: ZnSO4 which means Zinc Sulphate could be confused for Morphine Sulphate (ISMP, 2004). As a result, practitioners should at all times use the full name of the medicine. In nursing, the laws and ethical considerations that are existent with regard to medical error reporting are divided into two categories. That is mandatory and voluntary reporting. Mandatory reporting requires that the practitioner must report the errors that they have committed while practicing nursing. Despite the fact that this strategy can yield reliable results, it is never a favourite to many practitioners since it has harsh consequences such as legal action, financial loss etc. On the other hand, voluntary reporting is quite accommodating since the practitioner reports the errors out of their own will. This channel is preferred by a lot of medical staff. However, the results from this channel are not satisfactory since a lot of cases are not reported. Voluntary reporting can be done through Voluntary reporting tools and Medication error reporting programs. The benefit of reporting is that it allows for errors to be detected immediately and corrected if it is not too late. Therefore, medical organisations should promote error reporting by their staff. The most inherent requirement for a nurse is to ensure that they practice what is in the hospitals’ policy and procedures with clarity. However, there are some challenges that are prone to affect nursing inherency. These include: lack of resources to ensure that all nurses do actually have equal rights while they practice. For example: an inherent task for a nurse would be to measure the heart beat of a patient. Now, if the nurse has a hearing challenge, then they cannot be in a position to work with the normal equipment unless another type of equipment is used such as the electronic stethoscope. Therefore, a challenge would occur in the acquisition of such extra equipment to cater for specific situations. The other nursing inherent challenge is with regard to sharing clinical trials information with the concerned parties such as the health care facility, health care provider, laboratory etc. Once the above challenges have been solved, opportunities are likely to be experienced in the health facility. These include: there will be a satisfactory working environment that can cater to all the practitioners regardless of their disabilities. Secondly, due to transparency in clinical trials information, better solutions could be realized that could improve the current state of nursing. Works cited Freisen, M. A., Farquhar, M. B., and Hughes, R. J. (n.d). The Nurse’s Role in Promoting a Culture of Patient Safety. Center for American Nurses. Web. Retrieved from: http://www.fmqai.com/library/attachment-library/3,%20Nurses%27%20Role%20Promote%20Culture%20Pt%20Safety.pdf FDA – U.S Food and Drug Administration. (2013). Strategies to Reduce Medication Errors: Working to Improve Medication Safety. Web. Retrieved from: http://www.fda.gov/drugs/resourcesforyou/consumers/ucm143553.htm Institute of Medicine (IOM). (1999). To Err Is Human: Building a safer health system. Web. Retrieved from: http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf Institute for Safe Medication Practices (ISMP). (2004). ISMP's list of error-prone abbreviations, symbols, and dose designations. Web. Retrieved from: http://www.ismp.org/Tools/errorproneabbreviations.pdf Lisby, M., Nielsen, P., and Mainz, J. (2005). Errors in the medication process: frequency, type, and potential clinical consequences. International Journal for Quality in Health Care, Volume 17 (1), pp. 15–22 Read More