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Medical Errors and Patient Safety

This guide is designed as an introduction to researching medical errors and patient safety.

What is considered a medical error?

A medical error is defined as a preventable adverse effect of medical care whether or not evident or harmful to the patient. Often viewed as the human error factor in healthcare , this is a highly complex subject related to many factors such as incompetency, lack of education or experience, illegible handwriting, language barriers, inaccurate documentation, gross negligence, and fatigue to name a few. There are also many different types of errors ranging from medication errors, misdiagnosis, under and over treatment, and surgical mishaps. Medical errors are also associated with extremes of age, new procedures, urgency, and the severity of the medical condition being treated.

ScribeAmerica

Patient safety is defined by the Institute of Medicine as “the prevention of harm to patients.” Emphasis is placed on the system of care delivery that (1) prevents errors; (2) learns from the errors that do occur; and (3) is built on a culture of safety that involves health care professionals, organizations, and patients.

NCBI/National Library of Medicine

 

Additional Information

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.

Low health literacy is more prevalent among:

  • Older adults
  • Minority populations
  • Those who have low socioeconomic status
  • Medically underserved people

Health Resources and Services Administration

Why It's Important

Health literacy is important for everyone because, at some point in our lives, we all need to be able to find, understand, and use health information and services.

Taking care of our health is part of everyday life, not just when we visit a doctor, clinic, or hospital. Health literacy can help us prevent health problems and protect our health, as well as better manage those problems and unexpected situations that happen.

Even people who read well and are comfortable using numbers can face health literacy issues when

  • They aren’t familiar with medical terms or how their bodies work.
  • They have to interpret statistics and evaluate risks and benefits that affect their health and safety.
  • They are diagnosed with a serious illness and are scared and confused.
  • They have health conditions that require complicated self-care.
  • They are voting on an issue affecting the community’s health and relying on unfamiliar technical information.

When organizations or people create and give others health information that is too difficult for them to understand, we create a health literacy problem. When we expect them to figure out health services with many unfamiliar, confusing or even conflicting steps, we also create a health literacy problem.

Research and evaluation are critical to identify health literacy needs, plan interventions and measure success.

Centers for Disease Control

The term “error” is negative and might sound malicious, but it doesn’t mean there was intentional harm. There are situations where doctors intentionally disrespect or don’t value their patients, but more often than not this isn’t the cause.

Most are due to systematic problems. Just like how there are system issues with reporting, there are also system issues that cause preventable problems:

  • Communication problems
  • Organizational transfer of knowledge
  • Inadequate information flow
  • Patient-related issues
  • Staffing patterns and workflow
  • Technical failure
  • Inadequate policies

All of these are controllable factors, which go to show that many mistakes are preventable. 

The term “error” is negative and might sound malicious, but it doesn’t mean there was intentional harm. There are situations where doctors intentionally disrespect or don’t value their patients, but more often than not, this isn’t the cause.

Most are due to systematic problems. Just like how there are system issues with reporting, there are also system issues that cause preventable problems:

  • Communication problems
  • Organizational transfer of knowledge
  • Inadequate information flow
  • Patient-related issues
  • Staffing patterns and workflow
  • Technical failure
  • Inadequate policies

All of these are controllable factors, which go to show that many mistakes are preventable. 

Etactics

There are thousands of types of mistakes. The most common type relates to diagnoses. Of those who experience mistakes, 59% said that it was due to an incorrect diagnosis, late diagnosis, or a problem that wasn’t diagnosed at all. 

Diagnostic mistakes lead to the death or injury of 40,000 to 80,000 annually. The misdiagnosis rate is 10% to 15%. These problems are a challenge regardless of medical specialty. 

Surgical errors are another common problem with at least 4,000 occurring each year in the US. What’s interesting is that many are a result of systematic issues, as I mentioned earlier. Some are a result of medical equipment during surgery, which leads to the third common type.

While medical devices advance and improve the health industry, they still aren’t perfect. There are over 5,000 kinds of medical devices used in healthcare, so mistakes are inevitable. Sometimes these devices end up getting recalled because of their risks. 

The top fifteen most common types of errors:

  • A medical problem was misdiagnosed.
  • A mistake was made during a test, surgery, or treatment.
  • Received a diagnosis that didn't make sense.
  • Were not treated with respect.
  • Were given wrong instructions about follow-up care.
  • Were administered the wrong medication dosage.
  • Received treatment that was not needed.
  • Were given instructions from different providers.
  • Got an infection after hospitalization or treatment.
  • Received wrong medication from a doctor.
  • Test results were lost, delayed, or not shared.
  • Received the wrong medication from a pharmacy.
  • Fell down or out of bed.
  • Got a bed sore.
  • Accidentally took too much medication.

Etactics

 

The best thing you can do to prevent medical errors is to be involved in your health care. Learn and know about your health problem, medicine, and treatment as best you can and take part in making all decisions about your care. Talk to everyone who is involved in your health care. This includes your doctors, other health professionals, family, and friends.

Before you agree to a medicine, treatment plan, surgery, or lifestyle change, such as changing what you eat, be sure you understand it. Always ask if you are not clear on what, how, or why.

  • Speak up if you have questions or concerns.
  • Make sure that someone is in charge of your care.
  • Make sure that all health professionals involved in your care have health information about you.
  • Ask a family member or friend to be there for you.
  • Know that "more" is not always "better."
  • If you have a test, don't assume that no news is good news.
  • Learn about your condition and treatment.

University of Michigan Medicine

Clean hands can protect you from serious infections while you are a patient in a healthcare facility. Most germs that cause serious infections in healthcare are spread by people’s actions. Hand hygiene is a great way to prevent infections. However, studies show that on average, healthcare providers clean their hands less than half of the times they should. This contributes to the spread of healthcare-associated infections that affect 1 in 31 hospital patients on any given day. Every patient is at risk of getting an infection while they are being treated for something else. Even healthcare providers are at risk of getting an infection while they are treating patients. Preventing the spread of germs is especially important in hospitals and other facilities such as dialysis centers and nursing homes.

  • Healthcare providers might need to clean their hands as many as 100 times per 12-hour shift, depending on the number of patients and intensity of care.
  • Everyone should know the truth about hand hygiene and alcohol-based hand sanitizer:
    • Alcohol-based hand sanitizer kills most of the bad germs that make you sick and is the preferred way to clean your hands in healthcare settings.
    • Alcohol-based hand sanitizer does not kill C. difficile, a common healthcare-associated infection that causes severe diarrhea. Patients with C. difficile should wash their hands with soap and water and make sure their healthcare providers always wear gloves when caring for them.
    • Alcohol-based hand sanitizer is more effective and less drying than using soap and water, and does not create antibiotic-resistant superbugs.
  • Hand hygiene should be a topic of conversation between healthcare providers and patients. Healthcare providers can explain how and why they clean their hands before, after, and sometimes during patient care, and let patients know it’s ok to ask about hand hygiene.
  • Patients and their visitors can protect themselves by cleaning their own hands.

Centers for Disease Control

 

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