amednews: Revealing their medical errors: Why three doctors went public :: Aug. 15, 2011 ... American Medical News

In September 2010, Kimberly Hiatt made a medical error. The critical care nurse at Seattle Children's Hospital miscalculated and gave a fragile 8-month-old baby 1.4 grams of calcium chloride, 10 times the correct dose of 140 milligrams.

The mistake contributed to the death of the child and led to Hiatt's firing and an investigation by the state's nursing commission. In April 2011, devastated by the loss of her job and an infant patient, Hiatt committed suicide.

Hiatt, who had worked as a nurse for more than two decades, was another in a long line of "second victims" of medical error, the term used in medical literature to describe physicians and other health professionals who often feel guilty and depressed after adverse events. Many physicians and other health professionals hold themselves to a standard of perfection, and when things go wrong, they feel alone.

via ama-assn.org

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Medication Errors, FDA U.S. Food and Drug Administration

FDA receives medication error reports⁴ on marketed human drugs (including prescription drugs, generic drugs, and over-the-counter drugs) and nonvaccine biological products and devices.  The National Coordinating Council for Medication Error Reporting and Prevention⁵ defines a medication error as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use."

The American Hospital Association⁶ lists the following as some common types of medication errors:

• incomplete patient information (not knowing about patients' allergies, other medicines they are taking, previous diagnoses, and lab results, for example);
• unavailable drug information (such as lack of up-to-date warnings);

via fda.gov

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Silent Treatment Study, silenttreatmentstudy.com #rnchat #nursing #nurses

Research and regulatory bodies have long confirmed that poor communication in healthcare is harmful at best and deadly at worst.

In the 2005 study, Silence Kills, VitalSmarts and the AACN found that 84 percent of healthcare professionals observe colleagues take dangerous shortcuts when working with patients and yet less than 10 percent speak up about their concerns.

Since that time, the healthcare community has turned to safety tools and checklists to reduce unintentional slips and errors. And yet, a new study called The Silent Treatment has found that the effectiveness of safety tools is undercut by undiscussables. Every day, healthcare professionals are making calculated decisions to not speak up—even when safety tools alert them to potential harm.

The Silent Treatment reveals that despite the safety interventions taken in the last decade, silence still kills. Safety tools do not compensate for crucial conversations failures in the hospital.

via silenttreatmentstudy.com

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amednews: 1 in 3 patients harmed during hospital stay :: April 18, 2011 ... American Medical News

By Kevin B. O'Reilly, amednews staff. Posted April 18, 2011.

One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.

The study, in April's Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.

• Detecting adverse events
• Links
• See related content

The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine's headline-grabbing report "To Err is Human." The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.

"This is one of the best studies that now gives us a sense of how much harm is happening to patients in American hospitals," said Robert Wachter, MD, chief of the medical service at the University of California, San Francisco Medical Center, who was not involved in the research. "There is a tremendous amount of harm befalling patients who are admitted to hospitals and humongous opportunities for improvement."

via ama-assn.org

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Nurse's suicide follows tragedy | Seattle Times Newspaper

By Carol M. Ostrom

Seattle Times health reporter

Related

Crisis help

Don't wait to seek help if you're in crisis.

In King County, call: 206-461-3222 (TTY/TDD 206-461-3219).

Outside King County, call 800-273-TALK (8255).

The suicide of a nurse who accidentally gave an infant a fatal overdose last year at Seattle Children's hospital has closed an investigation but opened wounds for her friends and family members, as they struggle to comprehend a second tragedy.

Kimberly Hiatt, 50, a longtime critical-care nurse at Children's, took her own life April 3. As a result, the state's Nursing Commission last week closed its investigation of her actions in the Sept. 19 death of Kaia Zautner, a critically ill infant who died in part from complications from an overdose of calcium chloride.

After the infant's death, the hospital put Hiatt on administrative leave and soon dismissed her. In the months following, she battled to keep her nursing license in the hopes of continuing the work she loved, despite having made the deadly mistake, friends and family members said.

To satisfy state disciplinary authorities, she agreed to pay a fine and to undergo a four-year probationary period during which she would be supervised at any future nursing job when she gave medication, along with other conditions, said Sharon Crum of Issaquah, Hiatt's mother.

via seattletimes.nwsource.com

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Not Running a Hospital: Painfully slow

You can already imagine the responses. "That's just in North Carolina." "Our patients are sicker." "There are problems with the data."

What would prompt that? This New York Times article, citing a forthcoming NEJM study about medical errors in North Carolina. Here's the lede:

Efforts to make hospitals safer for patients are falling short, researchers report in the first large study in a decade to analyze harm from medical care and to track it over time.

The study, conducted from 2002 to 2007 in 10 North Carolina hospitals, found that harm to patients was common and that the number of incidents did not decrease over time. The most common problems were complications from procedures or drugs and hospital-acquired infections.

via runningahospital.blogspot.com

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Drug Errors on the Rise - NYTimes.com

The number of people treated in hospitals in the United States for problems related to medication errors has surged more than 50 percent in recent years.

In 2008, 1.9 million people became ill or injured from medication side effects or because they took or were given the wrong type or dose of medication, compared with 1.2 million injured in 2004, according to the Agency for Healthcare Research and Quality.

Although several national reports in recent years have sounded the alarm about the toll of medication errors, the latest data show the problem continues to persist. The A.H.R.Q. data measure only patients treated in the hospital or emergency department as a result of a medication error. The data don’t distinguish between prescribing, dispensing or consumer errors. Some of the errors resulted from a physician prescribing the wrong drug or dose; others occurred because a pharmacist or nurse gave the wrong drug, or because a patient at home used the wrong type or dose of medication.

via well.blogs.nytimes.com

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