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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Many paid caregivers lack health literacy skills :: May 4, 2011 ... American Medical News

More than a third of the people paid to care for seniors are not health literate, and 60% wrongly interpret the instructions on prescription labels, a study says.

Caregivers often are hired by families to help care for seniors with cognitive loss, dementia or Alzheimer's disease and who have trouble performing daily activities such as toileting, bathing, cooking and shopping. This makes it especially important that caregivers have the ability to understand health-related instructions, said Lee A. Lindquist, MD, MPH, lead author of the study published in May's Journal of General Internal Medicine (www.ncbi.nlm.nih.gov/pubmed/21161420/).

Caregivers' poor health literacy skills can affect patient care, said Dr. Lindquist, a geriatrician at Northwestern Memorial Hospital in Chicago.

via ama-assn.org

See also:

Death By Handwriting, By Maureen Glabman, Trustee Magazine :"Most Americans don't receive any formal handwriting instruction beyond the third grade, so how we learned to write then is more or less what we are stuck with for the rest of our lives. It's a worn joke that when someone writes poorly, we tell him he could be a doctor. But a medical error due to misinterpretation of illegible writing is no laughing matter--and for physicians it is a major threat to patient safety. The Joint Commission does not know precisely how often hospitals are reproached for handwriting deficiencies, but the problem is believed to be substantial. "The Joint Commission almost always finds instances where handwriting is of poor quality," says Peter Angood, M.D., JCAHO vice president and chief patient safety officer. The standard that encompasses handwriting legibility also includes stipulations that medical records be dated, that patients be identified and that diagnoses are supported, among other requirements, so it is difficult to sort out individual deficiencies."
http://www.trusteemag.com/trusteemag_app/jsp/articledisplay.jsp?dcrpath=TRUST.../PubsNewsArticleGen/data/2005/0510TRU_FEA_Handwriting

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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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