Nursefriendly.com: error reduction

Showing posts with label error reduction. Show all posts

Tuesday, August 16, 2011

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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Saturday, July 16, 2011

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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Friday, July 8, 2011

When Nurse Make Mistakes (Theresa Brown, RN) - NYTimes.com

By THERESA BROWN, R.N.
This year, a Seattle nurse named Kim Hiatt committed suicide. Ms. Hiatt’s death came nearly seven months after she had given an unintended overdose to an infant heart patient, a medical error that was said to have contributed to the child’s death days later.
Ms. Hiatt had been a nurse for 27 years and had often cared for the 8-month-old girl during the child’s stay in the pediatric intensive care unit of her hospital. She had probably drawn up the right dose of the drug hundreds of times in her career. But once, she made a life-changing error. A baby died, and she was suspended, then fired from a profession she loved. And now she’s dead.

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Friday, April 22, 2011

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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Monday, April 18, 2011

Hung-over surgeons more error-prone | Reuters

Surgeons might want to steer clear of alcohol the night before operating, according to a new report that shows a hangover fuels errors during simulated surgery.

While there is no question about the immediate effects of alcohol on surgical skills, there aren't any rules for how much doctors can drink the day before going to the operating room.
"Historically, the medical profession has had a reputation for high rates of alcohol consumption," Anthony Gallagher, of the Royal College of Surgeons in Ireland, and colleagues write in the Archives of Surgery.
"It is likely that surgeons are unaware that next-day surgical performance may be compromised as a result of significant alcohol intake."
To measure the degree of that impairment, the researchers invited eight surgeons and 16 students out for a night on the town.

via reuters.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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Thursday, April 14, 2011

Checking Your Medical Records - More Important Than Ever Before

Months ago, grand discussions of the shift from paper medical records to digital, electronic health and medical records, was all the rage. In particular, among my Twitter colleagues, it seemed like it was all anyone wanted to talk about.

At the time, the big question was, how would doctors afford to make the shift? Beyond just computerizing their records, they would need systems that actually share our records! And systems that, once the meaningful use laws were determined, would allow patients to access their own records, too.

Here at the About.com Patient Empowerment site, we looked at electronic medical records - what they are, the plusses and the problems....

via patients.about.com

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Partnership for Patients - Win, Win, Win for American Healthcare

It's called the Partnership for Patients. (I like it already - it's focused on patients.) It's a program being developed by the federal government, under Secretary of HHS (Health and Human Services) Secretary Kathleen Sebelius, along with CMS (Center for Medicare Services) Dr. Donald Berwick, a man with an impeccable patient safety advocacy record. But they aren't in it alone - they have dozens of private and public organizations backing them, as members of the partnership.

Can this possibly be

A WIN for patients.

A WIN for providers.

And a WIN for payers, too?

via patients.about.com

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Monday, April 11, 2011

Is the US healthcare system too litigious or too careless? | boxcuttersinc

In a recent study published in Health Affairs, researchers at the University of Utah and the Institute for Healthcare Improvement found that errors “occurred in one-third of hospital admissions”. Moreover, they “found at least ten times more confirmed, serious events than … other methods.”

Commenting on this study, Health Affairs Editor-in-Chief Susan Dentzer said:

Without doubt, we’ve seen improvements in health care over the past decade, and even pockets of excellence, but overall progress has been agonizingly slow. It’s clear that we still have a great deal of work to do in order to achieve a healthcare system that is consistently high-quality–that is, safe, effective, patient-centered, efficient, timely, and devoid of disparities based on race or ethnicity.

Wow, what an indictment of a healthcare system that many consider to be the best in the world!

via boxcuttersinc.wordpress.com

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Thursday, April 7, 2011

Errors still common in U.S. hospitals | Reuters

About one in three people in the United States will encounter some kind of mistake during a hospital stay, U.S. researchers said Thursday.

The finding, which is based on a new tool for measuring hospital errors, is about 10 times higher than estimates using older methods, suggesting much work remains in efforts to improve health quality.
"Without doubt, we've seen improvements in health care over the past decade, and even pockets of excellence, but overall progress has been agonizingly slow," said Susan Dentzer, editor-in-chief of Health Affairs, which published several studies on a special issue on patient safety.
The special issue came 10 years after an influential Institute of Medicine report that found significant gaps in health quality.

via reuters.com

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Wednesday, March 30, 2011

Why Not The Best (Hospital Benchmark Data)

Comparative Health Care
Performance Data

See how well U.S. hospitals perform on measures of evidence-based care, patient experience, readmission and mortality rates, and costs

Compare a hospital's performance with peer organizations and national benchmarks

Find case studies and tools to help improve the quality of care

via whynotthebest.org

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How safe is your hospital? - chicagotribune.com

Just before it was disclosed that a medical error at the University of Chicago led to the death of James Tyree, a well-known financier and philanthropist being treated for cancer, I was putting together a presentation examining the quality of care at some of the area's best-known hospitals.
Using publicly available data, I told a meeting of local health care executives that there were warning flags at several institutions, including the U. of C. Tyree, ironically, would have known about any actual problems in far greater detail. He served on the board of the hospital where he died from an air embolism in a dialysis catheter, and hospital officials said in an interview that they regularly report safety data to board members.
There's an important distinction between great doctoring and great safety. The U. of C. has a reputation for outstanding cancer care. That's likely the reason that Tyree, suffering from stomach cancer and pneumonia, had a relatively good prognosis when he entered the hospital and why his death so shocked his family and friends. But as a wise physician once warned, "Every hospital should have a plaque at its entrance that reads, 'There are some patients whom we cannot help; there are none whom we cannot harm.'"

via chicagotribune.com

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AIM: Adverse event reporting is on the rise

Although the FDA's Adverse Event Reporting System (AERS) database has been in existence since 1969, more than half of the incidents in it were received in the past decade, according to an article published online March 28 in the Archives of Internal Medicine.
These 2.2 million events represent a 1.65-fold increase from the prior decade, wrote Sheila Weiss-Smith, PhD, from the University of Maryland School of Pharmacy in Baltimore, and colleagues. "Report volume increased from 2000 to 2010 at a mean annual rate of 11.3 percent,” the authors continued.
AERS is a repository of passively reported adverse drug events designed as a safety net so the FDA can monitor all marketed drugs and detect serious safety problems. Weiss-Smith and colleagues sought to characterize the current reporting patterns.

via cmio.net

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The Epidemic of Preventable Medical Harm, HealthcarePSI.org

The Centers for Disease Control reports that 1.7 million people who enter the hospital this year - for any reason - will contract a Hospital Acquired Infection which is completely unrelated to the condition they entered with, and 99,000 of those patients infected will die within the year. Many thousands more will never fully recover.
The Sepsis Alliance - a physician group studying the condition - states that 215,000 people die each year from sepsis, a blood stream infection. The Alliance also states that half of those deaths could be prevented if hospitals would identify and treat patients in a timely manner.
In November 2010, the Office of the Inspector General released a damning report stating that every month in US hospitals, 15,000 Medicare patients over the age of 65 are killed by preventable medical harm. That's 180,000 needless deaths a year. Another 45,000 Seniors on Medicare are injured every month, but survive their hospitalization.
The three studies above document more than 386,000 preventable deaths a year in US hospitals - and that's only a small glimpse of a problem that has reached epidemic proportions.
The Institutes of Medicine estimates there are 100,000 documented preventable harm deaths per year, however they also reluctantly admit that only 5%-20% of preventable medical harm incidents are ever documented on patient records. That means their figure is badly underestimated. By how much? You do the math.

via healthcarepsi.org

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Sunday, March 27, 2011

Admitting harm protects patients - Sunday, March 27, 2011 | 2 a.m. - Las Vegas Sun

As Nevada legislators debate this week whether to require hospitals to publicly report when they harm patients, they could learn a lot from Paul Levy’s experience in pulling back the veil of hospital secrecy.

Levy became a revolutionary figure in medicine when, as CEO of Beth Israel Deaconess — then the weak sibling among Harvard University’s teaching hospitals — he began blogging about injuries and infections suffered by his hospital’s patients. His competitors eventually followed suit and now, with Massachusetts law imposing transparency, they acknowledge openness has brought greater accountability and a more focused commitment to protecting patients.

“It’s not just fear of public embarrassment” that drives the improvements, said Dr. Ken Sands, chairman of Beth Israel Deaconess Medical Center’s health care quality department. “It’s an easy way to show something is a priority and is deserving of attention.”

via lasvegassun.com

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Sunday, March 13, 2011

Pain Medication Mistakes: Overdoses, Side Effects, and More

It's been a hard day, and Joe's back is killing him.

His wife has some Percocet left over from a trip to the dentist, and there's that big bottle of Tylenol under the sink, so Joe grabs a couple of each and washes them down with a slug of beer.

Luckily for Joe, he's a fictional character invented for this article. But there are a lot of real-life Joes out there making big mistakes with over-the-counter and prescription pain pills.

Can you spot Joe's mistakes? Joe didn't make every mistake in the book. But he made quite a few.

Here's WebMD's list of common pain pill mistakes, compiled with the help of pharmacist Kristen A. Binaso, RPh, spokeswoman for the American Pharmacists Association; and pain specialist Eric R. Haynes, MD, founder of Comprehensive Pain Management Partners in Trinity, Fla.

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Wednesday, March 2, 2011

Texas Senate panel advances bill to protect nurses | AP Texas News | Chron.com - Houston Chronicle

A Texas Senate committee approved legislation Tuesday aimed at strengthening protection for nurses who report abuse by doctors.

The bill filed by state Sen. Jane Nelson, R-Flower Mound, protects nurses from being fired, discriminated against or punished. Nurses would be immune from criminal prosecution under the bill.

The bill now goes to the full Senate. If enacted, doctors would be fined up to $25,000 if convicted of retaliation.

Lawmakers saw a need for a more stringent law after two West Texas nurses were fired and criminally charged after reporting a doctor for allegedly practicing bad medicine.

The charges were dropped against Winkler County nurse Vicki Galle, but Anne Mitchell was prosecuted for "misuse of official information" and threatened with 10 years in prison.

Galle and Mitchell anonymously filed their complaint against Dr. Rolando Arafiles with the Texas Medical Board in 2009. But with help from the sheriff, Arafiles found out who the nurses were.

Despite Mitchell's acquittal, the case stirred outrage from medical communities nationwide. Nursing advocates want to ensure nurses can report malpractice without fear of retaliation.

"Patients are best served when nurses can advocate on their behalf," Nelson said. "The case of the Winkler County nurses highlighted the need for additional protection for nurses."

Mitchell said the decision to report Arafiles was carefully considered, and one she felt she had to make on behalf of her patients.

But the price she paid was high. She said her nursing career is over, her income has been cut in half and she continues to endure the effects of being labeled a whistleblower.

"That label basically reads 'don't hire me'," she said. "Nurses are frequently the last safety net for patients. If our voices are stifled, our patients will suffer. My hope is that the passage of this bill will prevent other nurses from having to go through what we went through."

via chron.com

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e-Autopsy: Kaiser Hospitals Dig In to Data to Assess Mortality

You've heard the macabre joke that hospitals and doctors "bury their mistakes." Well, here's an interesting twist: At Kaiser Permanente hospitals in Southern California, doctors are doing precisely the opposite. They're rolling back time in the death process – exhuming their unknown mistakes so to speak – to see what, if anything, they can learn in order to save similar patients the next time around.

But they're not doing it the old way through invasive autopsies. Those are expensive, increasingly unpopular with families, forbidden by some religions, and often don't reveal that much about errors in the process of hospital care.

Kaiser has a new concept, the e-Autopsy.

Kaiser's hybrid manual and electronic mortality review uses storytelling and specialists' scrutiny to study medical charts of patients who died in the hospital. The process builds a precise timeline of what happened. The goal is to prevent death and/or improve end-of-life care by looking for places to improve—from ambulatory settings prior to admission to the inpatient bedside.

via healthleadersmedia.com

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Tuesday, March 1, 2011

HHS Releases National Plan to Improve Health Literacy | HHS.gov

Today, the United States Department of Health and Human Services released The National Action Plan to Improve Health Literacy aimed at making health information and services easier to understand and use. The plan calls for improving the jargon-filled language, dense writing, and complex explanations that often fill patient handouts, medical forms, health web sites, and recommendations to the public.
According to the report, efforts to improve the health literacy skills of both the public and health professionals are needed to achieve a health literate society—a critical need as health reform generates more demand for consumer and patient information that is easy-to-understand and culturally and linguistically appropriate.
According to research from the U.S. Department of Education, only 12 percent of English-speaking adults in the United States have proficient health literacy skills. The overwhelming majority of adults have difficulty understanding and using everyday health information that comes from many sources, including the media, web sites, nutrition and medicine labels, and health professionals.
“Health literacy is needed to make health reform a reality,” said HHS Secretary Kathleen Sebelius. “Without health information that makes sense to them, people can’t access cost effective, safe, and high quality health services. But, HHS can’t do it alone,” she added. “We need payers and providers of health care services to communicate clearly and make the necessary changes to improve their communication with consumers, patients, and beneficiaries. Today’s plan is only the beginning of a long-term process with our many partners in all sectors that we hope will result in a society that encourages people to live longer, healthier lives.”

via hhs.gov

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Thursday, February 24, 2011

Nearly 60% of paid home caregivers make medication errors, study finds - McKnight's Long Term Care News

One-third of paid caregivers who work for clients who live in their own homes had difficulty reading and understanding health-related information and instructions. Furthermore, 60% of them made medication errors involving their clients, according to Northwestern University researchers, who say the study is the first of its kind.

Investigators at the university recruited 100 paid, non-family caregivers in the Chicago area and evaluated their literacy with health-related tasks and knowledge. While researchers emphasized that the majority of caregivers are good people who are trying to support their families, medication-error levels are a serious cause of concern.

They found that most paid caregivers are women with an average age of 50 years old. Many are foreign born with limited schooling. They are usually paid about $9 an hour, though almost one-third earns less than minimum wage.

via mcknights.com

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Tuesday, August 16, 2011

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

Saturday, July 16, 2011

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

Friday, July 8, 2011

When Nurse Make Mistakes (Theresa Brown, RN) - NYTimes.com

Friday, April 22, 2011

Nurse's suicide follows tragedy | Seattle Times Newspaper

Monday, April 18, 2011

Hung-over surgeons more error-prone | Reuters

Not Running a Hospital: Painfully slow

Thursday, April 14, 2011

Checking Your Medical Records - More Important Than Ever Before

Partnership for Patients - Win, Win, Win for American Healthcare

Monday, April 11, 2011

Is the US healthcare system too litigious or too careless? | boxcuttersinc

Thursday, April 7, 2011

Errors still common in U.S. hospitals | Reuters

Wednesday, March 30, 2011

Why Not The Best (Hospital Benchmark Data)

Comparative Health Care
Performance Data

How safe is your hospital? - chicagotribune.com

AIM: Adverse event reporting is on the rise

The Epidemic of Preventable Medical Harm, HealthcarePSI.org

Sunday, March 27, 2011

Admitting harm protects patients - Sunday, March 27, 2011 | 2 a.m. - Las Vegas Sun

Sunday, March 13, 2011

Pain Medication Mistakes: Overdoses, Side Effects, and More

Wednesday, March 2, 2011

Texas Senate panel advances bill to protect nurses | AP Texas News | Chron.com - Houston Chronicle

e-Autopsy: Kaiser Hospitals Dig In to Data to Assess Mortality

Tuesday, March 1, 2011

HHS Releases National Plan to Improve Health Literacy | HHS.gov

Thursday, February 24, 2011

Nearly 60% of paid home caregivers make medication errors, study finds - McKnight's Long Term Care News

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