Nursefriendly.com: hospital errors

Showing posts with label hospital errors. Show all posts

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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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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Saturday, February 19, 2011

LegalNursingConsultant.com, Medical Legal Resources, Nursing Entrepreneurs

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Welcome.
This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty.
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Special Reports:
Legal Eagles: Put nursing, law and business together and what do you get? The exciting field of legal nurse consulting! By Barbara Marquand, Minoritynurse.com:"Gloria Blackmon, RNC, BSN, LNC, LNHA, never met the young man who lost his legs, but after reading over his medical records, the compassion she felt for him was as strong as if he had been her own patient. The young man had been living in an intermediate care facility for developmentally disabled adults when circulation problems in his legs became so severe that both limbs had to be amputated. His parents sued the facility and it was Blackmon’s job, as a legal nurse consultant for their attorney, to review the records and determine if they had a valid case."
Peter Fuhrman National Sales Manager
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Combine Nursing and the Law through Legal Nurse Consulting, Meghan Persichino, RN, BSN, LNC, Nursingspectrum.com:"Nursing and the law: While some nurses think only of the possibility of being sued, others understand the power of this partnership in improving health. These forward-thinking nurses are blazing a trail as legal nurse consultants (LNCs). An Emerging Role Nurses have been working alongside attorneys for almost 25 years, if not more. These nurses went by titles such as "nurse paralegal," "medical litigation consultant," and other monikers. In some instances, they combined the duties of both the paralegal and nursing professions; there was no uniform role definition."
http://nsweb.nursingspectrum.com/cfforms/GuestLecture/nursingandlaw.cfm
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Switching Gears Becoming a Legal Nurse Consultant Diane Barnet, RN, BA, Nursingspectrum.com:"It sounded so easy. On the strength of a guest opinion piece I wrote about the nursing shortage for The Dallas Morning News, an attorney contacted me in the spring of 2002. I was suspicious. What would a lawyer want from me? “I’d like to send you a case,” he offered. “But I don’t have any legal background,” I protested. “That doesn’t matter,” he replied. “You can write.”"
http://community.nursingspectrum.com/MagazineArticles/article.cfm?AID=12518
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Legal Nurse Consultant by Sara Courson, BSN, Career Development, PA State Nurses Association:"Legal Nurse Job Search Quick Links: What is a Legal Nurse Consultant Educational Requirements Specialty Certification Salary Ranges Entry Advice Associations Publications Schools References About the Author."
PA State Nurses Association
2578 Interstate Drive, Suite 101
Harrisburg, PA 17110
1-888-707-7762 717-657-1222
FAX: 717-657-3796
E-mail: panurses@panurses.org
http://www.psna.org/c_profdev_legalnurse.htm
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Legal Consulting by Nurses, By Joy Collins, RN, BSBA, CLNC, LNCC, Wild Iris Medical Education, Inc.:"Nurses have been assisting attorneys with their medically related cases for far longer than is generally realized. It is only lately that the sub-specialty of legal nurse consulting has become a recognized field of nursing that the media has thrust into the mainstream. As far back as the 1980s (and probably earlier), nurses and other medical professionals were assisting the legal world to arrive at a fair settlement by moving through the quagmire of medical records and jargon that we nurses take for granted."
Wild Iris Medical Education
PO Box 257 Comptche, CA 95427
(707) 937-0518 ph (707) 937-2546 fax nurses@nursingceu.com
http://www.nursingceu.com/courses/244/index_nceu.html
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Medical Information, The Internet, and You By Janabeth Fleming Evans R.N., R.N.C., Doereport.com:" As a medical-legal consultant and Internet researcher I am asked every day to find authoritative medical literature references for a broad spectrum of topics. The information I am looking for may be used to support a claim, to debunk an expert theory, or to educate the attorney during the course of a case evaluation. Changes in the way medical information is stored, accessed, and retrieved have created a wealth of health care information. The Internet provides free access to a great deal of the medical literature, either in full text or citation/abstract format. Because anyone with access to the Web can establish a Web page, many medical sites contain little useful information, even though they may be visually appealing. For this reason, the quality of information available varies from very good to poor, and some sites even intend to mislead. It is important to search for peer reviewed information, from an authoritative source.
1275 Shiloh Road Suite 3130 Kennesaw, Georgia 30144
Phone: 770.805.0460 800.338.5954 Fax: 770.805.0430
Email: info@doereport.com
http://nursingexperts.doereport.com/20001130janabeth.php
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Friday, February 18, 2011

Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

via sfgate.com

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Monday, January 31, 2011

Institute For Safe Medication Practices

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Thursday, January 13, 2011

CMS 30-minute rule for drug administration needs revision, ISMP.org

In our June 17, 2010 newsletter, we covered a precarious topic best known as the “30-minute rule”—a requirement in the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation Interpretive Guidelines to administer scheduled medications within 30 minutes before or after the scheduled time (see pages 174-175 at: www.cms.gov/manuals/Downloads/som107ap_a_hospitals.pdf). In our July 2010 nursing newsletter, Nurse Advise-ERR, we asked frontline nurses who are most directly affected by the 30-minute rule to weigh in on the issue by completing a short survey. And WOW, did they ever! More than 17,500 nurses responded to our survey, providing more than 8,000 additional comments (see Table 1 on page 2 of the PDF version of the newsletter), making it very clear that the issue is of great significance to nurses.
Respondent profile and compliance rates
Almost half of the responding nurses work on medical/surgical units, and the other half work in critical care, telemetry, or specialty inpatient units. Most nurses feel that the 30-minute rule is unsafe, unrealistic, impractical, and virtually impossible to follow. Approximately three out of four respondents (70%) told us their organization enforces such a policy. Of these nurses, only five of every 100 (5%) were always able to comply with the policy, while more than half (59%) were infrequently or only sometimes compliant (see Graph 1 on page 6 of the PDF version of the newsletter). Why nurses find it difficult to comply with the 30-minute rule was expressed by many (see Table 2 on page 3 of the PDF version of the newsletter), including a nurse who sent a pragmatic yet eloquent account of a Day in the Life of a Nurse (see Sidebar that follows this article).

via ismp.org

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Wednesday, November 17, 2010

Children's Hospital launches 'zero errors' initiative

Reeling from the deaths of two children due to medication errors, the staff of Seattle Children's Hospital devoted Saturday to special training designed to prevent a recurrence of the tragedies.

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"It's so very important that we never forget that we harmed these children," said Pat Hagan, president of Children's Hospital. "We were all devastated by this when it happened. It struck us at our core."

Hagan said the patient deaths have been a "great, great tragedy for these families," and "a profound tragedy" for the hospital staff.

"We never want to forget how this feels. That feeling is going to be what drives us to continue to find ways to improve what we do here," he said.

Over 550 doctors, nurses, pharmacists and other staff members gathered at Children's for a special Patient Safety Day to address the medication errors that caused two deaths over the past 18 months.

More than 28 patient safety sessions were held, including 11 devoted to medication safety.

But first, participants gathered together in the morning to remember the two small patients who died.

"How we emerge from this situation today and over the coming months will be the real test of us as an organization," said Thomas Hansen, the hospital's CEO. "As I look around this room, I'm confident that we have the best and brightest people to rise to this challenge."

He told the staff "we must strive for zero errors, this must be our promise."

The day's sessions included topics such as decreasing verbal orders and increasing the safety of verbal orders when they are necessary, standardizing medications located on care units, ordering, dispensing and administration of high-risk medications, interruptions, provider-to-provider hand-offs and communication, ambulance transport and patient safety training using simulation.

Hospital spokesperson Louise Maxwell said Children's also is fully cooperating with state investigations of the recent medication errors and has made a number of improvements to decrease the chance of errors.

The hospital has also initiated a re-evaluation of the entire medication delivery system and launched a detailed analysis to determine why usual safety processes failed in each of the medication error cases.

Hospital officals said Saturday's special training did not affect care for patients or others needing urgent or emergency services.

via seattlepi.com

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Tuesday, November 16, 2010

Hospital care fatal for some Medicare patients - USATODAY.com

An estimated 15,000 Medicare patients die each month in part because of care they receive in the hospital, says a government study released today.

The study is the first of its kind aimed at understanding "adverse events" in hospitals — essentially, any medical care that causes harm to a patient, according to the Department of Health and Human Services' Office of Inspector General.

Patients in the study, a nationally representative sample that focused on 780 Medicare patients discharged from hospitals in October 2008, suffered such problems as bed sores, infections and excessive bleeding from blood-thinning drugs, the report found. The federal Agency for Healthcare Research and Quality called the results "alarming."

"Reducing the incidence of adverse events in hospitals is a critical component of efforts to improve patient safety and quality care" in the U.S., the inspector general wrote.

The findings "tell us exactly what some of us have been afraid of, that we have not made much progress," said Arthur Levin, director of the independent Center for Medical Consumers and a member of an Institute of Medicine committee that wrote a landmark 1999 report on medical errors. "What more do we have to do to make sure that sick people can rest assured that they're not going to be harmed by the care they're getting?"

Among the findings in the report obtained by USA TODAY:

•Of the 780 cases, 12 patients died as a result of hospital care. Five were related to blood-thinning medication.

Two other medication-related deaths involved inadequate insulin management resulting in hypoglycemic coma and respiratory failure resulting from oversedation.

•About one in seven Medicare hospital patients — or about 134,000 of the estimated 1 million discharged in October 2008 — were harmed from medical care.

•Another one in seven experienced temporary harm because the problem was caught in time and reversed.

About 47 million Americans are enrolled in Medicare, a government health insurance program for people 65 and older and those of any age with kidney failure.

The adverse events found in the study weren't necessarily due to medical mistakes, said Lee Adler, a University of Central Florida medical professor who was involved in the study. For example, he said, an allergic reaction to a penicillin injection is an adverse event, but it's a medical error only if the patient's allergy was known prior to the shot.

Among the problems identified in the report were Medicare patients who had excessive bleeding following surgery or a procedure. For example, one patient had excessive bleeding after his kidney dialysis needle was inadvertently removed, which resulted in circulatory shock and an emergency insertion of a tube to allow breathing.

When the tube was removed the next day, the patient inhaled foreign material into his lungs and needed lifesaving medical help, the report said.

Peter Pronovost of Johns Hopkins University, co-author of the book Safe Patients, Smart Hospitals, said medical mistakes are "an enormous public- health problem."

"We spend two pennies trying to deliver safe health care for every dollar we spent trying to develop new genes and new drugs," Pronovost said. "We have to invest in the science of health care delivery."

via usatoday.com

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Sunday, March 27, 2011

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

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

Saturday, February 19, 2011

LegalNursingConsultant.com, Medical Legal Resources, Nursing Entrepreneurs

Welcome.

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Friday, February 18, 2011

Released hospital patients' many unhappy returns

Monday, January 31, 2011

Institute For Safe Medication Practices

Thursday, January 13, 2011

CMS 30-minute rule for drug administration needs revision, ISMP.org

Wednesday, November 17, 2010

Children's Hospital launches 'zero errors' initiative

Tuesday, November 16, 2010

Hospital care fatal for some Medicare patients - USATODAY.com

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