scholarly journals The Impact of Fatigue on Medical Error and Clinician Wellness: A Vignette-Based Discussion

2018 ◽  
Author(s):  
Philip Salen ◽  
Kenneth Norman
Keyword(s):  
Medical Error ◽  
The Impact

scholarly journals Mistakes, Errors and Foul-Ups: Practice-Based Evidence for Evidence Based Practice

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Mark Turner
Keyword(s):  
Patient Safety ◽  
Clinical Setting ◽  
Medical Error ◽  
Human Medicine ◽  
Team Work ◽  
World Health ◽  
Patient Journey ◽  
Hospitalised Patients ◽  
Pubmed Database ◽  
The Impact

In human medicine, the management of care to ensure safety for the service-user constitutes an important element of the patient ‘journey.’ The name given to this discipline is patient safety. It is founded upon those elements of good medical practice which help avoid or mitigate human error.  Investigations in the U.S. first highlighted the alarming extent of medical error: Brennan et al. (1991) concluded that in the state of New York, the overall rate of adverse events was approximately 4% for hospitalised patients, which equated to over 13,000 deaths a year. Doctors looked to other safety critical industries and aviation in particular (Reason 1995), to address this phenomenon: there is now a wealth of research on the impact of various safety initiatives on measurable rates of harm. The World Health Organisation’s ‘Safe Surgery Saves Lives’ initiative - a campaign that advocates the use of a surgical checklist to standardise aspects of peri-operative care - is one example of aviation methodology successfully employed in a clinical setting (van Klei et al. 2012). The critical importance of effective communication, leadership and situational awareness has also been discussed at length in the human patient safety literature.ObjectivesVeterinary patient safety is an analogous discipline and researchers have attempted to understand more about the topic of veterinary medical error. However, the evidence-base for veterinary patient safety is sparse.  This presentation aims to summarise the evidence to date and highlight the benefits in practice of an emerging subject. MethodA search of the terms veterinary patient safety on the PubMed database from 1990 to 2016 was performed.Findings15 articles were identified as contributing to the veterinary patient safety literature.OutcomeThe available literature has addressed a number of areas. The use of checklists in a clinical setting has been proven to reduce the incidence of specific undesirable events: alterations to a standard anaesthetic protocol in light of a clinical audit led to a demonstrable improvement in one North American university hospital (Hofmeister et al. 2014).Research into the progenitors of mistakes in practice reveal the effect of poor communication and a lack of team work (Kinnison et al. 2015). Research has also investigated vets’ attitudes toward error and their experiences of it. The psychological precursors to error in our industry seem to mirror those found in human medicine (Oxtoby et al. 2015). The evidence supporting a new attitude and approach to veterinary patient safety is growing.

The Perceptions of Nurses About the Behavioral Needs for Daylighting and View to the Outside in Inpatient Facilities

2019 ◽  
Vol 13 (1) ◽  
pp. 191-205
Author(s):  
Arsalan Gharaveis ◽  
Hamed Yekita ◽  
Gholamreza Shamloo
Keyword(s):  
Mixed Methods ◽  
Nursing Staff ◽  
Medical Error ◽  
Behavioral Responses ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Behavioral Needs ◽  
Extensive Body ◽  
Nurses Perceptions ◽  
The Impact

Objectives: This research aims to explore the perceptions of nursing staff regarding the effects of daylighting on behavioral factors including mood, stress, satisfaction, medical error, and efficiency. Background: In spite of an extensive body of literature seeking to investigate the impact of daylighting on patients, a limited number of studies have been done for the sake of nurses’ perceptions and behavioral responses. Method: A mixed-methods approach, comprised of qualitative explorations (structured interviews) and a validated survey, was applied and the results were compared and triangulated. Five nurses were interviewed and 156 nurses volunteered for a lighting survey from six departments of three inpatient facilities in Iran. Results: The findings of this study are consistent with the existing evidence that daylighting and view to the outside enhance nurses’ perceptions regarding satisfaction, mood, stress, medical error, and alertness, while reducing fatigue and stress. Conclusion: Patient rooms and work stations are the most crucial areas to provide daylighting from nurses’ perspectives.

The Psychological Impact of Medical Error on Patients, Family Members, and Health Professionals

2017 ◽  
pp. 171-196
Author(s):  
Mary I. Gouva
Keyword(s):  
Medical Errors ◽  
Medical Error ◽  
Health Professionals ◽  
Psychological Impact ◽  
Psychological Effects ◽  
History Of ◽  
Underlying Causes ◽  
The Individual ◽  
The Impact

The current chapter examines the psychological implications emerging from medical errors. Whilst the psychological effects have studied, nonetheless the consequent impacts and the underlying psychological causes have not been sufficiently analysed and/ or interpreted. The chapter will add to the literate by using a psychodynamic approach in analysing the psychological impact of medical errors and provide interpretations of the underlying causes. The chapter concludes that medical errors lead to a series of implications. For the patient the quality of interactions with health professionals are directly affected and usually have immediate consequences. The impact of these consequences in the patient is mediated by the patient's personality, history of the individual and the psychoanalytic destiny of the patient. For the patient's relatives medical errors create emotional cracks leading to regression and eventual transference of the medical errors as a “bad” object. For health professionals medical errors impact upon the psychological defence mechanisms of the psychic Ego.

Disclosure of Error in the Intensive Care Unit

2018 ◽  
Author(s):  
Leslie Hale ◽  
Katrina Kirksey Harper ◽  
Anna Bovill Shapiro
Keyword(s):  
United States ◽  
Patient Care ◽  
Medical Errors ◽  
Medical Error ◽  
Hospital Costs ◽  
The United States ◽  
Target System ◽  
Treatment Providers ◽  
Prolonged Hospital ◽  
The Impact

Each year, as many as 98,000 hospital deaths in the United States can be attributed to medical error. Considering that at least half of all medical errors go unreported, the impact they have on mortality, morbidity, prolonged hospital stay, rising hospital costs, and the doctor-patient relationship cannot be overemphasized. At the heart of the dilemma are patients and their family members, who rely on clinicians to provide optimal medical care, devoid of mistakes and error, and want an apology if an error has taken place. In this review, we discuss the moral obligation of hospitals to disclose medical error, no matter what the impact. Whereas in the past, a paternalistic approach to medicine viewed this acknowledgment as weakness, there is now a consensus to advocate for full disclosure, apology, and discussions that facilitate early disclosure of error using teams representing administration, patient care liaisons, and treatment providers. Many institutions now recognize that medical errors are commonly the result of a breakdown of checks and balances, and an increasing number are implementing protocols that target system errors to prevent similar future occurrences. We examine institutions across the United States that take a proactive approach by assembling “communication and resolution” programs to address the concerns of patients and their families through the process of disclosure. We also explore barriers to disclosure, which are attributed to lack of training, fear of litigation, and the “shame and blame culture.” We discuss the benefit, to both patient and provider, of disclosure of accountability as we move toward a culture of strengthening systems and improving patient care and patient-provider relationships. Key words: apology, culture, disclosure, error, resolution

Disclosure of Error in the Intensive Care Unit

2017 ◽  
Author(s):  
Leslie Hale ◽  
Katrina Kirksey Harper ◽  
Anna Bovill Shapiro
Keyword(s):  
United States ◽  
Patient Care ◽  
Medical Errors ◽  
Medical Error ◽  
Hospital Costs ◽  
The United States ◽  
Target System ◽  
Treatment Providers ◽  
Prolonged Hospital ◽  
The Impact

Each year, as many as 98,000 hospital deaths in the United States can be attributed to medical error. Considering that at least half of all medical errors go unreported, the impact they have on mortality, morbidity, prolonged hospital stay, rising hospital costs, and the doctor-patient relationship cannot be overemphasized. At the heart of the dilemma are patients and their family members, who rely on clinicians to provide optimal medical care, devoid of mistakes and error, and want an apology if an error has taken place. In this review, we discuss the moral obligation of hospitals to disclose medical error, no matter what the impact. Whereas in the past, a paternalistic approach to medicine viewed this acknowledgment as weakness, there is now a consensus to advocate for full disclosure, apology, and discussions that facilitate early disclosure of error using teams representing administration, patient care liaisons, and treatment providers. Many institutions now recognize that medical errors are commonly the result of a breakdown of checks and balances, and an increasing number are implementing protocols that target system errors to prevent similar future occurrences. We examine institutions across the United States that take a proactive approach by assembling “communication and resolution” programs to address the concerns of patients and their families through the process of disclosure. We also explore barriers to disclosure, which are attributed to lack of training, fear of litigation, and the “shame and blame culture.” We discuss the benefit, to both patient and provider, of disclosure of accountability as we move toward a culture of strengthening systems and improving patient care and patient-provider relationships. Key words: apology, culture, disclosure, error, resolution

scholarly journals An eHealth Diptych: The Impact of Privacy Regulation on Medical Error and Malpractice Litigation

2001 ◽  
Vol 27 (4) ◽  
pp. 361-419
Author(s):  
Nicolas P. Terry
Keyword(s):  
Managed Care ◽  
Medical Error ◽  
Corrective Action ◽  
Health Law ◽  
Bill Of Rights ◽  
Patient Privacy ◽  
Privacy Regulation ◽  
Malpractice Litigation ◽  
Professional Journals ◽  
The Impact

Notwithstanding the continuing debate over the future of managed care and the appropriate protections to be included in a Patient's Bill of Rights, the safeguarding of patient privacy and the reduction of medical error have emerged as the dominant health law issues. Displacing even the implications of the advances in genomics from the front and editorial pages of our newspapers, privacy and medical error have left the cozy world of professional journals and political platitudes to demand corrective action.

Disclosure of Error in the Intensive Care Unit

2017 ◽  
Author(s):  
Leslie Hale ◽  
Katrina Kirksey Harper ◽  
Anna Bovill Shapiro
Keyword(s):  
United States ◽  
Patient Care ◽  
Medical Errors ◽  
Medical Error ◽  
Hospital Costs ◽  
The United States ◽  
Target System ◽  
Treatment Providers ◽  
Prolonged Hospital ◽  
The Impact

Each year, as many as 98,000 hospital deaths in the United States can be attributed to medical error. Considering that at least half of all medical errors go unreported, the impact they have on mortality, morbidity, prolonged hospital stay, rising hospital costs, and the doctor-patient relationship cannot be overemphasized. At the heart of the dilemma are patients and their family members, who rely on clinicians to provide optimal medical care, devoid of mistakes and error, and want an apology if an error has taken place. In this review, we discuss the moral obligation of hospitals to disclose medical error, no matter what the impact. Whereas in the past, a paternalistic approach to medicine viewed this acknowledgment as weakness, there is now a consensus to advocate for full disclosure, apology, and discussions that facilitate early disclosure of error using teams representing administration, patient care liaisons, and treatment providers. Many institutions now recognize that medical errors are commonly the result of a breakdown of checks and balances, and an increasing number are implementing protocols that target system errors to prevent similar future occurrences. We examine institutions across the United States that take a proactive approach by assembling “communication and resolution” programs to address the concerns of patients and their families through the process of disclosure. We also explore barriers to disclosure, which are attributed to lack of training, fear of litigation, and the “shame and blame culture.” We discuss the benefit, to both patient and provider, of disclosure of accountability as we move toward a culture of strengthening systems and improving patient care and patient-provider relationships. Key words: apology, culture, disclosure, error, resolution

scholarly journals A Mixed Methods Approach to Assess the Impact of an Interprofessional Education Medical Error Simulation

2019 ◽  
Vol 84 (2) ◽  
pp. 7133
Author(s):  
Colleen Marshall ◽  
Jessi Van Der Volgen ◽  
Nancy Lombardo ◽  
Claire Hamasu ◽  
Elizabeth Cardell ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Medical Error ◽  
Interprofessional Education ◽  
Mixed Methods Approach ◽  
Education Medical ◽  
The Impact ◽  
Error Simulation

scholarly journals The Impact of a Patient Safety Program on Medical Error Reporting

2005 ◽  
Vol 91 (3) ◽  
pp. 16-21
Author(s):  
Donald R. Woolever
Keyword(s):  
Patient Safety ◽  
Medical Error ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Management Program ◽  
Regional Hospital ◽  
Error Reporting ◽  
Safety Program ◽  
Chi Squared ◽  
The Impact

ABSTRACT Background: In response to the occurrence of a sentinel event—a medical error with serious consequences—Eglin U.S. Air Force (USAF) Regional Hospital developed and implemented a patient safety program called Medical Team Management (MTM) that was modeled on the aviation industry’s Crew Resource Management program and focused on communication, teamwork, and reporting. Objective: To determine the impact of a patient safety program on patterns of medical error reporting. Methods: This study was a retrospective review of 1,102 incident reports filed at Eglin USAF Regional Hospital in Florida between 1997 and 2001. Collected data from the comparison periods (1998 and 2001) was statistically analyzed using the chi-square test. Results: The number of reports submitted increased significantly from 200 for 4,671 hospital admissions in 1998 to 276 for 4,003 admissions in 2001 (chi-squared = 28.38, P < 0.0001). Evaluation of incident severity showed 172 (86 percent) near misses (no impact on patient) in 1998 and 251 (91 percent) in 2001. In 1998, there were 28 (14 percent) adverse events (patient minimally effected) and 25 (9 percent) in 2001 (chi-squared = 3.302, P = 0.069). Analysis by rank of person filing the report revealed 39 reports submitted by junior nurses and 11 submitted by junior enlisted personnel in 1998, while in 2001 those numbers increased to 75 and 24 reports, respectively (chi-squared = 6.554, P = 0.161). Conclusion: This study indicates that, since the implementation of MTM, there has been a statistically significant increase in the number of reports filed at Eglin USAF Regional Hospital. Similarly, the severity of incidents shows an overall decline approaching statistical significance. Although there was an increase in reporting from junior team members, this was not statistically significant. These findings suggest that there have been changes in the patterns of error reporting since the implementation of MTM.

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