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What Nurses Can Do to Prevent Medical Errors

Medical error statistics are alarming. When you take into account that 90% of errors are not reported, you can only imagine what the true numbers are. Either way, there is much room for improvement. Technology is quickly improving patient safety, but as modern medicine becomes more complex, there is more safety risk. Nurses are at the forefront of recognizing, minimizing, reporting and correcting many medical errors.

Did You Know?

  1. Medical errors lead to more than 250,000 deaths per year.
  2. Medical errors are the third leading cause of death in the US, just behind heart disease (#1) and cancer (#2).
  3. Approximately 10% of all deaths in the U.S. are from medical errors.
  4. Medical errors impact one in 5 households.
  5. Yearly, medical errors cause $20 billion in excess healthcare insurance claims nationally.

What Is a Medical Error?

Medical errors go beyond just medication errors. A medical error is defined as any "preventable adverse effects of medical care, whether or not it is evident or harmful to the patient." It encompasses a wide range of mistakes, from misdiagnosis and over/under treatment to patient misidentification and documentation errors. Medical errors can lead to injury, whether from medication errors, medical equipment malfunctions, infections, falls, burns, restraints or a number of other issues. Error rates are often higher in specialty areas, such as oncology departments, operating areas, emergency departments, or operating rooms, where patients receive intense or urgent care for a severe condition.

How Can You Prevent Medical Errors?

Below are three tips to minimize medical errors in nursing.

  1. Add more medication "rights." Historically, nurses have been taught to use the five "rights" when administering medication: Right patient, right drug, right dose, right route, and right time. Newer systems include right frequency, right history, right assessment, right drug interaction evaluation, right to refuse, right education and information, and right documentation. Consider adding new "rights" into your practice.
  2. Use technology. Technology can protect patients, but only if people understand it and use it. Electronic medical records (EMRs) flag for all types of precautions (e.g. fall, thrombocytopenia), drug interactions and abnormal lab values. Take medication machines for example: The machine only allows access to your patients' drugs. You scan their ID bracelet and the drug as a double check. Documentation is automatic. Sounds great, right? Safety issues arise when nurses override the system to obtain drugs, skip dosage calculations (when needed), or don't look up labs or unfamiliar drugs.
  3. Everything must match. For blood products and chemotherapy, be sure to double-check safety measures to reduce error. Technology can act as a backup, but it is important to ask colleagues for a double check or triple check if you feel you lack proficiency with procedures and high-risk medications.

What Is the Personal Cost of a Medical Error?

Clearly, patients suffer from medical errors. Surveys show that people involved in a medical error suffer "long-lasting physical, emotional, and financial harm." Depending on the medical error, patients can lose trust not only in the erring facility and clinicians, but also the entire healthcare system. This can have significant downstream effects, as patients may delay or even avoid seeking medical care in the future.

Additionally, medical errors have a significant impact on nurses. Nurses can experience severe emotional distress, self-blame, guilt, shame and professional isolation, becoming the "second victim" of the medical error. They may lose their confidence and even question whether they chose the right career or should continue nursing practice.

What to Do If You Make an Error?

The first thing to do if you make an error is to admit it and report it. Organizations are working to establish a safety culture where errors are viewed as opportunities for improvement, and not a reason for scolding, isolation or termination. Errors can rarely be attributed to just one person — they are often due to a combination of events. If the error goes unreported, it is likely to be repeated, and potentially with more serious consequences.

Finally, forgive yourself. Seek support. Look for specific support programs such as group therapy, peer-response programs and counseling. Check your employee assistance program.  

Nurses are human, and errors will occur. All nurses are a key part of the solution to transform healthcare to the goal of zero harm. From the staff nurse who ensures medication rights to the chief nursing officer who creates a safety culture, everyone is responsible. The goal is to prevent or minimize errors while maximizing patient safety. After all, patients' lives depend on it.

Learn more about the University of Maine at Fort Kent's online RN to BSN program.


Sources:

NCBI: Your Health Care May Kill You: Medical Errors

NCBI: Medical Error — the Third Leading Cause of Death in the U.S.

Centers for Disease Control and Prevention: Leading Causes of Death

Cureatr: There's Much Work to Be Done: 8 Medical Error Statistics to Know

PSQH: Lehman Report Analyzes Cost of Medical Errors Despite Healthcare Progress

NCBI: Medical Error Prevention

NCBI: Medical Error

NCBI: Patient Safety and Quality: An Evidence-Based Handbook for Nurses

NCBI: More Than 1 Million Potential Second Victims: How Many Could Nursing Education Prevent?

Duke Global Health Institute: Establishing a Safety Culture Is Key to Savings Lives

Modern Healthcare: Helping Staff Who Are Traumatized by Errors

Joint Commission Center for Transforming Healthcare: Leaders Facilitating Change Workshops


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