Statistics of Medical Errors, Reducing Medication Errors and Increasing Patient Safety - Literature review Example

Literature Review on Medication Errors Name Institution Instructor Course Date of Submission Executive Summary Medical errors have been recorded in many places of the world and the rate at which they have been scrutinized and evidenced among communities has not been empirical proofed and ascertained. An intervention program or outline into the matter is on high demand because of the fact that the consequences involved are fatal. With regard to this, several researchers have carried out a lot of research in many parts of the world and therefore, there is need to review the case studies to identify the major causes of medical errors. The paper reviews literature of different scholars who have tried to establish types of medical errors that affect health of people. The paper also looks at the possible interventions that can be applied by stakeholders to minimize effects and impact of medical errors to human health. Introduction For along time, medical error has been defined as a preventable effect of healthcare on patients whether it is harmful or not. This can be categorized as an incomplete or inaccurate admittance of medication, diagnostic procedures, and or treatment. Ailments available in this category include adverse effect when nursing disease, syndrome, infection, and treatment. Scientific inquiry outlines that many medical errors are related to human errors and limitations in healthcare (Cook et al 2004). Effect of errors depends on what method has been chosen by healthcare providers when they administer their medical services on patients. Even though such occurrences have been detected in many hospital and healthy centres, the extend to what medication errors have affected provision of medication services can not be ascertained and therefore there is need or demand to do more research (Cook et al 2004). In the current decade, medical scientists have tried to find methodologies and approaches through which errors in medication can be minimized because the impacts on patients have always varied from minor to major errors. Statistics of Medical Errors In the U.S alone, medical errors have been detected in many hospitals and the results has been that about 44000 or a maximum of 98000 patients have died out of errors that could be prevented through early mitigation systems. Similarly, several case studies have outlined that about 1 million patients have greatly have experienced severe or excess suffering from poor or medical errors that is provided by medical health providers. Despite this, some medical stakeholders and practitioners have questioned whether the statistics found are relevant and accurate or not. This is because; there is no exact research method that can outline conditions of the patients prior or before the medication (Cook et al 2004). A close scrutiny depicts that by providing optimal medication and health care, many patients can survive in the current world and that a lot of deaths or worsening of a patient’s condition could be prevented or controlled within manageable limits. It is estimated that medical errors generated a lot of losses such that in 2000 alone, the U.S government used about $ 887 as extra costs to streamline the admittance of medical care. However, these figures does not include the salaries or wages that have been lost due to outlaying of jobs that result from dismissal of sick workers (Cook et al 2004). Atleast about 1.5 million patients have been harmed due to poor medical administration and wrong provision of medical services. The figures provided have been criticized by many to be conservative figures but the same figures have been identified as the core implications and dimensions that result from poor medical admittance practices. About 400000 drug related damages are recorded per year in the United States hospitals and the impact as not been accurately determined because of the variability that exists between research methods that are used (Devers, Pham & Liu 2004). Iatrogenic injury has been identified as the leading cause of death among patients due to poor medication and health care service provision. From this category alone, 180000 end up being yearly victims and the extend to what the medication affects other stakeholders in the medication and healthcare sector remains undetermined and unascertained. Empirically, a large percentage of healthcare problems are associated with human errors which can only be minimized to a small extend (StratisHealth 2013). Excess effect occurs after medication error has occurred and effected or administered to a patient (StratisHealth 2013). This is because, wrong medication stimulates the body to react differently against the administered medication or nursing procedures and the costs incurred after the application exceed the normal the normal prescribed pricing frameworks for specific ailments or impairments that result from the erroneous admittance of medication (Devers, Pham & Liu 2004). IOM case study outlines that approximately 55 % of patients do receive recommended healthcare while at the same time, 30 % of patients do receive medication that is considered unnecessary. There is lot evidence that many patients have always ended up getting medication and healthcare services that are irrelevant or twisted away from the norm. It is against rules or research since most of the case studies have only evaluated and looked at the effects that result from principal treatment practices (Devers, Pham & Liu 2004). For example, if a practicing physician recommends an incorrect laboratory test, it may not be suspected at any stage but the effects are empirical if the admittance of medication is given according to the prescribed diagnosis. These variations that affect determining of frequencies of medication errors have depended on the levels of or accuracies at which the data is collected and analyzed for relevance and for significance. This therefore signifies that there are a lot of medication errors that go unnoticed or that can not be scrutinized by common research methodologies. With regard to variability, it is of great significance to note that there are diversified networks in which detection of errors becomes a difficult process or task to detect or ascertain. Since human beings are susceptible and more vulnerable towards making errors, 80% of all medication errors have been associated with human limitations and inexperience that either directly or indirectly controls the medication practices (Devers, Pham & Liu 2004). Medical practices involve giving out of drugs in the right rations depending with the diagnosis results that are recorded after physical evaluation or lab analysis. Several cases have also outlined that many errors occur without the medical practitioners realizing that they have failed to use the right drugs, systems, procedures, or methodologies (StratisHealth 2013). In the medical profession, a small change in labelling or prescription may lead to great losses that include loss of life or irreversible health problem. This is because, anything less or excess can lead to severe poisoning and destruction of human health system beyond controllable levels. For example, when a doctor prescribes 10grams mistakenly instead of 1.0g it poses many health problems to the patient including death as the ultimate result of wrong medication. Since the impacts are great, many researchers have laid down strategies and conducted many qualitative investigation with the main aim of identifying exact mistakes and consequences that occur out of wrong medication or related medical applications (StratisHealth 2013). The investigation also seeks to identify different categories of medication errors and how they can be minimized in health centres and hospitals (Devers, Pham & Liu 2004). No empirical data has been collected that represents all impacts that have always affected practice in medicine. Patients being consumers, doctors and all medical practitioners are required to provide accurate medication services to the public while ensuring that proper medication is economical and sustainable and that several medication errors are dangerous and have negative impacts to a patient’s health. The medical errors are caused by many factors which cut across negligence, unprofessionalism and lack of effective and efficient medication system. Analytical Review on Medical Error Devers, Pham and Liu have established that there are many causes of medication errors that have so far been identified by medical scholars through application of systematic research methods (Devers, Pham & Liu 2004). These researchers have established that a large percentage of medication errors vary across many sectors and social entities like the military, health centres and hospitals. From their investigation, they have empirically ascertained that there is no single hospital or health centre that has never recorded medical. Similarly, reports on their research have indicated that medical errors are diversified and intertwined within the operational frameworks of the healthcare providers. Even though these causes have been associated by human error, these scholars have agued that the cause is beyond human weaknesses and that it is more associated with cognitive failures and fatigue that several medical stakeholders experience while at the work place (Devers, Pham & Liu 2004). In 1990 Allan and Barker found the same results about the cause of medical errors. According to them, medical errors in medical field are quite often caused by inexperienced nurses and physicians who normally use wrong procedures or systems while trying to administer medication to patients. Compromise due to the age of a medical practitioner has also been noted by Allan and Barker to be one of the factors that make many physicians and doctors to be excessively vulnerable or susceptible to causing medical errors (Allan, & Barker 1990). Within the frameworks of their research, poor communication resulting from language barrier was also noted and evaluated to be among the most dangerous aspects that may lead to medication error. This occurs when a patient can not elaborate or effectively explain his or her problem. The same happens when the physician on duty does not understand the language of the patients, a scenario that may lead to excessive dosage or application of medication procedures. According to them the best way to reduce medical errors should involve application of systematic methodologies that looks forward at ensuring that all medical practitioners are fully trained and updated on the most effective ways that are available to them (Allan, & Barker 1990). Allan and Barker also noted that from the outlook, many patients have ended up being treated for a different disease from what they are suffering from because of failure to identify and communicate the right symptoms (Allan, & Barker 1990). Incompetence in medicine was established to be a critical issue that according to them, according to them, effects of medical errors can be minimized within the shortest time possible. On the other side of the matter, Allan and Barker have agued that patients are sometimes to be blamed for failure to express themselves in good modes that can easily be understood by nurses, nutritionists or other medical practitioners. In addition, they have clearly outlined that several agencies have been whistle blowed for failing to provide good services to their clients. Finally, they have concluded that the services administered should include frameworks and effective systems through which scientific analyzes and tracking of patient’s problems can be carried out (Allan, & Barker 1990). 1n 2011, Breckenridge-Sport, Johantgen and Patrician carried out an investigation and outlined that excessive staffing or under staffing of medical practitioners in hospitals is one of the reasons that have increased the rate at which medical errors are being reported in many health centres (Breckenridge-Sport, Johantgen & Patrician 2011). This is the same aspect that has fueled the spread of medical errors throughout the medical provision centres and institutions. This problem is evident in military camps where under staffing of workers occurs. According to them, it happens that many of the wounded victims are attended to by few medical practitioners. Because of the fatigue and long hours of working, they end up becoming frustrated and demoralized in offering efficient services (Breckenridge-Sport, Johantgen & Patrician 2011). The ratio of medical provider to the patients being attended to should be maintained within the frameworks of accountability and excellent service provision as stipulated or outlined in the medical practice ethics charter. StratisHealth consisting of several researches have looked at how impacts of medication errors can be reduced to smaller low percentages if nurses, doctors and any other physicians are involved. According to them, the big question has been, how should medical practitioners be prepared to reduce these impacts and effects when it is considered that many of the can be reduced. With regard to the StratisHealth findings, some professional psychologists have agued that the reduction can only occur to some extend beyond which the other sources of errors will remain significant. This is because, some errors or causes of errors are not tied to experience but to the capacity of human beings to be able control their brain practices. Human brain has an effective capacity of relating ideas and medical practices but when it is overloaded, chances that there will be medical errors increases significantly (StratisHealth 2013). The study by StratisHealth has also outlined that enormous problems that cause medical errors are related to the cognitive issues of human brain development and the capacity to suppress or minimize errors. StratisHealth have also established that errors have not only occurred in hospitals but in some operation rooms where youths are taught to use strategic methods to prevent themselves against spread of sexual transmitted diseases (StratisHealth 2013). It has been established that after sometime after youths attending health training programs in their places of residences, they have ended up being shown wrong methodologies and strategic ways through which they can reduce chances of minimizing infection that results from sexual transmitted diseases. Similarly, Kohn, Corrigan and Donaldson have outlined that some failures or medical errors are associated with poor communication networks between senior and junior physicians. Furthermore, they have identified that protocol frameworks have made it difficult for medical practitioners and scholars to establish truth of the matter because their line of operation is not linked into closed loop systems through which feedback and correspondence can be made (Kohn, Corrigan & Donaldson 2000). It is clear and empirical that several medical practitioners should install effective information systems so that inquiries and feedback on the type of medication can be verified by senior staffs before the application can be administered to the identified patients. Unclear lines of medical authority also have left gaps in understanding what really happens when wrong medication is administered to patients. When information is not shared between medical stakeholders at the health centre, it becomes very difficult for one to establish the truth on what exact method should be used for a specific ailments or injury. The diagnostic procedure may be correct but the levels of dosage vary from one patient to the other depending with age of patient, gender, and severity of the problem (StratisHealth 2013). In developing nations, medical errors have been associated to many factors that surround incompetency and inefficiency in handling of some matters. For example, findings by Devers, Pham, and Liu have exposed that there are few individuals in the medical field in developing nations who understand or have knowledge on how some machines operate (Devers, Pham & Liu 2004). This therefore means that the critical machines are only operated either once or twice in a month. Such happenings prove that there is no firm platform of experience among some machine operators. This leads to incompetence and may lead to many errors that may affect status of the patient by worsening or altering the normal operation procedures which may end up costing life of a patient (Devers, Pham & Liu 2004). Similar case scenario has been spotted in other areas whereby many medical practitioners have developed an automated way of life whereby they over rely on machines rather than by checking the machine for accuracy and precision (Devers, Pham & Liu 2004). Automated machines can fail to function or to serve the purpose it was designed for not by stopping to work but by giving wrong prescriptions, ratings or by giving estimated figures about temperatures of patients. Such occurrences leave a lot of question marks on whether these machines or automated gadgets are reviewed and evaluated and audited for performance or not. Till now, there are no clear procedures that have been put forward to minimize errors that results from automated procedures or machines (Lisby et al. 2012). Even though some medical practitioners have been accused for failing to perform or carry out the right treatment and diagnostic procedures, performance of machines and failure to audit them for accuracy is to be blamed and scrutinized (Lisby et al. 2012). It has been confirmed and empirically evidenced that it is critical and a cumbersome activity to evaluate sources of errors among poor communities because first, there are no community healthcare experts or scientists and that there are no accurate equipments that can help the practitioners to give accurate diagnostic procedures or treatment to patients (Lisby et al. 2012). This is also because most of the patients have always complained of more than one symptomatic ailment that are associated with nutritional deficiency as well as body impairment disorders. In addition, some of the medical errors have been caused by many medical practitioners who have a tendency of reducing costs within their operational frameworks. Paying a close scrutiny also reveals that some of the failures that have occurred within many health care providing centres are associated with outdated costing systems that looks at minimizing costs or amount of money spent on some illness (Lisby et al. 2012). Lisby and others outline that he biggest problem in developing countries happens when the patient and the medical provider fails to communicate or agree on some things because of illiteracy and language barrier. This is because, the medical provider is forced to make some assumptions about the patient’s statements not knowing that the assumptions have lethal and fatal effects to the patients present status during the time of assessments and evaluation (Lisby et al. 2012). Critically, the situation even becomes worst when individuals are in critical conditions such that they can not completely communicate or attempt to communicate with the medical care provider (Lisby et al. 2012). This group of researchers also identified that assumptions are good when they are made in the frameworks of wanting to save the situation from worsening rather than to save the situation by worsening. Philosophically, medical errors are caused due to human limitations and errors that can be minimized only to some percentages or manageable levels. In the recent times, many practitioners have also complained that they have failed to perform well because they are always frustrated by their bosses who quite often disconnect communication networks for their own good and benefit (Lisby et al. 2012). In 2009 Cook and Hoas outlined that medical errors are high in rural settings where there are no effective monitoring and evaluation frameworks that can be used y quality assurance team. The situation worsens when the rural community lacks professional who can question medical care providers operating in the region. According to them and in the recent years, many of the rural dwellers or individuals from the rural settings have complained that the services they get are substandard compared to the services that their fellow urban dwelling colleagues get (Cook & Hoas 2009). The variability and discrepancies have occurred because of the assumption by the medical team that rural residents do not understand what they should get from care providers. As a result, the medical providers favor elites more than other citizens who are common individuals. In such cases, patients have been given wrong drugs for irrelevant symptoms or they have received injections that are underdose or in excess of what they require or want at the time of administering (Cook & Hoas 2009). Is sleep a factor that contributes to medical errors? Sleep is of great importance to anybody else and is the reason why it is advisable that everybody must get enough sleep if he or she is expected to perform well at the workplace. It has been established that many interns who are always or constantly deprived of their sleep increases chances of causing medical errors among patients who are innocent about what they are to be exposed to. When sleep accumulates over a number of days, the medical provider becomes exhausted, less effective, a scenario that finally leads to application of wrong medication or use of poor medical facilities or equipments. Such cases have been identified in many hospitals or centres where there are no shifts for practitioners or where there is low number of patient’s attendants. Other risk factors that affect performance of a medical provider include fatigue, stress, and depression of high intensity (Cook & Hoas 2009). Is medical error evident in all parts of the world? Yes, Boyle outlined that medical errors have happened and experienced in different parts of the world even in the world remotest areas. Researchers have carried out investigations and noticed that physicians are quite often affected by the idea that they have attempted to or have caused a medical error to an innocent patient who has hope of getting well soon after while being attended to by the physicians (Boyle 2013). In the recent years, it has been revealed from Boyle that physicians have always struggled with guilty and anger after realizing that the procedures or medication they have given are substandard or beyond what they should give. Analytically, stress and depression among medical practitioners increase when the patients die or get permanently damaged beyond repair or correction. It is critical to note that once a practitioner gets depressed, there are chances that he or she may be unable to prevent the next medical error (Boyle 2013). To reduce such mistakes, it is therefore advisable that all stakeholders should install effective information systems that can support sharing of information, ideas, and mechanisms of understanding (Benjamin 2003). Refresher courses should also be conducted as a way to update the medical providers on mechanisms that can be used or applied to minimize medication error (Boyle 2013). Critique Table from the findings Causes of Medication errors Remedy Recommendation Poor Communication and feedback among health care providers Install effective and efficient information networks All health care provision centres should be installed with good communication networks Training Incompetence Employ qualified practitioners Refresher courses should be provided to all medical practitioners quite often Language barrier between practitioners and patients Language interpretation systems Health centres should have international language translators together with effective communication networks Similar symbols of medical prescription Uniqueness of symbol required Medicines and all drugs provided should be clearly elaborated Lack of skills to operate critical or operational machines Skills and experience required Machine operators should be constantly trained through practicals and thorough assessment Sleep deprivation Shifts required Practitioners should work in shifts in order for purpose of alertness Stress and depression Given enough time for relaxing as well as good working environments Medical practitioners should be allowed to relax enough and the management should provide a good working environment Conclusion Medical errors have been recorded and evidenced in many parts of the world by different medical scholars who have conducted a lot of case studies to verify the matter. Research from these scholars has indicated that the causes are diversified and spread along the patient and medical care provider failures or incapability. The most common sources of medical errors include language barrier, poor communicatory systems, and networks through inquiries can be made and feedback generated. Errors associated with medication have led to deaths and more injuries that have left marks of sorrow and depression among medical providers and patients. However the situation is worse in developing countries where machines lack skilled operators such that their operations pose many dangers than help to patients under consideration. However, all these medical errors can be minimized if effective and efficient communication systems will be installed in healthcare centres. In addition, they can be minimized by ensuring that the stakeholders in the medical sector get enough rest and sleep so that their levels of alertness increase. 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