Conclusions - by the very nature of culture and humanity, humans tend to be group animals -- they thrive in groups, coalesce into groups, indeed, the very process of moving from hunter-gatherer to cities was part of a group behavior. Group norms are internal rulings that are followed by individuals so that the synergistic effect of the group will be more efficient. These values usually focus on the way members of that group look and behavior towards themselves, and the hierarchical structure they tend to set up to "police" their efforts. Norms help groups solve problems, define and address new situations, make better decisions, and even process their daily work. Groups, in this case members of the medical community, join these groups in order to reflect specific notions and values associated with the overall group. Normative behavior in the medical field is covered by a willingness to help, to "do…...
mlaBibliography
Physicians Want to Learn from Medical Mistakes. (2008, January 9). Retrieved November 2010, from Agency for Healthcare Research and Quality: http://www.ahrq.gov/news/press/pr2008/errepsyspr.htm
Error Disclosure. (2009, March). Retrieved from Agency for Healthcare Research and Quality: http://psnet.ahrq.gov/primer.aspx?primerID=2
Improving America's Hosptials. (2010, March). Retrieved November 2010, from the Joint Commission's Annual Report on Quality and Safety: http://www.jointcommission.org/NR/rdonlyres/D60136A2-6A59-4009-A6F3-04E2FF230991/0/2010_Annual_Report.pdf
Dewar, D. (2010). Essentials of Health Economics. Philadelphia, PA: Jones and Bartlett.
Large health care systems with multiple facilities can track as many as 1,000 events each month" (Berntsen, 2004, p. 44). That is an amazing number of cases that came extremely close to becoming medical errors, and they were only stopped by caregiver response or sometimes by chance. Near misses are an extremely important part of the healthcare facility's treatment program, because they can indicate just how accident and error-prone a facility is, and they can even indicate which departments and individuals may be the most error-prone.
How does a staff effectively reduce medical errors in their facility? Authors Turner and Kurtz believe debriefing of the team is key to reducing errors. They write, "Effective debriefing is the key to long-term sustainable improvements in patient safety and care. It is only through debriefing that an organization, team, or individual will improve consistently over time" (Turner, and Kurtz, 2008). Debriefing, the authors…...
mlaReferences
Berntsen, K.J. (2004). The patient's guide to preventing medical errors. Westport, CT: Praeger.
Turner, S.H., and Kurtz, W.D. (2008). Debriefing for patient safety. Retrieved 28 Nov. 2008 from the Patient Safety & Quality Healthcare Web site: http://www.psqh.com/novdec08/debriefing.html .
Legal Aspects of Medical Errors
Various factors in the health care system are reported to be contributors to medication errors. This work reviews a case study discussed in 'Hospital Pharmacy' (Smetzer and Cohen, 1998) which provides a clear example of the complex nature of the health care system and the process of medication use and how this interrelates to medication safety and quality. The nurse made the decision to administer the medication by IV. The syringe was labeled IM use only. The administration of the medication by IV would prove to be lethal since the drug is insoluble and obstructs blood flow the lungs needed for transferring oxygen to the individual's airways. The baby after it had died was found to not be in need of the treatment after all.
There were 50 latent and active failures that had occurred during the medication-use process and the majority of these failures were not…...
mlaBibliography
ASHP Technical Assistance Bulletin on Hospital Drug Distribution and Control (2011) Drug Distribution and Control: Distribution -- Technical Assistance Bulletins. Retrieved from: http://www.ashp.org/DocLibrary/BestPractices/DistribTABHosp.aspx
Institute of Medicine. (2007). Understanding the causes and costs of medication errors (Case on the death of the day-old infant). In P. Aspden, J.A. Wolcott, J.L. Bootman, & L.R. Cronenwett (Eds.), Preventing medication errors: Quality chasm series (pp. 43 -- 4-5)Retrieved from http://books.nap.edu/openbook.php?record_id=11623&page=43 .
Pharmacist's Manual Section IX -- Valid Prescription Requirements (2012) Office of Diversion and Control. DEA. Retrieved from: http://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/pharm_content.htm
Reflection on Medical ErrorTo err is human, and the doctors are human themselves, proving that medical errors are inevitable. The Institute of Medicine released a publication that stated that 98,000 deaths were accounted for the medical errors each year, which were even greater than the road accidents (Bari, Khan & Rathore, 2016).The Healthcare system is becoming more complex each day with the up-gradation of the technologies and new scientific methods with discoveries; even a simple method of administering the right medication involves several humans in the process (Jacob, 2017). This paper aims at elucidating a personal account of the medical error and how it affected the healthcare providers, patients, and their families.The medical errors related to anesthesia are critical as 947 out of 1000 ICU cases have been reported due to anesthesia medication errors (Kothari et al., 2010). The mortality and morbidity of these errors are expected to be much…...
mlaReferences
Bari, A., Khan, R.A. & Rathore, A.W. (2016). Medical errors: Causes, consequences, emotional response and resulting behavioral change. Pakistan Journal of Medical Sciences, 32(3), 523-528. https://doi.org/10.12669/pjms.323.9701
Glavin, R.J. (2010). Drug errors: Consequences, mechanism, and avoidance. British Journal of Anesthesia, 105(1), 76-82. https://doi.org/10.1093/bja/aeq131
Jacob, A. (2017, May 16). Are medical errors inevitable? HCP Live. https://www.hcplive.com/view/are-medical-errors-inevitable
Kothari, D., Gupta, S., Sharma, C. & Kothari, S. (2010). Medication error in anesthesia and critical care: A cause for concern. Indian Journal of Anesthesia, 54(3), 187-192. https://doi.org/10.4103/0019-5049.65351
educing Medical Errors in the Modern Healthcare Setting
One of the biggest challenges impacting healthcare providers are the total number of medical errors that occur on a regular basis. These areas are problematic, as they are adversely effecting the safety and quality of care provided. This is because nurses are often overwhelmed from the increasing number of responsibilities and regulations. (Orgeas, 2010)
For example, a study that was conducted by Orgeas determined that the most critical departments (such as: the ICU) are facing these challenges with him saying, " Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention. An observational prospective multicenter cohort study of these MEs was conducted from March 27 to April 3, 2006, in 70 ICUs; 16 (23%) centers were audited. Harm from MEs was collected using specific scales. Fourteen types of MEs were selected as indicators; 1,192 MEs…...
mlaReferences
Boyle, D. (2011). How Medical Errors Effect Physicians Emotionally. AAOS. Retrieved from: http://www.aaos.org/news/aaosnow/nov11/managing8.asp
Cole, B. (2009). Overworked Nurses are Hurting Patient Care. Health Related Media. Retrieved from: Are-Hurting-Patient-Care- and-Outcomes##http://www.healthleadersmedia.com/content/LED-235900/Overworked-Nurses-
Davis, D. (2011). The Adult Learner's Companion. Boston, MA: Wadsworth.
Encinosa, W. (2008). The Impact of Medical Errors. Health Service Residential, 43 (6), 2067-2085.
Ethics and Legalities of Medication Error Disclosure
As Philipsen and Soeken (2011) note, it is the nurse's duty and ethical responsibility to inform the patient of any medical error in treatment, even if the error is "insignificant." The patient still has a right to know, as do all individuals who are impacted by the error (staff as well). This allows the medical community to remain transparent, which is a foundation of trust in the staff-patient relationship. Thus, the ethical implications of disclosure and non-disclosure are clear: to not disclose a medical error is to act unethically and without the transparency and loyalty that is owed the patient as well as the members of the staff. The legal implications of disclosure vs. non-disclosure are also clear. The severity of the error is what is most likely to affect the outcome if the error becomes known and there was no disclosure made…...
mlaReferences
Anderson, P. (2010). Medication errors: Don't let them happen to you. American Nurse Today, 5(3).
Edwin, A. K. (2010). Non-disclosure of medical errors an egregious violation of ethical principles. Ghana Medical Journal, 43(1): 34-39.
Kentucky Revised Statutes. (n.d.). Kentucky Board of Nursing. Retrieved from http://kbn.ky.gov/practice/Documents/aos34.pdf
Philipsen, N. C., Soeken, D. (2011). Preparing to blow the whistle: A survival guide for nurses. The Journal for Nurse Practicioners, 7(9): 740-746.
appease the allegation that medical errors beset the healthcare industry and generate major risk to patients. As with any matter posing a potentially significant impact on a population, the government has a sizable interest. Lately, the government decided to take action toward enacting quality of care and patient protection regulation. In an optimal setting, this would appear easy to execute, but reality indicates such top-down regulatory answers to health care quality and patient safety lead to negative domino effects, including increased health care costs, unforeseen conflicts with pre-existing regulation, and decline of provider self-governance.
egulation carries its weight in gold through its function ratio of benefits to costs. In regards to the cost side of the equation, it includes costs to the government, consumers, and regulated entities. A study conducted in 2002 to assist research in understanding the estimated comprehensive value of health care regulation found the figures led to…...
mlaReferences
Ellig, J. (2012, March 27). Healthcare Law Highlights Problems With Regulatory Process - Economic Intelligence (usnews.com). Retrieved from http://www.usnews.com/opinion/blogs/economic-intelligence/2012/03/27/healthcare-law-highlights-problems-with-regulatory-process
McGuire, T., Newhouse, J., & Sinaiko, A. (2010). An Economic History of Medicare Part C.Milbank Q, 89(2), 289-332.
Mekel, M. (2010). Emerging Issues in Health Care Regulation: Protecting Patients or Punishing Providers? Journal of Legal Medicine. doi:10.1080/01947641003598138
Pittman, D. (2013, August 26). Medicare's DME Bidding Program Criticized. Retrieved from http://www.medpagetoday.com/PublicHealthPolicy/Medicare/41184
Patient Handoffs
Majority of the medical errors take place in the patient's handoffs. A shift among the doctors is a common practice. There are a number of old patients who approach around 16 different doctors in a year, while young patients who are healthy refer to normal physicians and to specialists as well (Philibert, 2008). In a hospital normally, less attention is given to the patient by his primary doctor, while the trainees and the hospitalists are more involved in that patient. Patients are rotated to different doctors with an average of fifteen times in a five day stay at the hospital. Young doctors often accept appointments of more than 300 patients in a month, in their initial training period just because of time pressure (Chen, 2009, p. 1).
Alteration that have been brought about in the patients care have increased the quality of the services that are offered to the patients…...
mlaReferences
Centers for Medicare & Medicaid Services. (2010). Electronic health records overview. Retrieved from http://www.cms.gov/EHealthRecords/
Chen, P.W. (2009, September 3). When patient handoffs go terribly wrong. The New York Times. Retrieved from http://www.nytimes.com
Decision support systems may reduce inappropriate medical tests. (2011). Retrieved from / article:decision-support-systems-may-reduce-inappropriate-medical-tests-/http://www.theexigencegroup.com/news/intelligence
Encinosa, W.E., & Bae, J. (2011). Health information technology and its effects on hospital costs, outcomes, and patient safety. Inquiry, 48, 288-303. doi:10.5034/inquiryjrnl_48.04.02
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and legibility after…...
mlaReferences
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…...
mlaReferences
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
Personal Critique and Lessons Learned from the Article:
The article was well-written with many studies to back up the findings of the usefulness of the error management system discussed. It was interesting to see so many parallels between two diverse fields of occupation.
The stress levels, risks to human life, and the importance of teamwork were highlighted examples of similarities. However, it was the differences that were the most intriguing.
Clearly aviation accidents are more highly publicized than the individual medical accidents that occur each year; yet, it was startling to learn that it is estimated that up to nearly 100,000 people die each year from medical accidents, far less than aviation accidents. Although not as highly publicized, litigation following medical accidents, in the form of malpractice suits, would lead one to believe that the medical profession would be motivated to institute the types of processes and protocols that the aviation industry has…...
mlaReferences
Helmreich, R. "On error management: Lessons from aviation." BMJ 320 (2000, Mar 18): pp. 781-785. September 26, 2006 http://bmj.bmjjournals.com/cgi/content/full/320/7237/781?ijkey=C.kPjYhV51IB .
Medication Errors
One of the major challenges impact healthcare providers is medical errors. These issues are challenging, as they will have an adverse impact on quality and safety. In the case of the ICU, these challenges are becoming more pronounced. This is because of the different conditions and large number of patients they are working with. A good example of this can be seen with insights from Orgeas (2010) who said, "Although intensive care units (ICUs) were created for patients with life-threatening illnesses, the ICU environment generates a high risk of iatrogenic events. Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention. We describe the selection of indicator MEs, the incidence of such MEs, and their relationship with mortality. We selected indicator MEs using Delphi techniques. An observational prospective multicenter cohort study of these MEs was conducted from March 27 to…...
mlaReferences
Data and Statistics. (2014). CDC. Retrieved from: http://www.cdc.gov/hai/surveillance/
Marcucci, L. (2012). Avoiding Common ICU Errors. Hoboken, NJ: Wiley.
Marino, P. (2012). ICU Book. Thousand Oaks, CA: Sage.
McClean, S. (2011). Intelligent Patient Management. New York, NY: Springer.
Errors and oot Causes
Why do Errors Happen? How Can We Prevent Them? (Dr. Lucian Leape's video)
Error is defined as the failure of a planned series of physical or mental activities to attain its planned outcomes, when these failures cannot be attributed to possibility. Errors do not just happen in institutional or inpatient surroundings, but in all surroundings. Errors frequently occur as a result of convergence of several contributing factors. In almost all industries, one of the main contributors to accidents is simply human error. Majority of the errors happen because of equipment failure. Errors could be avoided by: redesigning of the respective equipments to default, a safe mode; minimizing the variety of device models bought; applying clear procedures for checking the respective supplies, equipment and many more; orientation and training of new personnel with the team(s) with which they shall work with, offering a supportive surrounding for recognition and communication…...
mlaReferences
Mastal, M., Joshi, M., & Schulke, K. (2007, December). Nursing Leadership: Championing Quality and Patient Safety in the Boardroom.Retrieved January 30, 2016.
O'Daniel, M., & Rosenstein, A. H. (2008). Chapter 33. Professional communication and team collaboration. Patient safety and quality: An evidence-based handbook for nurses. Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality, Rockville, MD.
Wolf, Z. R. (n.d.). Retrieved January 30, 2016, from http://www.ncbi.nlm.nih.gov/books/NBK2652/
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones is…...
Medical Use of Marijuana
Increasing use of medical marijuana
Having looked at the various areas that medical marijuana has been brought into use and the various forms in which marijuana is administered, it is also important to take note of the various challenges that come with it. There have been various researches that have been conducted that covers the medical as well as the ethical side of the medicinal marijuana, and there have been a dilemma in the balance of the two sides on whether to institutionalize the drug or to stop it, and even on whether the medicinal use can be made to work without the proneness to abuse as is the case at the moment.
Medicinal marijuana has neither medical nor ethical standing within the contemporary society where drug abuse is one of the biggest worries of governments across the world and the alternative medicines that medical research can appropriately come…...
Impact of Electronic Medical Records on Patient Care
The benefits and challenges of using electronic medical records (EMRs) in healthcare delivery
How EMRs have improved the accuracy, efficiency, and accessibility of patient information
The role of EMRs in reducing medical errors and improving patient safety
The potential risks to patient privacy and security associated with EMRs
The impact of EMRs on the patient-physician relationship and trust
Technological Considerations for EMR Implementation
The key technological requirements and challenges for successful EMR implementation
The different types of EMR systems available and their respective strengths and weaknesses
The importance of data interoperability and standards....
A Health Information System (HIS) is a system that captures, stores, manages, and transmits health-related data. It includes a combination of people, processes, and technology that collects, processes, and presents information to support healthcare provider decision-making and improve patient outcomes.
Health Information Systems typically include electronic health records (EHRs), computerized physician order entry (CPOE) systems, and clinical decision support systems (CDSS), among other components. These systems help healthcare providers to efficiently manage patient care, track patient progress, and ensure accurate and timely communication among healthcare professionals.
Overall, a Health Information System plays a crucial role in improving the quality, safety, and efficiency....
Health Information System (HIS)
A Health Information System (HIS) is a comprehensive, integrated information system designed to manage, store, and process health-related data and information. It provides a platform for the collection, analysis, and dissemination of patient health information, facilitating efficient and effective healthcare delivery.
Components of a Health Information System
A comprehensive HIS typically consists of the following components:
Electronic Health Record (EHR): A digital repository of patient health information, including medical history, medications, allergies, vital signs, diagnostic test results, and treatment plans.
Patient Management System: A module for scheduling appointments, managing patient demographics, and tracking insurance coverage.
Clinical Decision Support Tools:....
Impact of Technology on Healthcare in Developing Countries
Introduction
Technology has profoundly transformed healthcare systems worldwide, and its impact on developing countries is particularly significant. By providing access to new medical tools, improving communication, and empowering individuals with health information, technology has the potential to revolutionize healthcare delivery and improve health outcomes in these nations.
Increased Accessibility to Medical Services
One of the primary benefits of technology in healthcare is its ability to increase accessibility to medical services. In developing countries, where geographic barriers and transportation challenges often limit access to healthcare facilities, technology-enabled solutions such as telemedicine and mobile health (mHealth) have emerged....
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