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Short term and long term impacts of medical errors

Discuss about the Description of the Medical Situation Case Study Leg Ulcer Injury Dressing Injury.

The case study involves a patient who is receiving home visit by a registered nurse for leg ulcer injury dressing injury, in every 4 days for a period of 5 weeks. Upon arrival at the hospital and diagnosed, he is found with acute pneumonia acquired through the community set up. After 10 days, the patient was discharged from hospital to home care, test assessments reveal that the medication earlier on administered needed to be reduced to 2 mg dose, Nifedine 10 mg TID, Coumadin 2 mg, Deoxycylcine  100 mg for 6 days administration with Nitrospray drug used for dressing the ulcerative leg in weekly basis. The dressing was advised to be resumed after with weekly bath. Meanwhile the registered nurse was to resume the diagnosis and visits at the home facility. As the client was being discharged, his neighbour picked him from the hospital. She took the new prescription given in the hospital, so the neighbour agreed to get the drugs for the client and some few groceries in the market and drop them at the hospital. The pharmacist at the chemist gave the neighbour the new information sheet with the new drug administration, which later the neighbour provided them to the client.

As the neighbour dropped the drugs to the client for consumption, it was the time at which the client was supposed to take medication. The client was so exhausted, so he decided to take the medication however as he was trying to reach for his glasses to read the prescription. However, he was so tired and could not find the glasses and noted the new pills and took the drugs as was prescribed in the hospital.

The client had taken wrong medication; the prescription given by the chemist was not conforming to the drug prescription of the hospital. The new drug had exerted anti coagulant effect in the body. The client was overpowered by the drug and felt so weak and unable to make any movements. The patient slept in bed till later on when the ambulance was called in after visit by the nurse. However already medical error had been committed and the patient had to be rushed for emergency care in the hospital. The neighbour was traumatised on his part that he had procured harmful drugs for the client. This tormented him so much.

Response of senior management on medical errors incidences

It is often said that ‘to err is human,’ medical errors are common phenomenon and have been found to have dilapidating impacts on the medical practitioners who fall into third victims, (White & Gallagher, 2011). In America research has shown that many people die as a result of medical errors which range from the auto mobiles accidents and statistics have shown that they are about 98,000 deaths per year. Most medical errors often go unreported, (Harolds et al., 2015). Due to this under reporting little has been established as to determine these cases. Self perceived medical errors have been found to be common among the health practitioners.

As a result of this medical errors, second victims often feel feelings of guilt, much disappointment, a lot of fear and feeling of inadequacy which often have varying lengths levels, (Hobgood et al., 2005). The impact of these medical errors on the second victims has been a key area often needing attention. Second victims who are in the medical practice who take responsibility for the mistake have been shown to be more likely to report these mistakes often and make constructive adjustments.

Long term impacts have included the reduction of emotional state of the medical practitioners well being, the quality of life, professional practice and conduct. The second victims often feel more guilt, upset depression and being scared. Others often have reported that it affects job satisfaction, ability to sleep, depressions and sacredness. Second victims have been found to have difficulty in adapting to coping strategies to manage the case.

When tackling this issue, the role of senior health staff professionals should be supportive in nature and offer non judgemental approach to the second victims when medical errors occur. Among the health care organization there has been no specific roadmap for tackling medical errors. In the teaching fraternity there is no proper teaching on medical errors handling. At the current state of affairs the senior management staffs needs to ensure that there are proper reporting system of medical errors among the patients in the health care homes, (White et al., 2011).

The health care management staffs need to facilitate proper health care professionals support and proper counselling services to the second victims. Some of the organizations often provide some type of employee staff support after the incidence occurrences. There is need to improve on the systems so as to minimise on medical errors. The management staffs need to provide safe environment which don’t promote the occurrence of the medical errors.

Impacts of medical errors on organizational culture

Second victims need formal support frameworks which gives them an opportunity to avoid the pervasive nature of the medical harm which is caused by the incident. There is need for removal of barriers which often are the blocking blocks of the effective support systems on the patients, (Scott et al., 2009).

Creation of strategies which focus on the on the second victims have often risen. Providing them with educational skills of coping strategies is effective in solving the issue. Providing them with emotional support is effective in solving the issues they are facing and overcoming these challenges, (Bell, Moorman & Delbanco, 2010).

Organizational culture has been found to be closely associated to the health care staff. Safety culture window often represents the staff understanding of the hazards of often encountered in the health care work place, (Singla, Kitch, Weissman, & Campbell, 2006). Patient safety has been an important avenue in the health care work place and has been shown to have impact on the general staff in the organization.

Medical errors have an effect on team work performance. In organizations it has been stated that humans are systems which rely on err free performance which are doomed to fail. The need for patient safety has been observed to provide non punitive open disclosure by the individual staffs on the individual staff accountability and ensures team performance.

Relational co-ordination has been linked to medical errors on teamwork co-ordination. It affects on timely and accurate information reporting and response, effects on mutual respect, common goals, shared knowledge view and respect of the staff.  Future medical errors leads to reduce levels of team level management as it leads to barriers in team building and coordination among staff and workers in the health set ups.

Organizational systems in managing medical errors

Management of medical errors should be linked to proper organizational management process. Safety paradigm process should be ensured that they play key role in managing the staff levels. There is need for fully functional systems of care in which are interdependent on specialized functional systems.

There is need for addressing system change in organizational management strategies in health care. Systems changes can be linked to the occurrence of addressing supplies shortage and proper equipment process which are geared towards minimising medical errors, (Cunningham et al., 2007). The need to incorporate information technology in health care practice is a component of system change is effective in error reduction and minimising harm among the clients. There is need for incorporating computerized physicians order entry systems and clinical support systems which are aimed at addressing the information technology issues which aid in reduction of errors, (Btaes, et al., 1998).

Organizational systems in managing medical errors

Effective support from the health care organizations need to be based on the premise of reliable and effective management policy which is aimed at reducing the chances of recurrences and avoiding medical errors. Enhancing solid intervention like building of new hospital information systems and reviewing the process often involved in removing hazardous effects of drugs.

The handling of medical errors is strongly linked to the choice often take by the organizations to disclose these errors. The manner in which the information is passed and disclosed to the family members plays critical role in managing medical practitioner’s actions, (Zimlichman & Bate, 2012).

The approach adopted in managing the errors is often made in such a way that it is professional. Evaluation of the errors committed in health care is essential in managing errors and its consequences. Health care organizations need to be honest and incorporate participative and accountable models of handling manner among the staff often regarded as second victims, (Scott et al., 2009).

Enhancing effective communication and collaboration and ensuring adequate administrative support for clinical safety is essential in supporting staff. Organizational psychological support is essential in managing the staff to handle and mange post effects of medical errors.

The second victims have crucial role in managing the occurrence of medical errors, there is need for assisting the organizations in refashioning health care systems on minimizing of errors that are recipe for harm. There is need to be cognisant and acknowledge on the need to better handle ways of handling harm when they occur, (HHs, 2010).

Conclusion

Hence with this view, there is need for more organizational support in enabling the staff to manage medical errors which have negative harmful effects on the life and general working conditions. Having a well established community which offer effective social support is essential in managing medical errors when they occur. Thus building conducive environment which provide support between the staff and the organization is crucial to facilitate medical error management process.

References

Bates DW, Cohen M, Leape LL, et al. Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc. 2001;8:299–308.

Bell SK, Moorman DW, Delbanco T. Improving the patient, family, and clinician experience after harmful events: the “when things go wrong” curriculum. Acad Med. 2010; 85: 1010?1017

Cunningham TR, Austin J. Using feedback, goal setting, and task clarification to increase the use of the “hands free” technique by hospital operating room staff. J Appl Behav Anal. 2007;40:673–677.

Harolds JA. Quality and Safety in Health Care, Part III:To Err is Human. Clin Nucl Med. 2015;40(10):793–795.

HHS Office of Inspector General. Adverse events in hospitals: national incidence among medicare beneficiaries. November 2010. OEI-06-09-00090 https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.

Hobgood C, Hevia A, Tamayo-Sarver JH, Weiner B, Riviello R. The influence of the causes and contexts of medical errors on emergency medicine residents’ responses to their errors:an exploration. Acad Med. 2005;80(8):758–764.

Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the health care provider "second victim" after adverse patient events. Qual Saf Health Care 2009;18:325-30.

Singla, A. K., Kitch, B. T., Weissman, J. S., & Campbell, E. G. (2006). Assessing patient safety culture: A review and synthesis of the measurement tools.Journal of Patient Safety, 2, 105–115. doi:10.1097/01.jps.0000235388.39149.5a

White AA, Bell SK, Krauss MJ, Garbutt J, Dunagan WC, Fraser VJ, et al. How trainees would disclose medical errors:educational implications for training programmes. Med Educ. 2011;45(4):372–380. doi:10.1111/j.1365-2923.2010.03875

Zimlichman, E., & Bates, D. W. (2012). National patient safety initiatives: Moving beyond what is necessary. Israel Journal of Health Policy Research,1(20). Retrieved from https://www. ijhpr.org/content/1/1/20/abstract

White AA, Gallagher TH. After the apology-coping and recovery after errors. Virtual Mentor. AmMed Assoc. 2011;13(9):593–600. doi:10.1001/virtualmentor.2011.13.9.ccas1-1109.

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