Causes of Medical Errors
In research, it has been found that In the United States, the chief causes of demise are due to medical errors. Around 14 per cent of patients are becoming the victim of such medical errors. Medical errors in the health care system can occur at any hospital, nursing home, surgery centres and pharmacy (Gupta et al., 2019). The most common error observed in the health care system is medication error, sparse monitoring after a procedure and, technical medical errors. In various studies, it has been found that children are at higher risk of encountering medication errors. They are at risk because of insufficient communication with the medical professional at hospitals and the health care system. Medication errors generally occur due to wrong medication, dose omission and inaccuracy in administration techniques. Bahrain country of the Middle East has reported most cases of Medication errors; the omission prescription was at the top and has been reported as 89.28 per cent of medication errors. Sometimes unfavourable drug reactions might occur in the body, which may lead to the death of the patients (Ottosen et al., 2018). The most common error is ill-suited medication use, and the medication errors can occur at any stage of the process; in these kinds of activities, medical professionals such as nurses and physicians are involved. Wrong and inappropriate dosage is given to the wrong patient, a leading cause of medication errors in the medical field. Communication-related issues cause most medication errors; some difficulties generally involve illegible and misinterpreted medication (Manias et al., 2019). Scope of this trend will assist in the different health systems, these are: medications are available from health care providers all around the world. However, with increased drug use comes an increased chance of side effects (Erlewein et al., 2018). This is exacerbated by the necessity to prescribe for an ageing population with a growing number of chronic diseases—sophisticated medical needs and the launch of a slew of new drugs. In primary care, these challenges are very important. In many circumstances, the prescription is a difficult task (Szilagyi et al., 2021). Those started in general care, and those started in hospitals can both be continued in the primary care setting.
There are different kinds of issues related to medical errors in health care issues. Some examples of these errors in medical health care systems are communication problems, inadequate information, human problems, patient-related problems, technical problems, staff patterns, and workflow (Senders, 2018). In research, it has been found that nursing communication measures any hospital or health care system's rating.
The communication of nurses with patients is vital to finding out the actual problem. It also supports building a relationship with patients to avoid medication errors. The best practices involved in communication with a patient require communication boards, roundings, and respect. Nursing communication is an important factor that helps make the culture and courtesy that a patient expects (Park et al., 2018).
Some of the questions that can be dealt with while communicating with nurses are:
- How often did nurses with patients treat patients with respect and courtesy while staying in the hospital?
- Did nurses listen to the patients patiently or carefully?
- How often are nurses able to communicate and understand the patient's requirements?
- How often could nurses have explained things to the patients in a way that they can understand?
Best Practices for Communication with Patients
The best practices or the communication between patients and nurses can be regulated through various tactics, such as courtesy and respect; in a study, it has been found that non-verbal communication skills such as showing respect and kindness are most actual words to communicate with patients by improving the communication skills such as speaking softly, patient care and patient satisfaction. All these tactics are important to adhere to effectively exemplify courtesy and respect (Robertson & Long 2018). Another important tactic is to give clear explanations; this is required to communicate the clear medical treatment process. Right communication and regulation of consistency are important for the patient's experience. Listening is another factor that can help in reducing medication errors. Listening is important for nurses and medical staff as it can impact patients as to how the medical staff is listening and about their satisfaction (Amudha et al., 2018). With the listening problems of patients, nurses will be more efficient or attentive to the requirements of patients so that nurses can better communicate and care for them accordingly.
The flow of the information should be maintained by the hospital staff while discharging the patients. The medicines and other prescriptions should be clearly explained to the patients so that they can take care post-discharge at their homes. The health care providers should communicate more effectively about the steps of discharging (Tyynismaa et al., 2021). All the instructions should be made clear and repetitive for admission and discharging the patients. Medical staff or health care providers should be able to form an always culture; they should identify the requirements and discuss the plans, preferences, and plan for the patients' discharge. Written health information can be provided to the patients, including the side effects and medications that a patient needs to take (Assiri et al., 2018). Patients and family members are required to be vigorously involved during the time of discharge planning. While sending the patients home, the families should be provided with a detailed plan for further medication, and if there is a requirement for the next visit, the patients and families should be informed. This supports improving or making better adherence during discharge instructions. This will help in improving better health care results (Diong et al., 2018). When patients return to their homes, doctors and nurses should make a clear list of diet and medications so that patients can easily understand and can follow them. Every instruction needs to be clearly explained by nurses about the dosage, purpose of taking medicine and the side effects (Assiri et al., 2018).
On the discharge day, health care providers must ensure the paperwork, and it should have had some important points, such as reviewing patients' diagnosis, the outcomes of the test being conducted during the stay of patients, treatments received by the patients, observation of symptoms and medication need to follow after discharge (Tyynismaa et al., 2021).
Some of the questions that can be asked from patients in getting the information concerning the patient's transition care are:
- Had the medical health care providers taken the preferences of the patients and their family members, and what medications and health care would be required when the patient is discharged?
- When are patients discharged from the hospital, whether they had a better understanding of various things in providing care?
- Whether the patients recognize the importance of taking each of the medications?
Effective Discharge Planning
In a study, suggested that inadequate information flow can result in various issues such as scarcity of vital information when required can greatly influence prescribing medications. Improper coordination of various medications orders should be maintained as this can also affect the health while taking improper medications (Motter et al., 2018).
In the current scenario, life has become fast through the help of technologies as the advancement of technology has provided better medical surgeries and care to the patients in a short time—robotic surgery accident. In a report, it has been found that between the years 2000 and 2013, around one hundred forty-four patients died during robotic surgery during failure of technology, and about one thousand three hundred ninety patients were injured (Van cott, 2018). It has been observed that these technical failures occur due to the machines' electrical sparking and internal issues. Many times, it has been found that most injuries and death occur because of the failure of these technologies. Before starting a surgery, technicians should ensure the technical problems so that the rate of failure can be avoided (Muller et al., 2019). Fear punishments have made the medical staff for reporting the errors, as they will also have a fear of losing their jobs. Unfortunately, the patients bear this loss as impacting injuries or by deaths.
Some rules are imposed by the Joint Commission to ensure patients' safety to develop a safer environment for the patients. The different goals of this commission are: To recognize the danger and risks involved. They are preventing the infections by curing with antibiotics and implementing some precautions. The labellings should be checked twice, and it should be ensured to provide the correct medication for patients (Rodziewicz et al., 2021). Proper labellings should be made on syringes and samples.
The Joint commission of health care had found the root causes of failure, and they had created improvements for the actional plans to reduce the injuries and deaths of the patients. For example, if a patient has an allergy to a prescribed antibiotic and develops some anaphylaxis, the patient dies. The death of such cases can be prevented by educating the medical staff concerning drug-drug interactions (Rodziewicz et al., 2021).
Defective infusion pumps usually assist in providing the nutrition and medication to the body directly. Failure in such pumps can result in an adverse effect, and the patients will not be able to get nutrition and will not be able to recover (Konttila et al., 2019). The FDA announced some of the steps in improving the safety of such pumps so that the patients' deaths can be reduced significantly. Defects in camera that full scan body, when there is a failure it will nor be able to find out the presence of oxygen levels in the body while operations (Konttila et al., 2019).
In a study, it has been found that about 1.5 million patients are affected by medication errors every year. In a review of Pennsylvania, a seventy-one-year-old lady has been given thiothixene (Navane); it is an antipsychotic, she must be provided with medication of anti hypersensitive medication amlodipine (Norvasc) for a period of one hundred twenty days (Da Silva & Krishnamurthy 2016). The patients developed some of the symptoms and physical harm that embrace ambulatory dysfunctions, tremors and personality changes. Despite her giving medical care, the old patient was overlooked by the health care providers. These errors occur at different levels, including prescription, pharmacy dispensation, and hospitalization. Adverse drug medication and overlooking the symptoms have reported many deaths of patients (Da Silva & Krishnamurthy, 2016). The nurses and medical staff do not report medication errors, adversely affecting the care providers and the economy.
Importance of Patient Engagement in Transition Care
Medication reviews are important that support the evaluation for the improvement in the health outcomes, and some of the interventions can be implemented to reduce the errors. Education is a vital aspect for improving the safety-related concerns of the patients (Hammoudi et al., 2018). Nurses and medical staff should be educated about drug interactions that can generate some allergies in the body, so it should be thoroughly studied so that any further errors can be stopped (Billstein-Leber et al., 2018).
Some of the strategies required for implementation to reduce medication error in health care systems are; nurses and medical staff should be educated concerning the common causes of the medication errors. The medical staff must be provided with different tools to support the safe medication prescription (Sarfati et al., 2019). It should be ensured that pharmacists are proactively reviewing the process of medication. A computerized system must be used as it may help in reducing errors. Research must be conducted on medication errors to develop better interventions to minimize the errors in health care systems. The patient's involvement and the family members are important to enhance the patient's safety. Family members support empowering patients to communicate what are the symptoms so that proper treatment can be done. Building a positive safety culture also assists in ensuring and promoting safety in primary care; it will help the patients communicate with medical staff without any hesitations, and they will be able to speak freely (Hammoudi et al., 2018). This will improve the feedback of the medical staff and will promote transparency to form a better safety culture. Checklists can be made to monitor the safety of patients, and in this way, patients can be provided with medications on time. Data quality also ensures the improvement in safety measures as it will support in regulating the risks and recognizing the strategies for improvement. Electronic systems should be used to record the data and the supporting diagnosis of the patients. It also helps in improving the management of various diseases (Sarfati et al., 2019).
There are several rights of medication administration: right patient, right medication, right dose, right route, right time, right documentation, right to refuse, right assessment, and right evaluation. The right patient can be recognized through the prescription and the wristband. The right medication allows to check the expiry dates of medicines and the prescription, and it should be ensured that medication is taken properly. The right dose allows the use of the appropriateness of medication. The right route confirms that the patient can take medication by the ordered route. The right time is essential for checking the frequency of the recommended medication. Right to refuse allows the consent of the patient for administration of medication.
Health care providers believe that using electronic technologies will help improve medical care, lower costs, and promote safety and surgeries; however, these technologies can also cause errors, which may harm the patient adversely. Solution to reduce the impairment of the electronic technologies is to provide trained operators and their availability during emergencies, and they should be trained on every piece of equipment. Regular maintenance is required when the signs of slow performance are detectable. This will help in reducing errors during medical surgeries. These device errors are due to inadequate maintenance and repair, improper plans for their replacements and poor technology interface that usually impacts the patients and the environment. Mishandling the instruments sometimes also cause errors. With the proper handling of the medical instruments, their (instrument) life can be increased, and they can work efficiently during any medical procedure. If the operators are not qualified, they should be not allowed to use the equipment. Sometimes a situation may arise for proper troubleshooting of the instruments; the most experienced operators are required to operate the instruments. During the stay of the patients in hospitals, chances of infections in different body parts may increase, so there is a need for preventing some infections by providing good medication. Hand washing is a productive method to minimize the rate of infection. Usage of sepsis bundles can decrease infections (Hans et al., 2021). The disease can be controlled through the utilization of various perspectives such as changing the gloves when treating each of the patients, by keeping the nails of patients as well as nails of nurses short, alcohol-based sanitizers should be used to reduce infections (Kletz et al., 2020). Some of the errors in information technology can be reduced by using the automating dispensing devices, by applying the barcoding and speedy action for drug interactions. The important points that a nurse or medical staff should ensure that to maintain good communication with patients for better understanding, check all the equipment prior to use so that technology error can be avoided and usage of computerized order entry can be made to progress (Hans et al., 2020).
Conclusion
With the growing population and to expect a longer life expectancy, there are more chances for medication errors. Various efforts can be implanted to include patient instructions and overall communication with the patients. Mandatory training can be provided to the medical staff of the health care system concerning the errors and adverse events in hospitals. When there is a rise in initial symptoms, nurses and medical staff should ensure the to provide safeguards and different medications to reduce the errors. With the development of communication, kindness, respect and teamwork, one can learn their misunderstanding or flaw in the hope reduce infections and medication errors. The flow of information should be proper and better prescription can help the patients effectively. Strong or good coordination of patients with nurses assist the patients in providing better medication, and it also reduces the risk of medication errors.
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