Hospitalization Risks: Patients at Risk of Clinical Errors & Unsafe Medication - Research Paper

Introduction

According to the World Health Organization (WHO) (2018), patient safety and health improvement are not guaranteed upon hospitalization. The possible incidents of clinical errors during provision of healthcare might lead to patient harm; this problem claims about 42.7 million adverse events annually around the world, within the hospitalized population. The WHO states that for every ten patients, one is harmed while in the hospital due to factors such as the use of unsafe medication. Other risks that might result in patient harm include the risk of being infected by other diseases while in hospital, surgical complications, incorrect and inefficient diagnoses, and exposure to radiation. If these risks are managed to reduce patient harm, the U.S. government and other governments around the world can save on Medicare; for instance, the U.S. government saved about $28 billion between 2010 and 2015, due to improvements in clinical safety. This paper discusses a possible way to minimize patient harm.

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Proposed Solution

According to Makary & Daniel (2016), medical error is one of the leading causes of death in the United States; however, the human is to err. Therefore, these errors cannot be entirely eliminated, but they can be regulated through various error prevention interventions, to reduce the number of deaths that they cause. The following strategies can be used: making errors visible once they occur so that action can be taken to fix them, having immediate treatment to rescue the patient, and making the occurrence of errors less often. Although technology is described as part of the problem and part of the solution (Powell-Cope, Nelson & Patterson, 2008), both technological and nurse effort can be instrumental in reducing cases of patient harm. Although nurses can minimize the problem by avoiding oral orders, writing legibly, and checking patient names well before administering medication, computing devices can be an auxiliary aid.

According to Gesme & Wiseman (2008), medication errors can be minimized through the use of systems such as Computerized Provider Order Entry (CPOE). Use of information technology intervention in healthcare increases patient safety by reducing medication errors, enhancing decision making, and improving timeliness. However, many might argue that some technologies have not reduced medical errors significantly because the devices used are controlled by human beings, who are capable of making errors, and due to system errors. Constant software and hardware updates, and staff training can resolve the problem of inefficiency of Health Information Technology (HIT) systems.

Feasibility of the Interventions

Over the decade, there has been a rapid increase in the use of healthcare technology in different hospitals around the world. Therefore, offering additional training to medical staff on what they already are familiar with will be an easy task, just like keeping the systems up to date. Also, hospitals that are not using HIT can easily install the systems since they are readily available in the market affordably. In their article, Alotaibi & Federico (2017) confirm that evidently, HIT devices improve patient safety by minimizing medical errors; for instance, CPOE and Clinical Decision Support (CDS), Patient Data Management System (PDMS), and Automated Medication Dispensing (ADC) have been beneficial in eliminating errors. There are other technological tools used in the health industry; however, the research done has not been able to provide evidence on their effectiveness in increasing patient safety. Furthermore, general training for nurses and other medical practitioners on ways to patient harm is possible since the process does not consume much time, and it might not affect their job schedule.

Methodology

According to Alotaibi & Federico, the outcomes of using health information technology varies from institution to institution; therefore, it is arguably true that some health institutions benefit from technology more than others. All health institutions can improve patient safety by identifying the specific areas where technology can help in eliminating risks to patients, involving key stakeholders, and most importantly the patient in the implementation of the technology. Other methods that will improve healthcare safety include making informed decisions when choosing health technology, including reviewing its effectiveness, and latest hardware and software; this will eliminate the risk of purchasing systems that are not beneficial in increasing patient health. Also, proper training for all hospital staff on the use of the technology can result in minimal errors when handling the systems, and there is need to monitor patient safety outcome constantly, to know whether the technology performs to expectations. Finally, the technology used will be customised according to patient needs, and also regularly updated (both hardware and software updates to ensure mechanical stability, and to keep up with the developing standards in regulation and clinical practice. However, research will be conducted to find out the needs of different hospitals in expanding the level of patient health.

General staff training will be done comprehensively to minimize errors they can make as individuals with or without information technology systems. The training will be done in three-hour sessions during the weekends for two months, to ensure that all nurses and other medical staff benefit from the activity regardless of their scheduled shifts. The training program will be achieved with the help a team of health technology specialists, and experienced doctors who have profound knowledge on healthy patient handling practices and effective medication that minimizes cases of patient harm. Also, the team of health IT specialists will guide the hospital management of the proper ways to make purchase decisions and implementation of various HIT systems to ensure that the technology employed increases patient safety. The specialists will also be consulted to find ways to minimize errors during surgery when using HIT devices, and the appropriate systems to install. Apart from a suitable venue for the attendance of health personnel and the speakers who will be training them, no additional resources will be required.

Expected Outcome

By the end of the training period, nurses are expected to have improved their observation skills and carefulness when handling the patient. Also, several error scanning stages will be implemented to make risks more visible, in order to minimize the risk of unnoticed patient harm events due to accidents. The usefulness of technology in increasing patient safety will improve since hospitals will only be using relevant techniques that prove efficient for their intended purpose. Moreover, nurses will be able to minimize medication errors with the help of technology, and several practices such as clear prescription and double-checking patient information before administering treatment. Teamwork is expected among the nurses to ensure the well-being of each other, resulting in reduced cases of errors, and clarity in the diagnosis of diseases. The success rate of surgeries is also expected to go up, with reduced cases of patient harm resulting from surgery mistakes.

With the decreased cases of patient harm, patient safety in hospitals is expected to go high, and the mortality rate is bound to decrease. Therefore, the national government is expected to minimize its expenditure on healthcare and increase savings, due to reduces cases of events.

Outcome Impacts

According to Ahmed et al. (2014), the wellbeing of nurses and resident duty hours (RDH) have a direct effect on patient outcomes; therefore, patient safety will depend on the safety of the health practitioner. Hence, having ample training time and RDH restrictions that are favourable to the residents will significantly reduce the cases of surgical errors, and increase patient safety.

The use of electronic systems such as CPOE, CDS, patient portals, telemedicine and ADC in healthcare will increase to minimize medication errors; therefore, health caregivers will rely more on technology than the conventional methods of prescription and medication. However, the use of health information technology will accompany the need to hire IT personnel to maintain the systems and to continually update them as required.

Some patients might be selective with hospitals because different hospitals guarantee different levels of patient safety; improving patient safety in such hospitals will lead to increased patient trust. Also, leaders and other key stakeholders in the health industry will become more involved in trying to implement solutions to patient harm. The overall effect of this participation will not only be reduced cases of medication errors and surgery errors but also reduction of hospital infections. Also creating partnerships with other hospitals and healthcare institutions will be instrumental in managing healthcare problems and patient safety since partnerships allow organizations to learn from each other and adopt techniques that seem beneficial to the quality of services they provide.

References

Ahmed, N., Devitt, K. S., Keshet, I., Spicer, J., Imrie, K., Feldman, L., ... & Kulkarni, A. V. (2014). A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Annals of surgery, 259(6), 1041.

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173.

Gesme, D. H., & Wiseman, M. (2012). Reduce risks to patients in your practice. Journal of oncology practice, 8(1), e11.Makary, M. A., & Daniel, M. (2016). Medical error-the third leading cause of death in the US. Bmj, 353, i2139.

Powell-Cope, G., Nelson, A. L., & Patterson, E. S. (2008). Patient care technology and safety. In Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US).

WHO. (n.d.). 10 facts on patient safety. Retrieved May 13, 2019, from https://www.who.int/features/factfiles/patient_safety/en/