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Patients Have Key Role in Reducing Medical Errors

By Sharon A. McNamara, RN, MS, CNOR

(ARA) - If the United States is to ever curb the alarming number of deaths and injuries each year caused by medical errors, patients must learn to take charge of their healthcare and be vocal in demanding that safe practices be followed.

A landmark report in 1999 by the Institute of Medicine, To Err is Human: Building a Safer Health System, estimated that as many as 98,000 people die annually as a result of medical errors. Unfortunately, a recent analysis of the report concluded that over the past five years there has been no significant overall reduction in injuries or lives lost due to medical errors.

While progress has been slow, the report was a wake up call to the medical community and has prompted the creation of numerous patient safety initiatives by hospitals and various medical associations and groups. 

The organization I head, the Association of periOperative Registered Nurses (AORN), has been a long-time advocate for improving patient safety procedures. Our 40,000 members work on the frontlines caring for patients from pre-surgery, to surgery and through recovery. We know first hand what can happen when proper safety procedures are not followed.

What we have found, and many studies have confirmed, is that systems failures cause most injuries, not bad physicians, nurses or clinicians. What is sometimes lacking in hospitals is a “culture of safety” that nurtures teamwork and produces a commitment on everyone’s part to establish and follow specific safety procedures.

To assist and encourage patient safety efforts, AORN last year inaugurated National Time Out Day to urge health professionals to take a “time out” before a surgical procedure is performed and review a check list ensuring patient safety procedures are being followed.

The success of last year’s event led to introduction of a bill now pending in Congress designating a date in June as National Time Out Day. A different aspect of patient safety will be spotlighted each year.

While promoting patient safety among our fellow health professionals is essential, we feel patient safety is far too important to be addressed only by the medical community. That is why our members encourage patients to take an active, informed role in their healthcare, particularly when they are facing surgery.

Our emphasis this year on reducing medication errors was prompted by a survey of 1,600 hospitals conducted by the Institute for Safe Medication Practices that found that only 41 percent of hospitals always label medications and solutions used in operating room settings. An alarming 18 percent of the hospitals don’t label containers at all and another 42 percent apply labels inconsistently.

Medication errors injure as many as 1.3 million people annually, according to the U.S. Food and Drug Administration. The 1999 Institute of Medicine report estimated that 7,000 people die each year from medication errors.

Going through surgery is an anxious experience for patients and the hospital setting can be intimidating. But it is important for patients to speak up and not automatically assume their health care providers have all the answers. Other tips for patients to follow in order to help reduce the chance of a medication error during surgery and in the hospital include:

* Know your medical history and make sure that your health care professionals know it too. This includes what medications you are currently taking (name, dose, and schedule) and what you’ve been on previously, including prescribed medications, herbal supplements and vitamins. 

* Be aware of the medicines that you cannot take due to allergic reactions, and share those with your doctor or pharmacist. Also tell them if you are taking something unusual.

* Know what your medications look like in order to ensure that you are consistently receiving the right one.

* Do not let anyone give you medication without checking your ID band beforehand. Make sure the nurse checks all the details against your armband to verify it’s the right patient, the right medications and the right dose. 

* Be vocal – don’t be afraid to ask questions in the pre-op area, including “what are you giving me?” and “why are you giving it to me?” and “what are you going to do to keep me safe?”

* Ask if taking the medication requires you to avoid certain foods, beverages, other medicines, or activities or if you need to alter your behavior in any way. 

* Tell your health care provider how you actually take your medication, especially if this is different from the originally prescribed directions. 

* Question anything you don't understand or that doesn't seem right.

Courtesy of ARA Content

Editor’s Note: Sharon A. McNamara is the president of A.O.R.N. and director of surgical services for WakeMed Health and Hospitals in Raleigh, N.C.

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