Table of Contents
The principal objective of a professional nurse is to ensure proper care for patients and enhance their health. Nurses provide and direct the care incorporating their knowledge of medicine, patient’s condition, the established diagnosis, and strategies to attain optimal health (National Council of State Boards of Nursing (NCSBN), 2016). They should protect their patients from hazards that might occur in the healthcare setting. Safety control and health promotion need to be ensured in a continuous and coordinated manner. However, today’s healthcare system in the United States appears to be fragmented and complicated, what results in a number of issues, including medical errors. This situation considerably impacts the patient safety, which is one of the main aspects of the proper functioning of healthcare system. According to NCSBN (2016), caregivers have to assess patient’s health and consider all factors that may impact his or her wellness. Nevertheless, the incidence of medical errors in the USA has become so dramatic that it is now considered the third leading cause of death (Makary & Daniel, 2016). Therefore, to prevent medical errors and their consequences, nurses need to be introduced a clear solution and support in addressing this serious issue by ensuring proper care coordination in the healthcare setting.
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Importance
The notion of medical error has many definitions. Some authors define it as a failure in medical treatment that causes a potential harm to a patient. It can also be defined as “any error in prescribing, dispensing or administering medication” (Ofosu & Jarrett, 2015, p. 2). Medical errors in the nursing practice can be caused by different issues, such as lack of coordination between nurses and physicians, interruptions during drug preparation, and poor drug calculation skills (Ofosu & Jarrett, p. 3, 2015).
Medical errors cause multiple issues ranging from the patient’s health aggravation to a fatal outcome. They can lead to complications, disease development, disability, or getting another disease. According to the statistics gathered during an 8-year period, over 250,000 deaths per year occur as a result of medical errors (Makary & Daniel, 2016). It translates into approximately 9.5 percent of all fatal cases in the USA annually (Frellick, 2016). This fact explains why medical errors have become the third leading cause of death, following cardiovascular disease and cancer and preceding respiratory disease.
However, medical errors affect not only patients but also physicians. According to Laurent et al. (2014), most caregivers who have committed a mistake experience its psychological implications for a long time. About 80 percent report that the error remains fixed in their memories while 20 percent say they question their professional competence (Laurent et al., 2014). Guilt, shame, anxiety, and fear are the most common feelings linked with committing a medical error. If these feelings persist, they may exert the negative impact on the caregiver’s personality. Moreover, medical errors are a huge economic burden, costing over $19 billion per year for the state (Andel, Davidow, Hollander, & Moreno, 2012, p. 40). This sum is mostly associated with the prescription drug services as well as inpatient and outpatient care. Additional costs are linked with the increased mortality rates and lowered productivity based on short- or long-term disability claims (Andel et al., 2012, p. 41).
Regardless of the fact that medical errors cause such serious problems, this issue receives insufficient attention and lacks funding (Frellick, 2016). The rate of deaths caused by medical errors is even not included in the reports of the Centers for Disease Control and Prevention (Makary & Daniel, 2016). It is undoubted that this problem requires an urgent solution to reduce or completely stop the incidence of medical errors and decrease their financial and health-related effects on the society. If the issue remains unresolved, the number of affected patients will only increase. People will continue to die from preventable causes. Moreover, it will lead to further disparities in the healthcare system and ineffectiveness of healthcare providers.
Patient Population
Many patients have already experienced the consequences of medical errors on their health. It has been estimated that about 10-15 percent of medical diagnoses are erroneous (Berner & Graber, 2008, p. S3). People with certain health issues are more susceptible to medical errors than others. These conditions include different mental illnesses, food sensitivities and allergies, myocardial infarction, cardiovascular diseases, infection, pulmonary embolism, and other disorders (McDonald, Hernandez, Gofman, Suchecki, & Schreier, 2009, p. 5).
Cultural values may have a large impact on the prevention of medical errors. For example, Americans value dialogue with their doctors. They tend to trust their caregivers, and most patients want to establish a long-term relationship with them. However, if a medical error occurs, it is difficult to facilitate open communication between a patient and a healthcare provider. Trust becomes lost in this case. Therefore, prevention of medical errors will help build a good relationship between a caregiver and a patient.
Solution Proposed
Not all medical errors are avoidable. However, most of them can be prevented by implementing certain actions and changing the healthcare system. Most medical errors, which are reported to the Food and Drug Administration, result from poor communication between nurses and physicians as well as insufficient coordination of their work. Different authors agree that communication breakdowns when patients are sent from one department to another cause the largest number of prescription errors (Makary & Daniel, 2016; Evans & Swan, 2015, p. 7; Laurent et al., 2014; Ofosu & Jarrett, 2015, p. 5; Neale, Woloshynowych, & Vincent, 2001, p. 322). A recent study also revealed that dosage errors primarily occur as a result of the caregiver’s insufficient knowledge about the medication or the patient to whom it is prescribed (Evans & Swan, 2015, p. 8). The abovementioned findings mean that most errors are related to the system, not to individual negligence (Makary & Daniel, 2016). As a consequence, the key to reducing their incidence is not in blaming individuals. After all, nurses and physicians are simply humans, and, like all humans, sometimes they make mistakes. The key to preventing medical errors is in enhancing the system of care delivery, thus helping healthcare providers reduce the possibility of making a mistake and ensuring their effective communication (Evans & Swan, 2015, p. 8; Neale et al., 2001, p. 328). What needs to be done is the elimination of all complexities in the healthcare system. It can be implemented through ensuring proper work coordination between different caregivers as well as introducing Electronic Medical Records (EMR) and other technological innovations into the healthcare setting.
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The utilization of innovative technologies in the healthcare system is significant in improving care coordination and reducing the number of medical errors (Ofosu & Jarrett, 2015, p. 8). It includes the use of electronic prescribing systems, programmable secure cabinets, EMR, and maintenance of records of all issues and receipts for a patient. All utilized systems should be interconnected and available for all caregivers involved in the patient’s treatment process (Ofosu & Jarrett, p.8, 2015). Besides, the use of EMR creates a possibility to share health data as soon as the patient visits a caregiver while the utilization of voice and video communication tools can ease the communication between nurses and physicians (Evans & Swan, 2015, p. 9). In this case, all caregivers will have continuously updated health information on their patient that will include his or her diagnosis, results of laboratory tests and screenings, and current health assessment from different points of view (Evans & Swan, 2015, p. 9).
In addition, the introduction of seamless and coordinated care delivery is essential to bridge the gap in the continuity of healthcare practice. In this case, patients can be provided with effective treatments, and caregivers can develop their skills. To properly coordinate the process of attending a patient, all healthcare providers involved in his or her treatment need to have access to relevant, up-to-date data on the patient’s health, as well as medical history and previous treatment plans (Frellick, 2016). In this case, it is possible to ensure drug reconciliation, which means to make sure that the prescribed medications are not inappropriate, duplicated, or harmful.
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Moreover, if healthcare providers involved in the patient treatment trust each other, effectively communicate and share information about medical records, they can assign successful treatment and prevention plans with the consideration of all past or present chronic and acute conditions of this patient (Neale et al., 2001, p. 328; Makary & Daniel, 2016). Therefore, effective communication between medical staff is crucial.
When such a solution is concerned, the aspects of ethics should also be regarded. If an error has occurred, caregivers need to openly talk about it with their peers, seniors as well as with the patient. They must not conceal the mistake or its consequences. It is ethically required from the healthcare provider to make sure that the patient understands why and how the error has occurred and what the next steps are. Admitting one’s mistakes is also essential to build or restore a trustful relationship with the patient and other medical professionals.
Goals
The short-term goal of the proposed solution is to teach healthcare providers how to choose and use innovative technologies in their work setting. For that purpose, the participation of specialists in innovative technologies is crucial, since most doctors find it challenging to select and use gadgets or electronic medical equipment. Regular lessons and consultations need to be included in the schedule of all healthcare providers. When electronic prescribing systems, programmable secure cabinets, and EMR are successfully used in the patient treatment, this goal will become attained.
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When the utilization of innovative technologies is easy for healthcare providers, it will be possible to achieve a long-term goal, which is to improve care coordination between different caregivers involved in the patient treatment. Creating a positive, supportive environment for all healthcare providers by means of frequent staff meetings, team building, and non-judgmental attitude might be helpful for reaching this objective. As soon as all caregivers become a team, trust each other, share their thoughts, and communicate effectively, this goal is attained. In such a way, communication between caregivers is improved, and care coordination is ensured.
Barriers
The implementation of the proposed solution may encounter certain obstacles. The first is the judgment on behalf of the peers and hospital seniors towards the caregiver who has committed a medical error (Evans & Swan, 2015, p. 8). It may decrease motivation and undermine trust within the team, as well as cause the feelings of shame and guilt. In such an environment, a caregiver cannot share his or her opinion with the peers and seniors or develop professionally. According to Laurent et al. (2014), the solution to this issue should start from the top when fighting against medical errors (p. 7). All healthcare providers need to work in a supportive workplace created with a target to encourage their professional growth. In this setting, medical errors should be perceived as a way to improve the work and discussed without fear of judgment, reprimand, or professional disqualification (Laurent et al., 2014). This approach will encourage caregivers to acknowledge their mistake and empower them to take responsibility, learn from it, and prevent it in future. Hospital seniors need to help their subordinates, coordinate their work, and increase their confidence. It will create a positive atmosphere for communication of all caregivers involved in the patient treatment. Moreover, such environment will help healthcare providers coordinate their care and improve treatment outcomes.
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The second possible barrier is the lack of basic computer skills and knowledge of innovative technologies. Many doctors find it difficult to accustom to these new systems. Some of them are not advanced computer users while others lack time and experience to choose proper technologies or consider their use to be too expensive (AARP, 2016). The strategy to eliminate this barrier consists in finding specialists who will instruct healthcare providers on utilizing computers and then complicated electronic prescribing systems, programmable secure cabinets, and EMR on a regular basis. The active involvement of all healthcare providers in the teaching process is crucial for the successful outcome.
Benefits
The benefits for patients include the increased safety, more efficient interaction with medical specialists, and better understanding of his or her medical condition. Moreover, since all patient records will be stored on electronic devices and accessible only to the caregivers involved in his or her treatment, the privacy of these records will be maintained. Overall, all these benefits will lead to increased treatment effectiveness and improved care outcomes.
The benefits of care coordination and use of innovative technologies are undoubted for caregivers. They include the development of their professional and personal skills. If all caregivers work as a single team, it will enhance trust and create the positive ambiance in the hospital, what will be beneficial for everyone. The reduced healthcare system disparities will facilitate the work process for nurses and physicians and make it more effective. Furthermore, when a patient visits a new healthcare provider, the latter needs to know as much as possible about this patient’s condition (Makary & Daniel, 2016). If caregivers can access correct, up-to-date patient information and see treatment plans provided by other doctors, he/she may avoid such errors as the prescription of inappropriate, repetitive, or conflicting medications, omission of required medications, oversight of chronic conditions and health risks, and improper treatment. In case caregivers use EMR and other technological innovations in their practice, it is possible to avoid errors associated with unclear handwriting as well as prevent confusion and reliance on memory. As a consequence, the improvement of care coordination with a simultaneous introduction of innovative technologies in the care process can solve the issue of medical errors.
Participants and Interdisciplinary Approach
To increase the effectiveness of the introduction of improved care coordination system and use of technological innovations, all nurses and physicians should be involved. They also need support from outside the nursing, and this support can be provided by hospital seniors and specialists who can teach them to select and use information technologies. Both of these parties can benefit the process. Hospital seniors may create an atmosphere of trust and confidence in the hospital where no one is afraid of sharing thoughts, opinions, and ideas (Laurent et al., 2014; Neale et al., 2001, p. 328). It will help healthcare providers build an effectively functioning team that successfully treats patients with different conditions. Besides, hospital seniors also need to encourage caregivers to continuously develop their skills and undergo professional development courses (Evans & Swan, p.9, 2015). In their turn, instructors of information technologies should assist healthcare providers in choosing and integrating innovations into their healthcare practice and use them efficiently. These instructors should do it with consideration of the caregiver’s profession and requirements while explaining how a specific technological innovation works, why it is better than others are, and how it can help improve the patient’s care outcomes (AARP, 2016, p. 20).
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Conclusion
Patient safety is one of the most important aspects of healthcare. For this reason, it is necessary to stop or reduce the incidence of medical errors. They exert an impact not only on patients and their health and life but also on caregivers who tend to experience psychological issues and doubt their professionalism after committing a mistake. Moreover, they affect the country’s economics due to the high annual costs of medical errors mitigating. This serious problem should get a sufficient amount of attention and research funding. To ensure its elimination, a change in the healthcare system is needed. The process of change should involve nurses, physicians, hospital seniors, and innovative technologies specialists. Care coordination is a decisive factor for preventing medical errors and achieving successful care outcomes. Nurses and other caregivers should become a team, work together, and communicate effectively. They should also get support to facilitate the use of innovative technologies and ensure their professional growth. The implementation of these changes in healthcare is crucial for preventing errors, optimizing care quality, and increasing patient safety.