Medical errors cause up to 98,000 people to die annually in the United States. They are the fifth leading cause of death and cost the United States $29 billion annually (Kohn 1999 in Al-Assaf, 2003). Medication errors result in devastating effects on the practice of a healthcare worker and a hospital where it is reported. It increases morbidity and mortality. It also heightens hospital cost and promotes litigations with concomitant bad PR. Healthcare administrators must be proactive to prevent these errors by creating learning communities among healthcare workers. They must rise up to the occasion when it occurs by tackling the challenge with tactful tenacity.
Causes of medication errors
Medical services by trainees has its associated risks particularly medication errors. Lack of technical expertise, error in judgement and breakdown in teamwork are leading causes of medical and medication errors. These are particularly common among trainees (Singh, 2007). Poor training is usually responsible for inadequate technical expertise. There is a minimum standard for every specialty in medicine: medicine, nursing, pharmacy and laboratory science. However, when situations arise that is beyond the medical expertise of a professional, the person can call a superior, or commit a medical error due to inadequate skill to tackle the problem.
Lack of supervision is also one of the causes of medication errors especially among trainees (Singh, 2007). It reflects teamwork breakdown between superiors and juniors. Interns and nursing students who are not well supervised by their superiors can make mistakes; in the former the prescription dosage may be inappropriate while in the latter, administration to patients may be incorrect or done at the wrong time. Santell et al (2003) prove through an internet based reporting system that 'performance deficit and procedure/protocol not followed were consistently identified as causes of error'.
Effects of Medication Errors
Medication errors can have devastating effects on patients. A disease can get worse; patients may deteriorate and may even die. In some cases, serious allergic reactions could result. In asthmatic patients who are mistakenly given non selective b-blockers, they could develop life threatening asthmatic attack. In a similar way, a patient on treatment for peptic ulcer disease who gets non steroidal anti-inflammatory agents (NSAIDs) has received wrong prescription; he may report serious dyspepsia or present at emergency with upper gastrointestinal bleeding.
Medication errors increase morbidity and mortality and heighten hospital cost. They reflect poor quality and safety practices. The community may lose interest in the doctor or the hospital where the error has been reported. It may also lead to loss of contracts with health insurance companies.
Besides, medication errors usually lead to a myriad of litigations against physicians, their service centres and hospitals including nurses, pharmacists and other healthcare workers who may have been involved in the mistake. Medical personnel found guilty risks punishments ranging from suspension, withdrawal of license to jail terms depending on the circumstances and severity of effects of the errors. These litigations are increasing in frequency, intensity and cost in recent times.
Solutions to medication errors
The devastating effects of medication errors demands serious consideration by healthcare administrators. It demands structural and organizational reforms that can promote quality and safe practices. This can be achieved by creating learning organizations within the healthcare chain. In a learning organization, the environment is suitable to learn from past mistakes. There is emphasis on excellent quality delivery based on the concept of Evidence-based medicine (EBM). Professional liability insurance scheme controlled by physicians can help to reduce the economic effects of medical errors (Theorell & Bejerot, 2011).
References
Al-Assaf, A., Bumpus, L.J., Carter, D. & Dixon, S.B. (2003) 'Preventing Errors in Healthcare: A Call for Action', Hospital Topics, 81(3), pp. 5-13.
Singh H., Thomas, E.J., Petersen, L.A. & Studdert, D.M.(2007) 'Medical errors involving trainees: a study of closed malpractice claims from 5 insurers', Arch Intern Med. 2007 Oct 22;167(19):2030-6.
Santell JP, Hicks RW, McMeekin J, Cousins DD. (2003) 'Medication errors: experience of the United States Pharmacopeia (USP) MEDMARX reporting system', J Clin Pharmacol. 2003 Jul;43(7):760-7.
Theorell T. & Bejerot E. (2011) 'Higher risk for medical errors reporting following reorganizations in health care', Lakartidningen, 108(48):2501-4.
