The nursing fraternity is a crucial facet of the overall medical arena, fundamental in the continued preservation and enhancement of patient health care and medical wellbeing. This therefore portends to the need of a coordinated effort, with respect to the implementation of various aspects pertinent to patient health improvement and the reduction of various forms/ types of medical errors. As earlier stated in previous studies, medical errors are not only attributed to human fallibility, but can also be attributed to systemic errors, thus the resulting gradual increase in complications and fatalities. The proposed evaluation plan’s core aim is to provide various procedural measures, as well as insight on how to better enhance the nursing fraternity’s overall output, especially regarding the reduction of associated medical errors. Key contributions will be from amongst others: my proposed evaluation project, other nurses, medical practitioners, related medical staff, top management and other stakeholders at large.
Participation will be primarily targeting the nursing and medical practitioners’ fraternities as these are crucial to the alleviation, mitigation and even reversal of the unfortunately increasing trend of medical errors within health/ medical care settings. Approval is crucial for the commencement of the implementation phase. This is majorly the role-play of not only the different health/ medical institutions’ top management, but also the larger medical fraternity and crucially so, the patient-base present. Additionally, other pertinent stakeholders such as different government agencies and institutions are also crucial towards availing better implementation measures, via their input. These are all vital in the overall implementation of the proposed project’s aims and goals within the greater medical sector. In obtaining the necessary approval, in addition to securing requisite support from leadership and fellow staff, there is need for their practical involvement (Odwanzny, 2004).
This can be achieved through such avenues as conferences, intra- and inter-departmental debates, pre- and post assessment tests, power point presentations, handouts, posters, surveys and questionnaires amongst other methods. Due to the fact that medical errors occur as a result of partly medical staff negligence and/ or systemic error (system failure or malfunction), there is need for collaborative input towards addressing it in a holistic manner. Blame should therefore not be the main priority, but rather focus should be on ways of reversing such occurrences. Negligence is the main contributor of medical errors, with regard to medical staff, as there is the omission of essential procedures, with respect to the handling of patients. Additionally is the fact that there is an increase in overall costs, not only to the hospital sector, but also insurance schemes individual contributions and government social welfare.
This is in reference to pension plans, insurance schemes and social policy, where additional costs do entail the diversion of scarce resources (funds/ money). These resources are diverted from other critical areas of governance and social development, and converted into unnecessary expenses. Above all, the prevailing nature of increased medical errors and related costs does result in various institutions having bad reputations, and thus creating untrustworthiness in the general populace (Nguyen & Nguyen, 2005). A case in point would be the U.S. where though having the largest economic input, by way of funding its health sector generally performs worst, when compared to other developed industrial nations. Medical errors do occur as aforementioned from systemic errors, with regard to various technological structures present, as well as human error, which is the project’s main focus.
Human error can be because of inexperienced medical practitioners, especially interns or new employees, with regard to the prescription, labeling and dispensing of medication to in-patients. This is further negatively affected by the prevailing nature of mismanagement, especially of clinical/ hospital settings, which contribute to the increase of such cases. This can be in the form of wrong documentation of patients’ files (filing system), improper naming/ labeling of various medications and the prevailing inadequate patient-nurse ratio. The latter is especially critical to point out as the prevailing contexts of an overworked nursing fraternity, provides for cases of fatigue and irritability, which may result in the lack of proper functionality. It is true that when a human being is tired and under stressful conditions, he/ she does not function optimally, thereby creating ground for errors to occur.
Towards reversing, mitigating and alleviating the resulting effects of medical errors, is the need for various holistic solutions. Amongst those proposed, include policy change or overhaul, a refinement of processes and procedures pertinent to patient care and the re-education and development of pertinent medical staff. Policy change is crucial in providing a comprehensive re-evaluation of existing rules, regulations, work schedules and management of various medical settings. This is crucial in the development of not only optimal working environments (for pertinent staff), but also provides for conducive atmospheres, which are crucial in patient treatment, recovery and wellbeing. With these being provided, there is also the need for not only individual, but also overall group/ entity accountability, in cases where errors result in adverse effects or deaths of patients (Berntsen, 2004).
The refinement of procedures and processes, pertinent to the optimal handling and management of patient hospital stay, is also fundamental, as various patient cases require different ways of handling, treatment and care. The ‘one-nurse-one-patient’ rule should be implemented, due to the fact that it not only enables, but further enhances the requisite patient-nurse relationship. Consequently, a particular patient should be allowed to have care provided by the specific nurse who attended to him/ her, from the admission point until the time of discharge. This is educated by the fact that a positive patient-nurse/ medical staff relationship, has the potential of increasing patient recovery, through a balanced holistic approach. This necessitates not only the physical wellbeing, but also the emotional and spiritual balance of the patient, vital for combating the prevailing ailment/ disease present.
Above all else, is the need for a re-education, advancement and development of the nursing fraternity, not only individually, but also as a group-entity. Preference should also be focused on fostering a form of autonomy (individually and as a group), so as to provide them with the space, time and means of carrying out their various duties without much pressure. Other pertinent medical staff should also be included in this development as the best approach, fundamental in providing the best possible results, regarding patient care and their healing process. There should be a consideration of increasing the available workforce, to complement the volume of patients admitted, or currently under care in a given institution, with the aim of balancing input and output of the medical fraternity (Lucian, Berwick & Bates, 2002).
Systemic faults are also responsible for various forms of medical errors. This may occur in various ways, such as the dispensation of drugs, accurate reading of various human factors crucial in maintaining their bodily functions, and in storing of vital data/ information (databases). This hence requires a review of all existing technologies, with better integration, functionality and human-system interaction, being the core focus of such an implementation process. Further still is the need of upgrading old or obsolete software and hardware (overall system structures), especially with the prevailing nature of the greater availability of more efficient and hence effective structures. Specialists, crucial in the maintenance, upgrade and repair of such a system should also be trained, increased and provided with autonomy, so as to better monitor and conduct various procedures towards ascertaining wholesome system functionality.
The rationale behind the selection of the aforementioned solution would be best provided through the following phrase: ‘Patient care and wellbeing is the fundamental role of not only the nursing fraternity, but also the prevailing medical sector, institutional management, government agencies and departments, as well as other pertinent stakeholders.’ When encompassed in such a statement, it is vividly clear that towards reversing the trend of increased medical errors is the need for wholesome and holistic approaches, which engage all the pertinent segments of the medical field. The lack of inclusion, of any given facet of the larger medical fraternity would portend to the partial implementation of such a proposed solution, thereby postponing the aspired change for a longer duration (Kalra, 2011). This would in turn adversely affect the intended progress to be made, which is critical in reducing the overall occurrence of medical errors.
The theoretical part of any given proposal, project or work is usually the easiest of phases. The implementation facet provides cause for concern, as there is need for a holistic approach. This is vital for the wholesome implementation of the same. Government input, by way of various departments, agencies and institutions should also be considered. This is because the medical fraternity not only requires micro-management and input, with regard to individual institutions and patient care, but also macro-management, regulation and interaction. The initiation of change is the core responsibility of all the aforementioned stakeholders, from those involved in the direct day-to-day running of these hospital/clinical settings, to the affiliated partners. It is only through such input, participation and implementation that the alarming levels of medical errors may be reversed and eventually resolved.
Implementation is always the hardest of phases to conduct and thereby providing reason for enhanced collaboration, interaction, input and development. Through such measures, there will be a clear reversal of all negative effects, to be replaced by positive outcomes, which will bring about a healthier and much happier general populace. Through implementing each of the aforementioned critical components, medical errors will be reduced to the minimum possible levels, which are acceptable, and majorly based on uncontrollable factors such as the stage and state of illnesses, the prevailing circumstances and the presence of suitable environments for optimal patient care (Nguyen & Nguyen, 2005). Funding is therefore a crucial aspect that should be considered, with input being provided by way of government subsidization of medical and health care provision (prevailing social welfare system), as well as individual institutional input.
In conclusion, human health care and mental wellbeing are the fundamental reasons why various medical institutions and clinical settings are in place. These are viewed as the last best possible solution, with regard to various ailments and complications encountered, and thus should not aggravate the prevailing situational circumstances further. Medical errors are indeed manageable, only if the right policies, rules, regulations and measures are put in place, without forgetting the requisite holistic approach and wholesome input of various pertinent stakeholders in the greater medical/ health sector.
References
Berntsen, K. J. (2004). The patient's guide to preventing medical errors. Westport, Conn: Praeger.
Kalra, J. (2011). Medical errors and patient safety: Strategies to reduce and disclose medical errors and improve patient safety. Berlin: De Gruyter.
Lucian, L. L., Berwick, D. M & Bates, W. B.(2002). What Practices Will Most Improve Safety? Evidence-based Medicine Meets Patient Safety. JAMA, 288(4), 501-507.
Nguyen, A. V. T., & Nguyen, D. A. (2005). Learning from medical errors: Clinical problems. Oxford: Radcliffe Pub.
Odwanzny, M. (2004). Continuing the journey to patient safety. Interview with Robert A. McNutt. Quality Management in Health Care, 13(1), 88-92.
