Health Care Newsletter
Preventing Medical Errors
In 1999, the Institute of Medicine released a report which revealed that an alarming number of injuries and deaths occur in U.S. hospitals each year due to preventable medical errors. One disturbing aspect is the frequency with which “medication errors” occur. Although statistics and estimates vary, medical errors related to prescriptions and drug administration are pervasive in the U.S. health care system. Such errors include:
- Prescribing and administering the wrong medicine
- Receiving the wrong dosage
- Receiving the medicine at the wrong time
- Medicine being administered to the wrong patient
- Medicine prescribed and administered in disregard of known allergic reactions
Possible Remedies
The causes of these errors vary significantly, ranging from illegible handwriting to a lack of qualified personnel and overworked staff. Due to the significant impact of such errors, the health care industry has been forced to consider health care delivery and procedure modifications to increase safety.
The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), an accrediting organization for health care facilities, requires member health care facilities to comply with the following:
- Improving the accuracy of patient identification, by requiring two forms of identification other than the patient’s room number, before medication is administered
- Implementation of “verification,” or “read-back,” for verbal orders for medication (including dosage)
- Standardization of abbreviations, acronyms and symbols
- Removal of certain dangerous and potentially lethal drugs (e.g., potassium chloride) from patient care units
- Standardization and limitation of the number of drug storage centers at the facility
Computerized Physician Order Entry Systems
One frequently suggested method for dealing with medication errors is the installation of a Computerized Physician Order Entry System (CPOE): a computer-based platform that provides an online, centralized database of patient records. Many such systems are available in the form of software packages for existing computer systems.
A CPOE system may include storage of electronic medical records; access to drug and other health information; and an image management system to move records around. Entry of prescriptions into a CPOE system can alert doctors to potential drug allergies and, among other benefits, may eliminate the need for sometimes illegible paper charts and prescriptions.
A study released in September of 2005 by Rand Health, an independent health research program, suggested that computerizing medical records would save the U.S. healthcare system over $81 billion a year and would result in improved patient safety.
Even though a fully-implemented computerized drug ordering system may lead to dramatic reductions in medical errors, the vast majority of hospitals still rely on paper charts. Statistics indicate that as few as two percent of U.S. hospitals have a CPOE system and require its use by physicians. Further, despite the implementation of such systems in some hospitals, doctors resistant to change have subverted CPOE effectiveness by refusing to utilize them and continuing to give nurses verbal orders.
Legislative Proposals
Reluctance to acquire a CPOE system is often the result of its cost. In recognition of this, bills have been introduced in Congress that would establish grants to hospitals and skilled nursing facilities for the purchase, lease or upgrade of CPOE computer software and hardware. Several bills have been introduced in both the Senate and House in 2001, 2002 and 2003, but have not received the necessary support to become law. One such bill, the Medication Errors Reduction Act of 2003, offered hospitals almost $100 million dollars each year for the ten-year period following the passage of the legislation. Some of the goals of the bill were the following:
- Implementation of safer health care practices with respect to medication delivery
- Implementation of “medication error reduction systems” by at least 25% of Medicare hospitals and skilled nursing facilities within the next ten years
- Disbursement of federal funds based on early adoption of “proven new patient safety technologies”
Along with identifying CPOE as an example of a “proven new patient safety technology” that might be funded under the Medication Errors Reduction Act of 2003, other technologies include:
- Electronic medical record systems: This technology allows doctors to quickly check for adverse drug interactions.
- Automated pharmacy dispensing: This type of system streamlines the medication disbursement process.
- Bedside verification: This procedure, based on the use of bar codes, ensures that the proper medication is distributed to the patient.
The Medication Errors Reduction Act of 2003 failed to receive sufficient support to become law. However, in light of the fact it was first introduced in 2001 and continues to receive substantial attention, similar legislation is expected to be addressed again by lawmakers in the future.
© 2024 NextClient.com, Inc. All rights reserved.
