foster anxiety and possible confusion, which also impede communication, potentially leading to errors. Older patients are also vulnerable to medication errors. The declining ability of the aging body to metabolize and eliminate drugs – along with potential visual, hearing, and cognitive issues – may lead to a misunderstanding or failure to recognize a potential drug error.
Older patients are also at high risk for falling. Among older adults, falls are the leading cause of injury deaths (CDC, 2009). Falls are also the most common cause of nonfatal injuries and hospital admission for trauma (CDC, 2009). The reasons for falls include vision problems, medication effects, and existing health problems such as arthritis, postural hypotension, and fragility (Gray-Miceli, Capezuti, Lawson, & Iyer, 2007).
Table 3: Twenty Tips to Help Prevent Medical/Dental Errors in Children: Patient Fact Sheet Be Involved in Your Child’s Health Care 1. The single most important way you can help prevent errors is to be an active member of your child’s healthcare team. Medicines 2. Make sure that all of your child’s doctors and dentists know everything your child is taking (including prescription and over-the- counter medicines and dietary supplements such as vitamins and herbs) and his or her weight. 3. Make sure your child’s doctor or dentist knows about any allergies and how your child reacts to medicines. 4. When your child’s doctor or dentist writes a prescription, make sure you can read it. 5. When you pick up your child’s medicine from the pharmacy, ask: Is this the medicine that my child’s doctor (or dentist) prescribed? 6. Ask for information about your child’s medicine in terms you can understand – both when the medicines are prescribed and when you receive them at the hospital or pharmacy. 7. If you have any questions about the directions on your child’s medicine labels, ask. 8. Ask the pharmacist for the best device to measure your child’s liquid medicine. Also, ask questions if you are not sure how to use the device. 9. Ask for written information about the side effects your child’s medicine could cause. Hospital Stays 10. If you have a choice, choose a hospital at which many children have the procedure or surgery your child needs. 11. If your child is in the hospital, ask all healthcare workers who have direct contact with your child whether they have washed their hands. 12. When your child is being discharged from the hospital, ask his or her doctor to explain the treatment plan you will use at home. Surgery 13. If your child is having surgery, make sure that you, your child’s doctor, and the surgeon all agree and are clear on exactly what will be done. Other Steps You Can Take 14. Speak up if you have any questions or concerns. 15. Make sure you know who (such as your child’s pediatrician) is in charge of his or her care. 16. Make sure that all health professionals involved in your child’s care have important health information about him or her. 17. Ask a family member or friend to be there with you and to be your advocate. Choose someone who can help get things done and speak up for you if you can’t. 18. Ask why each test and procedure is being done. 19. If your child has a test, ask when the results will be available. 20. Learn about your child’s condition and treatments by asking the doctor and nurse and by using other reliable sources. Note: Adapted from AHRQ. (2002). 20 Tips to Help Prevent Medical Errors in Children: Patient Fact Sheet . Retrieved from http://archive.ahrq.gov/
consumer/20tipkid.htm Patient education
Central to the patient safety movement is the participation of patients. The single most effective way that patients can help to prevent medical/dental errors is to be actively involved in their own health care. To be fully involved, patients must receive informed care. Although offering patient education is required by accrediting agencies and institutional policies, constraints of time and resources may limit the amount of attention this aspect of care receives. However, providing patient education is among the most significant interventions in reducing medical error (AHRQ, 2007, 2010a). A lack of health literacy among patients is a recognized public health issue (NPSF, n.d.), and according to the U.S. Department of Education’s National Center for Education Statistics (2003), millions of adults in the United States are nonliterate in English. It is vital that these limitations be recognized when attempting to provide patient education. The Joint Commission and many other groups have recommended a “universal” approach to all patient encounters
by using clear communication. The following six tools can assist healthcare professionals in communicating health information. ● Slow down: Communication can be improved by speaking slowly and spending just a small additional amount of time with each patient. ● Use plain, non-medical language: Explain things to a patient as you would to a family member. ● Show or draw pictures. Visual images can improve the patient’s recall of ideas. ● Limit the amount of information provided, and repeat it: Information is best remembered when it is given in small pieces pertinent to the issue at hand. Repetition further enhances recall. ● Use the teach-back or show-me technique: Confirm that patients understand by asking them to teach you in their own words what they learned. ● Create a shame-free environment: Make patients feel comfortable asking questions. Enlist the aid of others (a patient’s family or friends) to promote understanding (TJC, 2007).
PATIENT SAFETY INITIATIVES
Patient safety is defined as freedom from accidental injury resulting from medical/dental care or from medical/ dental errors (Kohn et al., 2000). Standards set by external
organizations – such as government agencies, regulatory bodies, professional organizations, and consumer groups – help healthcare agencies stay abreast of best practices and improve
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