a crucial part of treating a patient accurately and effectively. It is the only way to precisely evaluate how the therapy routine is advancing. Documentation also provides a written record of the patient’s progress as well as their strengths and weaknesses. Documentation allows the therapist to change the therapy, consult anew with the referring doctor, or reevaluate the progress. Standardized protocols One study of patients with severe respiratory disease found a four-fold increase in survival rate with the use of standardized protocols. Much of the current research efforts are committed to improving patient safety by providing tools to augment provider judgment. The Centers for Education and Research in Therapeutics (CERTs) will conduct research to increase understanding of ways to improve the appropriate and effective use of drugs, biologicals, and devices in treatments and to avoid adverse events by standardizing protocols. Drug legislation and safety The Food and Drug Administration (FDA) is responsible for creating guidelines for the approval and use of drugs. Gaining FDA approval usually takes several years to attain. The FDA requires that all approved drugs fulfill two requirements: ● The drug must be found to be effective against the disease for which it is seeking approval. ● The drug must meet safety criteria by being subject to extensive animal and controlled human testing.
referring physician and pose the question to him or her. There is never a reason to rush to judgment if all existing documentation is not understood and/or verified. Document after dosage administration/treatment Once again, documentation is the name of the game. Recording procedures and documenting actions is less than exciting and can quickly become boring. Nonetheless, it is Solutions for patient safety improvement Research into medical errors attempts to not only identify the causes and extent of errors but to develop and test better ways to prevent errors by reducing the reliance on human memory. Translating knowledge into practical solutions should be the ultimate goal in the world of computerized research documentation and implementation. Computerized ADE monitoring A computerized adverse drug event (ADE) monitor uses electronic medical records. Humans can use smart monitors such as automatic paging and computerized ADE monitoring to track many more parameters than would otherwise be possible. This would be most beneficial first in intensive care units. Other settings that could benefit would be schools and home healthcare. Computerized ADE monitoring works by setting an application called an event monitor over the clinical database. When an event is identified, a pharmacist can review it and take appropriate action including intervention if necessary. One organization estimated a savings of $900,000 annually with such a system due to a decrease in adverse drug events. Long-term, major benefits may be realized by improving communication between patients and providers and implementing monitoring at home.
Case study Sherlyn walked into the emergency department (ED) one Monday morning in October unable to breathe. Preliminary tests were performed, objective data was collected, and a detailed subjective history was taken. Time went by, but a diagnosis eluded the attending physician. She was given a dose of Lasix as a preventative measure, in case her shortness of breath was related to congestive heart failure. Finally, all the tests were returned and the physician was able to determine that Sheralyn had two massive pulmonary embolisms (one lodged in each lung). But why? She was overweight and had a sedentary lifestyle but was otherwise in average health. Throughout the day, various doctors, nurses, and other medical staff had taken a subjective history on Sherlyn in the ER as well as collected objective data. They all missed one key item. She had been prescribed Megace, a coagulant, 18 months earlier. Sherlyn had faithfully itemized medications she was on to every medical professional for the last 24 hours, but no one caught it. Safety needs of special populations
essential in communicating effectively and accurately. Research shows that patients are safer when a medical interpreter is used, but that hospital staff often still tries to “get by” without using them (Wasserman et al., 2014). ● Individuals with low health literacy : Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” (Nielsen-Bohlman et al., 2004, p. 2). Low health literacy is associated with higher medication errors, and the World Health Organization (WHO) issued a mandate in 2016 to address health literacy worldwide (Parekh et al., 2018). A single-question screening tool has been validated to assess low health literacy and consists of “How confident are you filling out medical forms by yourself?” Answers are “extremely,” “quite a bit,” “somewhat,” “a little bit,” or “not at all.” People who answer “somewhat” or “not at all” are considered to have inadequate health literacy (Keene et al., 2017).
Per 64B9-5.011 of the Florida Statutes, it is essential that all healthcare professionals who practice in the State of Florida be aware of special populations that are at particular risk for medical errors in order to be another layer of protection for these vulnerable patients. Some populations that are at increased risk for errors include: ● Infants and children: Pediatric populations are at an increased risk for medication errors due to the way dosage is calculated (Mueller et al., 2019). Limited communication abilities may also contribute to errors. ● Older adults : Older adults often experience communication problems due to impaired vision, hearing, and/or cognition. These impairments, along with frequent polypharmacy, can contribute to medication errors. Also, older adults are at increased risk for falls which can cause injury (Aldila et al., 2021). ● Individuals with limited English skills : Since communication is a vital part of medical error prevention, limited language skills put patients at a higher risk of errors. The use of medical interpreters is
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