Systems errors The Institute of Medicine (IOM) reports that the majority of medical errors are not produced by: ● Negligence. ● Lack of education. ● Lack of training. This is not to diminish in any way the need of education and training. Instead, IOM determined that more errors occur in the healthcare systems due to: One contributor to medical errors is the common practice of healthcare professionals working 24-hour shifts to ensure patients are cared for and have some continuity of care. Overwork and fatigue are known to lead to decreased mental concentration and alertness (Rodziewicz et al., 2023). Of course, this particular system design is going Failure to prevent injury One of the commitments of pretty much all healthcare professionals is to cause no harm. The focus from the nursing staff, physical therapist, occupational therapist, athletic trainer, speech language pathologist, or massage therapist is to create a plan of care to cause the patient ● Poor systems design. ● Organizational factors.
to fail because an individual, even though professional, cannot effectively function on a consistent basis for a 24- hour period of time repeatedly. Besides, these medical professionals are expected to function in an environment that is not ergonomically designed for optimal work performance. Rather than utilizing all that is available in the technology arena, these medical professionals are expected to rely on their memories and deliver safe care without substantial investments. Another flaw in the system is that the medical professional is expected to deliver care through a set of complex processes rather than one or two simple specific processes (Rodziewicz et al., 2023). The medical industry, as well as other industries, has shown that the probability of performing a task perfectly decreases as the number of steps in the process increases. to proceed to health or maximum level of functioning. Whatever that treatment plan, it is vital that it cause no injury. Every plan will have to be adjusted to the individual needs of the patient in order to not cause injury (Rodziewicz et al., 2023). Error in the Medication Process A 41-year-old female was ordered 160 mg daily of Temodar. The dosage was 20-mg in each capsule, so she was instructed to take eight capsules daily. However, the medication that the patient received from the pharmacy was a 250-mg capsule rather than the intended 20-mg capsules, and she administered eight capsules for a total daily dose of 2000 mg. The patient presented with pancytopenia and died 10 days following administration of the last dose.
Case studies Failure to Act on Abnormal Test
Louise (pronouns she/her/hers) went to her primary care physician after discovering some irregularities in her left breast. Dr. Breem did not think it was of any consequence but sent her for a mammogram even though she had just had one 5 months previously. The mammogram report was sent to Dr. Breem, and she noted that there was some irregularity in the breast. However, Dr. Breem made the decision to ignore the irregularity. One year later Louise died of breast cancer.
MEDICAL ERRORS AND ETHICS
Preventable adverse medical events An adverse event is an “injury resulting from a medical intervention, not the underlying condition of the patient” (Rodziewicz et al., 2023, n.p). An adverse event is preventable if it is due to “an error in management due to failure to follow accepted practice at an individual or system level” (Rodziewicz et al., 2023, n.p). Adverse events in medicine have not been reported systematically. Consequently, adverse events have not been studied or published on a consistent basis. A classification of errors and preventable adverse events is an important first step in improving patient care and eliminating medical errors. Just as clinicians use a diagnostic list for analyzing symptoms or a list of risk factors for assessing disease, a classification and listing of process errors and preventable adverse events can be used to prevent patient harm should an error occur. Errors of commission Errors of commission refers to those injuries arising as a direct consequence of treatment when the medical Ethical principles for healthcare professionals These five ethical principles can help healthcare professions to examine the ethical pros and cons of medical practices and medical regulation in today’s environment. Medical and healthcare professionals have a tradition of “utilitarian approach,” meaning that the greatest good should be
professional is prescribing a medication or a treatment plan that has harmful interactions with another medication the patient is taking (Rodziewicz et al., 2023). Errors of omission Just as lethal are those errors of omission. An example of an error of omission would be a medical professional failing to prescribe a medication from which the patient would likely have benefited. The reasons for this may be varied. If a therapist is in a situation where they know the patient has no health insurance, perhaps it may seem logical to recommend a lesser therapy plan so as not to put an excessive financial burden on the patient. Is this acting in the best interest of the patient? If the patient requests a lesser therapy plan, then the medical professional must advise the patient that his or her condition will not respond as efficiently or as quickly. However, this could be viewed as an error of omission. Is some treatment better than none at all, at least in this particular situation?
accomplished through any public health action (Bait Amer, 2019). To be clear, obligations to not harm others through a medical error carries a more stringent obligation than to merely help others by providing benefits, protecting interests, and promoting welfare.
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