At one time or another, we all need medical care. Whether it’s for a sudden illness, a chronic condition or a serious illness or injury, we’ll need a doctor’s help. Of course, we expect the care we receive to help us, not harm us. But unfortunately, that is not always the case. Doctors, nurses and other medical staff sometimes make mistakes, and sometimes accidents occur, all of which can harm patients. Do you know what steps you can take to reduce your risk? It’s National Patient Safety Awareness Week, (March 10-16, 2019) – the perfect time to learn tips for four patient safety hazards.
How can you reduce your risk of harm?
Being engaged in your care will help keep you safer. Research indicates that many errors can be avoided if patients were more involved in their care, either as individuals or as a group. Another study found that patients less involved in their care were more than twice as likely to experience a medical error in diagnosis or treatment plans.
This blog post covers 4 safety issues I think all patients should know about: medication errors, misdiagnosis, infections and surgical errors.
1. Medication errors.
You are at risk for medication errors at home and in the hospital (or other in-patient facility). Learning how to avoid medication errors can help you heal faster and just might save your life! Taking the wrong medication, or the wrong dosage, or the right medication at the wrong time, can cause harm. But many pills look alike or have similar sounding names, making it easy for nurses in hospitals and patients at home to make mistakes.
Medication mistakes are common.
The Institute of Medicine estimates the average hospitalized patient experiences at least one medication error each day! This IOM report also estimates there are 1.5 million preventable adverse drug interactions each year in US hospitals and long-term care facilities. Additionally, research has found that more than 50% of adults in the US don’t take their medications as prescribed. Furthermore, sometimes doctors prescribe medications that react negatively with other medications a patient is taking, leading to an adverse reaction.
Reduce Your Risk of Medication Errors
I cannot say this enough! You must pay attention to medication, whether you are in the hospital or at home. Follow my suggestions to reduce your risk of medication errors.
For hospitalized patients:
- Keep a complete list of all medications, prescription and over-the-counter, at your bedside. Make sure all doctors know exactly what medications, including dosages, you take.
- Ask the staffer to confirm the name and dosage of each medication before you take it.
- If a staff member gives you an unfamiliar medication, do NOT take it without getting clarification. Ask to speak to the charge (head) nurse. If you don’t get an answer that seems logical to you, ask to speak to your doctor, or the doctor covering the floor.
For patients at home:
- Always carry a complete list of medications you are taking, including over-the-counter medicines. Share this list with all your doctors – don’t assume each doctor knows what other doctors have prescribed.
- When your doctor prescribes a new medication, ask your doctor why, how and when to take any medications.
- When purchasing medications at the pharmacy, make sure you get the right medication. If a medication looks different than in prior refills, ask the pharmacist to confirm that you have the right pills.
- Use a pill sorter to organize your pills. It makes it easier to take the right pills and provides an easy visual reminder.
- Remind yourself to take your medications – set alarms on your phone and leave medications where you will see them.
For more information on reducing your risk of many types of medication errors, read these blog posts:
- How Can Patients Protect Themselves from Hospital Infections?
- How to Avoid Medication Errors in the Hospital and at Home
- Can Your Medication Make You Sicker?
- Easy Steps to Take Medication as Prescribed
2. Diagnostic errors.
Diagnostic errors include making the wrong diagnosis or causing a delay in the correct diagnosis. Researchers estimate that 12 million Americans experience a diagnostic error every year, and up to 1/3 of these suffer serious permanent harms, including disability or death. In fact, researchers estimate that 40,000 to 80,000 people die in US hospitals every year due to diagnostic failures. Furthermore, it is likely that at least that many suffer permanent disability. And that’s only in hospitals. When you consider patients misdiagnosed in other clinical settings, such as doctors’ offices, the total harmed is likely significantly higher.
To reduce your risk of misdiagnosis:
- Prepare for every appointment by writing down your symptoms and questions.
- Be sure your medical team understands your “story”.
- Don’t let the doctor cut you short. Be persistent. Read my blog post: Doctors Interrupting Patients Can Impact Our Health
- When asked yes/no questions, elaborate as needed.
- Don’t shorten your story because you are tired of repeating yourself. Leaving out important details can make it harder for a doctor to correctly diagnosis you.
- Ask the doctor for a list of possible diagnoses. Even if your doctor suspects a particular condition, he/she might have other ideas in mind.
- Follow up on test results. Don’t assume that “no news is good news”. Mark your calendar and contact your doctor if you don’t hear by the expected date.
- If the diagnosis doesn’t seem right, speak up.
- Don’t assume each specialist on your team is communicating – they frequently do not send or receive reports from other doctors.
- Get a second opinion – from a different hospital or medical group if possible. Get a third opinion if needed.
For more information on reducing your risk of diagnostic errors, read these blog posts:
- How to Reduce Your Risk of a Misdiagnosis
- 10 Steps to Reduce Your Risk of Diagnostic Error
- Learn a Lesson From Serena Williams: Trust Your Instincts When it Comes to Your Health
Unfortunately, dangerous germs lurk in hospitals and can make patients extremely ill. Even the cleanest looking doctor’s offices and hospitals can contain germs. One study found that about 1 in 25 patients were infected during their hospital stay, causing tens of thousands of deaths.
Hand washing is vital!
Patients and families can reduce the spread of infection by asking all healthcare staff to wash their hands before touching the patient and/or instruments. Research shows that hand washing rates among healthcare staff increase significantly when patients ask. Don’t be shy about asking medical personnel to wash their hands – your life may depend on it!
Hospitalized patients should ask their guests, including family members, to wash their hands. And, you should wash your own hands after you leave a healthcare setting.
Importantly, alcohol-based hand sanitizers will not kill all germs. Instead, people should wash their hands with soap and water for 40-60 seconds.
For more information on hand hygiene, read my blog post: Why is Hand Washing in Healthcare So Important? What You Need to Do to Stay Safe.
Pay attention to open wounds, IVs and catheters.
Wounds, as well as IV, drainage or catheter sites, provide easy entry for germs. Make sure all healthcare staff wash their hands before touching any of these vulnerable spots and/or the tubing. If you notice a loose or dislodged IV, catheter or drainage tube, tell your nurse so he/she can fix or remove it as soon as possible.
Additionally, every day, you should ask about the removal of catheters, ventilators and other tubes. The longer they are in use, the higher the risk of infection.
For more information on infections, read these blog posts:
- How Well Does Your Hospital Manage Sepsis Infections?
- Reduce Your Risk of Exposure to Superbugs in Hospitals
4. Surgical errors.
Surgery is scary. Your concern that something might go wrong is not without merit. Unfortunately, surgeons and their teams can make mistakes, sometimes with very serious consequences.
Wrong-site surgeries happen.
Although it is 100% preventable, wrong-site surgery, when surgeons operate on the wrong body part, occasionally occurs. One study estimated that wrong-site surgeries occur in 1 out of every 112,000 procedures. Although it can happen in any type of surgery, most reported cases involve orthopedic procedures.
The primary cause is poor communication. Risk factors include time pressures, emergency procedures, multiple procedures on the same patient by different surgeons and patients’ obesity. Checklists might reduce or prevent wrong site surgeries.
Reduce your risk of wrong site surgeries.
Since checklists might reduce or prevent wrong site surgeries, ask your surgeon if he/she uses checklists.
Also, right before your surgery, remind your surgeon what procedure he/she is going to perform. And if your surgeon doesn’t do it for you, use a marker to label which body part to operate on (and maybe even which one to avoid).
Sometimes surgical instruments and supplies are left inside the patient.
Retained surgical bodies (RSB) is the technical term for any items left inside the patient after surgery. Although surgical teams try to keep track of all of the instruments, sponges and other items used during a surgery, staff can mistakenly leave items inside the patient. Unfortunately, researchers estimate this happens about 1,500 times/year in the US. As a result, the patient often must undergo a subsequent surgery to remove the RSB.
How can you know if you have an RSB?
RSBs often cause pain, frequent infections and a palpable mass/lump. This is a tricky problem. Although symptoms can develop immediately after surgery, it might take months or years for symptoms to develop. If you have unexpected pain after an operation, ask your surgeon if it’s possible that a foreign body might be to blame. Because surgeons can be stubborn, you might have to insist on an x-ray (or another test) to determine if the surgical team left something behind.
Read my blog posts to learn more:
- How Common are Surgical Mistakes?
- Questions to Ask Before Surgery
- What Kinds of Things Can Go Wrong During Surgery?