Staunch advocates of truth telling in medical practice, who consider honesty and full disclosure essential features of the virtuous physician, insist that physicians Medication errors and ethical principles apprise their patients of any medical error that has had an adverse impact. There are at least two dimensions to this component of medical ethics and professionalism.
A reason often cited by medical malpractice plaintiffs for the filing of such suits is that patients or families were desperately searching for "answers" to persistent questions that had gone unanswered by those responsible for providing care. Her scholarly interests focus on philosophical inquiry, writing across the curriculum, qualitative research, and ethical considerations in healthcare.
While these basic rights can serve to govern and instruct the administration of medications for nurses, there is always room for error and Medication errors and ethical principles potential for ethical issues to arise. In the first, based on a small sample of nurses in one unit in one hospital, a qualitative analysis of observed medication administration found that participants monitored patients before, during, and after medication administration.
Unfortunately, the research also reveals that we have only weak knowledge of the actual incidence of errors. Future directions for medical error disclosure research. He would treat her aggressively with agents to increase her cell counts so that she would have enough reserve to keep her counts from going down to zero.
Naturally, physicians continue to ask how disclosure is best conducted. May had in her healthcare providers, even after the error. Nurses responded to 12 percent of the infusion error warnings by altering the setting and averting errors.
Most medication errors cause no patient harm or remain undetected by the clinician. Direct observation studies placed the estimate of total incorrect doses between 19 percent and 27 percent, 87 and when an extra review was done to separate the errors into stages of the medication process, between 6 percent and 8 percent of doses were in error because of administration.
Our primary focus here will be the latter. It was made clear that they needed to write something they could share with others, as we would set aside class time to read their stories aloud.
In both studies, the number of distractions was significantly reduced. For-profit hospitals were more likely than not-for-profit hospitals to have unit-dose medication distribution systems Not all of them receive as intense media scrutiny as the young transplant recipient at Duke Medical Center who died as a consequence of the failure of the transplant physician to confirm compatibility between donor and recipient.
CNAs are also responsible and accountable for their duties as defined in their position description and as proscribed by the standards of care by the state accrediting body. A broader discussion of each of these is beyond the scope of this article; however, many references are available online for further study.
Two studies conducted retrospective assessments, one using medical records 43 and the other malpractice claims. At the more advanced stage of incident reports, one study reviewed 68 malpractice cases involving MAEs in Sweden.
Of note, this information comes from large health systems or malpractice insurers that often coupled disclosure with an offer of patient compensation.
A few studies have indicated that one of every three medication errors could be attributed to either a lack of knowledge about the medication or a lack of knowledge about the patient. Without proper consent, doing what your colleague tells you could result in serious ethical and legal complications for which you will be held accountable.
A second study compared detection methods and found that more administration errors were detected by observation a Qualitative studies and much anecdotal evidence indicate that it is more often the effort to conceal medical error, rather than the timely, candid, yet sensitive disclosure of it, that is more likely to precipitate malpractice litigation.
Communication Five studies and one literature review assessed the relationship between communication failures and medication errors.
You are always so careful. It is difficult to reduce or eliminate medication errors when information on their prevalence is absent, inaccurate, or contradictory.
Distractions and interruptions Factors such as distractions and interruptions, during the process of delivering care can have a significant impact on medication safety.
These rights are critical for nurses. Systems factors Systems factors that can influence medication administration include staffing levels and RN skill mix proportion of care given by RNsshift length, patient acuity, and organizational climate. Research is needed that incorporates disciplinary perspectives of professionals in healthcare, law, communication, and ethics to help healthcare providers understand and implement ethical practices for prevention and management of medical errors.
Direct observation of the number and types of distractions provided the outcome measures in the first study; a questionnaire completed by each nurse administering medications provided the measure of distractions for the second. I have never felt this bad in my life, but I will make it.
One of the central features of the paradigm shift from the paternalistic to the shared decision making paradigm for the physician-patient relationship was the recognition that harm is a value-laden concept.
Direct observation of medication administration, a resource- and time-intensive approach to data collection, is the only way to gather unbiased data to evaluate the impact of BCMA on medication administration errors.
Amid the growing push for greater disclosure, two issues remain central to any discussion of the topic: Your Roles and Responsibilities The National Council of State Boards of Nursing NCSBN accepts responsibility for developing standards of nursing care and education that protect the health and welfare of the public, thus serving as a guide for state laws addressing nursing practice.
Bar-coded medication administration BCMA is promoted as the most effective way to reduce administration errors and is being implemented widely. Your position description or job description outlines your duties, responsibilities, and other expectations of your employer.
All of the studies reviewed here reported wrong drug and dose, but varied across the other types of MAE categories see Evidence Table 1 ; this was dependent upon the study methodology.
Several ethical issues may arise as a result of medication errors: harm to patients, whether to disclose the error, erosion of trust, and impact on quality care. Nurses' appropriate ethical responses to medication errors need to be supported.
The remainder of this column will discuss ethical principles related to medical errors for nurses to consider, along with recommendations that can help to shape a culture of safety for the prevention of medical errors. Ethical Considerations.
medical practice.2 Because medical errors have a large impact on pa- tient care, it is important to consider the ethical issues regarding dis- closure that arise when health care providers make or witness errors. Since doctors are ethically bound to disclose errors that cause or may cause harm to patients, this paper will show that non-disclosure of medical errors to patients and/or their families is an egregious violation of ethical principles and cannot be justified.
Principles of medical ethics: implications for the disclosure of medical errors Annegret F HannawaInstitute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, SwitzerlandAbstract: This review merges interdisciplinary perspectives from communication, law, and medical ethics to advance theoretically.
One approach to reduce medical errors in hospitals is to look at the problem from a systems perspective. Here are 13 principles that can be applied to any hospital in its pursuit of improving patient safety and delivering quality care.Medication errors and ethical principles