NHS4000 Dev Health Care Perspective

1THIS is THE WORK THAT WAS DONE ON WEEK 4
Medical Errors and Uncertainty in Primary Care
Name:
Instructor’s Name: Ilene Putterman
Institutional Affiliation: Capella University
Date: 3/5/2023
2
Medical Errors and Uncertainty in Primary Care
Topic Identification
The discussion on ethics in medical practice is incomplete without diving into one of the
most sensitive topics of medical errors and uncertainty. In healthcare, medical errors contribute
to a significant percentage of deaths. Several cases of deaths have reportedly been found to be a
result of medical errors. This also extends to diseases and other physical harm than death that
some patients experience. Therefore, medical errors and uncertainties pause a particularly unique
challenge to the medical profession, which seeks to streamline the provision of health services
and increase efficiency within the profession.
My interest in this topic stems from my personal experience where my uncle had to
endure pain for a more extended period after a medical error that worsened his condition. Despite
successfully recovering after the medical mistake, the experience remains. There is a fear and a
bit of disregard to the medical profession among those closely involved with my uncle’s
treatment and recovery, especially among his nuclear family. There have also been personal
experiences where close associates who are practitioners were involved in medical errors that
resulted in non-fatal injuries to the patients.
Discussion of Research
The keywords used in finding articles for this research included doctors, safety, quality,
medical, crisis management, errors, and uncertainties, among others. These keywords were used
to conduct a search for resources in the Capella library, where I narrowed the search down to
three articles. The articles were chosen based on publishing date; most recent reports were
included, while the much older ones were excluded from the study. The articles were also
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Medical Errors and Uncertainty in Primary Care
They were chosen based on their relevance to the research topic. In this case, I quickly perused
the articles to digest what they were about and kept those relevant to the study of medical errors
and uncertainties in medicine.
The articles that were retained are all peer-reviewed articles that were published within
the last five years. They were all published by reputed medical journals and institutions. The
information in the journal articles was determined to be relevant to the topic and was all
determined to be relevant to the topic in the present. In their report, Mannion et al. (2019)
explore the role of medical inquiries in promoting accountability among medical professionals.
This article looks at the role of oversight in ensuring the low occurrence of medical errors and
uncertainties within the medical field.
Ahmed et al. (2019) reported on a case study that investigated the perspective of medical
providers on medical errors. The study set out to find the rate of medical errors and the perceived
causes of these errors. This study contributes to the evaluation of medical professionals’ role in
managing possible errors within their field by assessing their awareness and knowledge of these
errors. Finally, Misztal-Okońska et al. (2020) looked at the role of education in managing
medical mistakes and uncertainties. The highlight of the study was an understanding of the
medical approach to crisis and public health issues. Notably, most medical errors and tensions
are likely to occur during disasters, as the most recent covid-19
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Medical Errors and Uncertainty in Primary Care
Pandemic. Misztal-Okońska et al. (2020) contribute to the understanding of the role of
education in managing medical errors and associated uncertainties.
Annotated Bibliography
Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medical errors: Healthcare
professionals’ perspective at a tertiary hospital in Kuwait. PLOS ONE, 14(5),
e0217023. https://doi.org/10.1371/journal.pone.0217023
This study set to find out the perceptions of healthcare providers on the causes of medical
errors. The study also aimed to get their views on the possible preventative measures against
possible known medical errors. The study found that most medical errors are associated with
adverse events experienced in the healthcare field. Other highlighted causes of medical mistakes
include the cost of healthcare provision and the general poor provision of healthcare services.
From the study, the researchers came up with a few mitigations to the known medical errors or
challenges in the medical field that they correctly identified in the course of the study. Causes of
medical errors identified by the study included inadequate experience in prescribing medication,
miscommunication among different healthcare providers and patients, and limited
pharmacological knowledge. Solutions proposed by the study had increased awareness about
medical errors and the need for continued reporting of such incidences, training, learning
workshops, and the advancement of reporting procedures.
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Medical Errors and Uncertainty in Primary Care
Mannion, R., Davies, H., Powell, M., Blenkinsopp, J., Millar, R., McHale, J., & Snowden, N.
(2019). Healthcare scandals and the failings of doctors. Journal of Health Organization
and Management, 33(2), 221–240. https://doi.org/10.1108/JHOM-04-2018-0126
The study set out to determine whether an official inquiry into medical incidences is an
effective way of ensuring the accountability of medical professionals. According to the
researchers, there is a rising need to ensure safety and quality in health care. The study carried
out a review of theoretical literature which had explored the subject and reports that the National
Health Service published. The study found that there was disproportionality regarding the role of
individual reporting in ensuring accountability. Notably, while there were reports indicating
inquiries into the issue, there was an indication that these reports only systematically focused on
a few members of the medical profession. Notably, it was clear that only a few doctors or
medical providers were responsible for most of the reported medical errors. Notwithstanding, the
study found that the so-called wrongdoing had grown in visibility in public inquiries and
recommendations, indicating a rising concern regarding medical errors and uncertainties.
Misztal-Okońska, P., Goniewicz, K., Hertelendy, A. J., Khorram-Manesh, A., Al-Wathinani, A.,
Alhazmi, R. A., & Goniewicz, M. (2020). How Medical Studies in Poland Prepare Future
Healthcare Managers for Crises and Disasters: Results of a Pilot Study. Healthcare, 8(3),
202. https://doi.org/10.3390/healthcare8030202
Medical Errors and Uncertainty in Primary Care
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In conclusion, The study looked at the increasing need for accurate and fast responses to
disasters in society, given the growth rates of natural disasters resulting from human activities.
According to these authors, continued climate change means the likelihood of more lethal and
hazardous occurrences that may heavily impact public health. They emphasized the role of
education in ensuring that society can handle such cases while minimizing the possibility of
medical errors due to unpreparedness. Notably, there is an increased likelihood of errors in the
event of natural disasters due to the urgency and the increased pressure that such disasters put on
the public health systems. The study concluded that crisis management is an essential aspect
within the healthcare provider and must therefore be adopted to increase the success rate in
managing disasters and pandemics such as covid-19 while minimizing the possible errors that
may arise as a result of practice.
References
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Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medical errors: Healthcare
professionals’ perspective at a tertiary hospital in Kuwait. PLOS ONE, 14(5),
e0217023. https://doi.org/10.1371/journal.pone.0217023
Mannion, R., Davies, H., Powell, M., Blenkinsopp, J., Millar, R., McHale, J., & Snowden, N.
(2019). Healthcare scandals and the failings of doctors. Journal of Health Organization
and Management, 33(2), 221–240. https://doi.org/10.1108/JHOM-04-2018-0126
Misztal-Okońska, P., Goniewicz, K., Hertelendy, A. J., Khorram-Manesh, A., Al-Wathinani, A.,
Alhazmi, R. A., & Goniewicz, M. (2020). How Medical Studies in Poland Prepare Future
Healthcare Managers for Crises and Disasters: Results of a Pilot Study. Healthcare, 8(3),
202. https://doi.org/10.3390/healthcare8030202
THIS IS FOR WEEK 4 AND WEEK 9 DISCUSSTION!
References
Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medical errors: Healthcare
professionals’ perspective at a tertiary hospital in Kuwait. PLOS ONE, 14(5), e0217023.
https://doi.org/10.1371/journal.pone.0217023
Mannion, R., Davies, H., Powell, M., Blenkinsopp, J., Millar, R., McHale, J., & Snowden, N.
(2019). Healthcare scandals and the failings of doctors. Journal of Health Organization
and Management, 33(2), 221–240. https://doi.org/10.1108/JHOM-04-2018-0126
Misztal-Okońska, P., Goniewicz, K., Hertelendy, A. J., Khorram-Manesh, A., Al-Wathinani, A.,
Alhazmi, R. A., & Goniewicz, M. (2020). How Medical Studies in Poland Prepare Future
8
Healthcare Managers for Crises and Disasters: Results of a Pilot Study. Healthcare, 8(3),
202. https://doi.org/10.3390/healthcare8030202
References
Hu, B., Wang, H., Ma, T., Fu, Z., & Feng, Z. (2021). Effect Analysis of Epidural Anesthesia
with 0.4% Ropivacaine in Transforaminal Endoscopic Surgery. Journal of Healthcare
Engineering, 2021. https://doi.org/10.1155/2021/2929843
For Week 9
this assignment, you will analyze the same current health care problem or issue
topic area you selected for the Week 4 assignment. If you have not already done
so, you must use this module to select your health care-related issue or problem
based on the presented topic areas. To explore the chosen topic, use the first
four topics of the Socratic Problem-Solving Approach for critical thinking that were
introduced in Week 4.
1. Start by defining the health care problem or issue based on the selected
health care topic.
2. Then provide details about the problems or issues that are part of the chosen
topic, and identify causes for the problems or issues.
3. Identify at least three scholarly or academic peer-reviewed journal articles
about the topic you are discussing by using articles found in the Week 4
assignment or searching the Capella library using the applicable
undergraduate library research guide.
Write Your Paper
1. Use scholarly information to explain a health care problem or issue.
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Assess the credibility of information sources.
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Assess the relevance of the information sources.
2. Analyze the problem or issue.
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Describe the setting or context for the problem or issue.
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Describe the reasons that make the problem or issue important to you.
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Identify groups of people affected by the problem or issue.
3. Discuss potential solutions for the problem or issue.
•
Describe potential solutions.
•
Compare and contrast your opinion with other opinions you find in
sources from the Capella library.
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Provide the pros and cons for one of the solutions you are proposing.
4. Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and
Justice) if potential solution was implemented.
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Describe what would be necessary to implement the proposed
solution.
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Explains the ethical principles that need to be considered (Beneficence,
Nonmaleficence, Autonomy, and Justice) if the potential solution was
implemented
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Provide examples from the literature to support the points you are
making.
Organize your paper using the following structure and headings:
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Title page. (A separate page.)
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Introduction. (A one-paragraph statement about the purpose of the paper.)
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Identify the elements of the problem or issue, or question.
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Analyze, define, and frame the problem or issue, or question.
•
Consider solutions, responses, or answers.
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Choose a solution, response, or answer.
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Implementation of the potential solution.
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Conclusion. (One paragraph.)
Academic Requirements
Your paper should meet the following requirements:
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•
•
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Length: Include at least 3–5 typed, double-spaced pages, in addition to the
title page and reference page.
Font and font size: Use Times New Roman, 12 point.
Writing: Produce text with minimal grammar, usage, spelling, and mechanical
errors.
Sources: Integrate into text appropriate use of scholarly sources, evidence,
and citation style.
References: Use at least three scholarly or academic peer-reviewed journal
articles and three in-text citations within the paper. Visit APA Style and
Format if needed.
• Academic Honesty: Submit a draft of your assignment to SafeAssign and
make any necessary changes before you submit it to your instructor for
grading.
Example assignment: You may use the Analyze a Current Health Care Problem or
Issue Example Assignment [PDF] to give you an idea of what a Proficient or higher
rating on the scoring guide would look like.
•
Note: Your instructor may use the Writing Feedback Tool when grading this
assignment. The Writing Feedback Tool is designed to provide you with guidance
and resources to develop your writing based on five core skills. You will find
writing feedback in the Scoring Guide for the assignment once your work has
been evaluated. Learn more about the Writing Feedback Tool on the course
Tools and Resources page.
SCORING GUIDE
Your work will be evaluated using this criteria.
VIEW SCORING GUIDE
Competencies Measured
By successfully completing this assignment, you will demonstrate your
proficiency in the following course competencies and scoring guide criteria:
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Competency 1: Apply information literacy and library research skills to obtain
scholarly information in the field of health care.
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Use scholarly information to explain a health care problem or issue.
Competency 2: Apply scholarly information through critical thinking to solve
problems in the field of health care.
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Analyze the problem or issue.
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Discuss potential solutions for the problem or issue.
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Competency 3: Apply ethical principles and academic standards to the study
of health care.
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Explain the ethical principles (Beneficence, Nonmaleficence,
Autonomy, and Justice) if potential solution was implemented.
Competency 4: Write for a specific audience, in appropriate tone and style, in
accordance with Capella’s writing standards.
•
Produce text with minimal grammatical, usage, spelling, and
mechanical errors.
•
Integrate into text appropriate use of scholarly sources, evidence, and
citation style.
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Analyze a Current Health Care Problem or Issue
Learner’s Name
Capella University
NHS4000: Developing a Health Care Perspective
Instructor Name
August, 2020
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2
Analyze a Current Health Care Problem or Issue
Patient safety, as discussed in the previous assessment, is an important element of quality
health care. This assessment will expand upon patient safety issues that occur when patients are
exposed to inadvertent harm or injury while receiving medical care. Health care organizations
should maintain and develop a safety culture to prevent patient safety issues. Patient safety
culture is defined as a system that promotes safety by shared organizational values of what is
important and beliefs about how things work. It also encompasses how these values and beliefs
interact with the work unit, organizational structures, and systems to produce behavioral norms
(Ulrich & Kear, 2014). As such, care should be taken to improve the infrastructure of health care
organizations. Improving patient safety should be discussed and addressed by every individual
associated with public health care.
Elements of the Problem/Issue
Research shows that while getting treated at health care organizations, patients might be
at risk of experiencing the harm or injuries associated with medical care. The most likely causes
of patient safety issues are preventable adverse events, which are adverse events attributable to
error. These errors can be classified as diagnostic errors, contextual errors, and communication
errors (Ulrich & Kear, 2014).
Diagnostic errors take place when health care professionals provide a wrong or delayed
diagnosis or no diagnosis at all (James, 2013). An example of a wrong diagnosis is a health care
professional diagnosing a patient with gastric troubles when the patient is actually experiencing a
heart attack. An example of a delayed diagnosis is a patient not being notified of an abnormal
chest X-ray, thereby delaying diagnosis of a serious medical condition. An example of a missed
diagnosis is a patient not being diagnosed with heart failure despite warning symptoms.
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Contextual errors occur when health care professionals fail to consider their patients’
personal or psychological limitations while planning appropriate care for them. An example is a
health care professional’s failure to recognize that basic follow-up discharge instructions may not
be understood by patients with cognitive disabilities (James, 2013). It is important for health care
professionals to be aware of their patients’ mental and physical abilities before they formulate a
plan of care.
Communication errors occur when there is miscommunication or lack of communication
between health care professionals and patients (James, 2013). They can cause severe harm to
patients. An example of this is a nurse failing to tell a surgeon that a patient experienced
abdominal pain and had a drop in red blood cell count after an operation, resulting in the death of
the patient due to severe internal bleeding. Limited health care knowledge; language barriers;
and auditory, visual, and speech disabilities could also lead to communication errors and cause
safety issues.
Analysis
As a medical transcriptionist, it is important for me to be aware of potential transcription
errors and privacy standards, which affect patient safety. Errors like these pose dangerous risks;
therefore, it is necessary to have an overall quality evaluation of the transcribed documents.
Also, I must ensure that serious difficulties in transcription resulting from poor-quality voice
files are reported immediately to the manager, who will then convey this to the health care
professionals involved in the process. This will help ensure that patient safety is not
compromised.
Context for Patient Safety Issues
With the advancement of medical technology, health care processes have become
extremely complex. Health care professionals are required to stay up to date with a lot of new
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knowledge and innovations obtained from research. This often overburdens them as there is a
need to apply the learning from research in their practice. Also, at the individual level, there is a
dearth of well-balanced continuing education programs, which has resulted in a lack of attention
to patient safety among health care professionals. At the system level, organizations fail to
deliver optimum health care as a result of being understaffed, an inability to provide appropriate
technology, and ineffective execution of patient care transfer (James, 2013). Overcrowding and
understaffing delays initiation of treatment and puts critically ill patients at significant risk. All
of these factors contribute to a rise in patient safety issues.
Populations Affected by Patient Safety Issues
Patients with a psychiatric history are also a vulnerable group of people who face patient
safety issues because their psychiatric records are often combined with their current symptoms.
Patients with a documented history of psychiatric illness may avoid seeking health care services as
they feel that their care will be based on their past record of illnesses and not their present needs.
Therefore, psychotherapists should implement measures such that their psychiatric data is concealed
from their medical records before it is shared with the third party, which helps protect patients’
confidentiality (Shenoy & Appel, 2017).
Considering Options
Patient safety in hospitals can be achieved by creating a culture of safety that involves
effective communication, correct managerial leadership styles, and the use of Electronic Health
Records (EHRs). Effective communication while passing patient-specific information from one
health care professional to another is essential in ensuring continuous and safe patient care.
Training the team could likely improve consistent successful communication and help prevent
errors. Standardizing critical content that needs to be communicated by the initial health care
professional ensures safe transfer of care (Farmer, 2016).
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It is essential for leadership teams to adopt organizational strategies that would improve
patient safety and transform their organizations into reliable systems for enhanced patient
satisfaction. They should set strategic safety goals, which could include adhering to standards of
health, assessing quality, using patient satisfaction reviews, and analyzing adverse event reports
to determine improvement in safety issues (Parand et al., 2014).
An EHR is another potential solution to prevent patient safety issues. It is a digital record
of a patient’s medical information that includes history, physical examination, investigations, and
treatment (Ozair et al., 2015). It helps manage multiple processes in the complex health care
system and prevents errors. EHRs utilize less storage space compared to paper documentation
and allow an infinite number of records to be stored. In addition to being cost-effective and
preventing a loss of records, EHRs help conduct research activities and provide quick data
transfer (Ozair et al., 2015).
Solution
In health care, because transmission of information takes place among different people
and electronic devices, there is a high likelihood of errors occurring. For example, transcription
errors (which occur due to poor audio quality or the lack of a quality evaluation process) can be
prevented by using recording equipment with good sound quality and by maintaining
proofreading and quality checks. However, integrating transcription processes with the HER
system helps prevent errors, helps access the required information faster, and allows health care
professionals to take accurate decisions about patients’ care.
Implementation
An EHR is an important mechanism for improving patient safety. Its advancement has
made it a viable option to prevent medical errors. However, the use of EHRs has certain ethical
implications such as security violation, data inaccuracies, lack of privacy and confidentiality, and
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6
challenges during system implementation. Security violation takes place when patients’
confidential health information is accessible to others without their permission. To avoid security
violation, data should not only be password protected but also encrypted to restrict access to
unauthorized individuals. Firewalls and antivirus software should be used to protect data (Ozair
et al., 2015).
Though EHRs improve patient safety by reducing medical errors, data inaccuracies are
increasing. Loss of data during data transfer leads to inaccuracies that affect decision-making
related to patient care. A problem of concern related to data inaccuracy is medical identity theft,
which leads to incorrect information being filed into a person’s medical record, which in turn
leads to insurance fraud and wrong billing (Ozair et al., 2015).
In health care, information that is shared during physician–patient interactions should be
kept confidential and should be made inaccessible to unauthorized individuals. Enabling rolebased access controls based on user credentials will restrict access to the EHR system to
authorized users. The user should also be made aware that he or she is responsible for any
information that he or she misuses (Ozair et al., 2015).
As EHR is a complex software, there is a high likelihood that software failure may result
in inaccurate recordings of patients’ data. Therefore, EHR system implementation may have
ethical implications due to the violation of data integrity (Ozair et al., 2015). EHRs can safeguard
patient confidentiality by using various methods that prevent security breaches. In addition to
this, creating reminders that ask for a confirmation before accessing confidential information can
help protect data. A nesting system could be developed, which would allow, for example, a
health care professional from a specific specialty clinic to access patient records by signing into
the specialty domain (Shenoy & Appel, 2017). These methods will enable the safe and efficient
use of EHRs and ensure patient safety.
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Conclusion
Patient safety involves preventing the risk of harm or injuries to patients by establishing a
safety culture and providing high-quality medical care. Health care organizations must
understand patient safety issues and find solutions for these issues by designing systems that
prevent errors from occurring. Potential solutions include effective communication, changes in
leadership style, and the use of EHRs. The ethical implications of these solutions should be
considered before implementing them in a health care setting. It is also important that health care
professionals undergo continuous education and effective training, provide appropriate medical
care, prevent errors, and follow safety practices to improve clinical outcomes.
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References
Farmer, B. M. (2016). Patient safety in the emergency department. Emergency Medicine, 48(9),
396–404. https://mdedge.com/emed-journal/article/113659/trauma/patient-safetyemergency-department
Flood, B. (2017). Safety of people with intellectual disabilities in hospital. What can the hospital
pharmacist do to improve quality of care? Pharmacy, 5(3).
https://ncbi.nlm.nih.gov/pmc/articles/PMC5622356/
James, J. T. (2013). A new, evidence-based estimate of patient harms associated with hospital
care. Journal of Patient Safety, 9(3), 122–128.
http://dx.doi.org/10.1097/PTS.0b013e3182948a69
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health
records: A general overview. Perspectives in Clinical Research, 6(2), 73–76.
http://dx.doi.org/10.4103/2229-3485.153997
Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality
and patient safety: A systematic review. BMJ Open, 4(9).
http://dx.doi.org/10.1136/bmjopen-2014-005055
Shenoy, A., & Appel, J. M. (2017, April). Safeguarding confidentiality in electronic health
records. Cambridge Quarterly of Healthcare Ethics, 26(2), 337–341. https://searchproquest-com.library.capella.edu/docview/1882434628?pqorigsite=summon&https://library.capella.edu/login?url=accountid=27965
Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of excellent
health care delivery. Nephrology Nursing Journal, 41(5), 447–456, 505. https://searchproquest-
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com.library.capella.edu/docview/1617932572/fulltextPDF/1486CC30B3624B3CPQ/1?ac
countid=27965
Copyright ©2020 Capella University. Copy and distribution of this document are prohibited.