According to research conducted by A.T. Still University in Mesa, Arizona, approximately 7,000 high school athletes suffer concussions annually. While most attention is focused on brain injuries from football, any high-school sport puts players at risk.
A state law passed in 2011 requires high school athletes to be removed from play if a concussion is suspected. The player is required to receive written clearance from a medical professional before returning to the field.
According to a spokesman from the Institute for Safe Medication Practices, Arizona hospitals that do not train doctors and nurses in medication safety may be putting patients at risk. Hospital education programs that are inconsistent and "siloed," or specific to a particular discipline, may increase the risk of a medication error. Recent studies show that medical practitioners are often lacking in training and knowledge related to medications.
A Pennsylvania-based institute administered a survey to medical practitioners that asked them questions regarding how well-oriented and trained they were at using high-alert drugs and preventing medication errors. The results showed that the average practitioner score was only 64 percent. Another study with similarly alarming results showed that of those hospitals who responded, only 34 percent had staff pharmacists who spend time in patient units to see how drugs were administered and stored. Even worse, only 28 percent of nurses were trained in the pharmacy while going through orientation.
In a case with implications from Arizona to New York, an Indiana heart surgeon screamed at an worker who handled a heart/lung machine during surgery, and the Supreme Court awarded the employee a $325,000 settlement. Experts report that employee relations among hospital staff and disruptive behavior between medical personnel can cause workplace problems that lead to surgical errors.
One executive explained that the emotional impact can distract medical personnel and endanger a patient's life. The Joint Commission has released standards for professionalism in the medical field in order to reduce and eliminate threats, intimidation and verbal outbursts that could affect employees or patients. Organizations are now realizing that patient safety is on the line.
Arizona residents may be aware that robot surgery performed with a system commonly known as the da Vinci is on the rise. In fact, 400,000 surgical cases used the da Vinci last year, tripling the number of cases just four years ago. However, there have been several deaths linked to the robot system, and some doctors feel that it's time to limit its use and curb the possible surgical errors. This may be of interest to Arizona readers because the da Vinci system is used nationwide.
The da Vinci is commonly used for removing gall bladders, prostates, hysterectomies, shrinking stomachs and repairing heart valves. It is less tiring for surgeons because they remain sitting at a computer screen, and robot hands don't shake. Sometimes, there is less bleeding and often patients go home sooner than they do following conventional laparoscopic procedures.
Approximately 2.5 percent of emergency room visits are for preventable adverse drug reactions. There are indications from collected data that show pharmacists may be able to help lower the number of medication errors.
Millions of people in America are taking a number of medications. A report presented at the American Pharmacists (APhA) Annual Meeting showed that lack of medication management at admission and discharge at hospitals is costing a great deal of money because medication errors account for nearly $1.5 million preventable adverse drug reactions that cost $3 billion per year. Many of these incidents can be attributed to poor communication during transitions in patient care.
New regulations in Arizona and across the nation limit first year medical students to 16-hour shifts at the hospital, down from 30-hour shifts. The intent of the shorter shifts was to give residents a break and cut down on harm to patients through medication errors, missed diagnoses and incorrect treatment. However, two studies indicate that the amount of errors may actually be increasing since the change was implemented.
The first study was at Johns Hopkins in Maryland. It followed 43 interns on three different schedules in the month before the switch from a 30-hour shift to a 16-hour shift. One schedule was the traditional 30-hour shift every fourth night, the other a 16-hour shift every fifth night and a "night float schedule" that was so unsuccessful that it was dropped before the end of the study. The study showed that despite the extra hours outside the hospital, the residents on the 16-hour shift weren't getting any more sleep on average than their 30-hour counterparts. Furthermore, those residents on the shorter shifts had a higher number of patient handoffs at the end of their shifts, which can lead to a higher incidence of errors.
Residents of Arizona may end up with the wrong medication if medical professionals are not careful when two medications have similar names. A medication error nearly occurred for a patient who was supposed to receive the drug eribulin but was nearly given epirubicin due to an order entry error. Both drugs are for breast cancer treatment, and their similar names have led to clerical errors in the past.
In spite of previous mix-ups, the issue had not been reported to the hospital's internal error reporting process, so it was not addressed at the time. In an effort to prevent future errors, the hospital is now using tall man lettering and listing fuller names for the drugs, so they are now listed as eriBULin mesylate injection and epiRUBICIN injection.
According to a study that was published in Health Affairs in 2011, adverse medical errors were a factor in almost 33 percent of patient admissions. Another report from 2012 discovered that of such adverse events, about 44 percent could have been prevented.
Surgical error takes many forms. Arizona residents might remember one well-publicized case where a single hospital committed two errors in a row after leaving an object inside a surgery patient, which necessitated a subsequent removal surgery. According to some estimates, medical errors cost around $1 trillion each year in lawsuits, fines, loss of productivity and other indirect costs. Many of these issues could have been prevented by organizational changes and improved communication between providers.
Arizona residents may have heard of robosurgery, a new form of surgery that involves a surgeon using a console much like the ones used to play video games to perform intricate procedures. The doctor works several feet away from the patient and uses a high definition display, hand controls and foot pedals to maneuver mechanical arms with surgical tools. It is thought to be safer and to reduce fatigue for doctors. However, a number of lawsuits involving a surgical error have been filed recently over debilitating injuries and deaths that have been attributed to robosurgery.
According to data sent to regulators since 2009, approximately 70 deaths have been linked to robot surgical systems manufactured by California-based Intuitive, and it is the only company with a system approved for soft tissue procedures that include gynecological, prostate and general surgeries. Some 367,000 surgeries were performed in 2012 with the systems, which cost $5.1 million each. An analyst noted that hospitals aggressively market their use without mentioning the cases gone awry, and patients request them because they perceive robotic surgery as being a better option.
According to a recent study published in the Journal of the American Medical Association, primary care doctors occasionally make diagnostic mistakes that can have serious health repercussions for patients in Arizona and across the nation. For instance, in one documented case, a doctor mistakenly diagnosed a pneumonia-stricken patient with bronchitis, which prompted an unexpected trip to the hospital.
The study examined 190 cases of diagnostic errors; 68 of these cases were wrong diagnoses. Errors were spread out across common conditions such as pneumonia, congestive heart failure, urinary tract infection and cancer. Such a misdiagnosis can lead to a medication error or the delay of needed treatment, which can have dire health consequences.
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