Patient Safety in Obstetrics and Gynecology ABSTRACT: Since publication of the Institute of Medicine's landmark report To Err is Human: Building a Safer Health System, emphasis on patient safety has steadily increased. Obstetrician–gynecologists should continuously incorporate elements of patient safety into their practices and also encourage others to use these practices. ______________________________________ The American College of Obstetricians and Gynecologists (ACOG) is committed to improving quality and safety in women's health care. The Institute of Medicine report, To Err Is Human: Building a Safer Health System, notes that errors in health care are a significant cause of death and injury (1). Despite disagreements over the actual numbers cited, all health care professionals agree that patient safety is extremely important and should be addressed by the overall health care system.
It said that there are 2,000 deaths every year from needless surgery; 7,000 deaths from prescription errors in hospitals; 20,000 from other errors in hospitals; 80,000 from infections in hospitals; and 106,000 deaths every year from non-error, fatal effects of medications. In all, 225,000 deaths occur per year in the US due to unintended medical errors. This assignment analyses on one of such cases of medical negligence. It will briefly summarize the case study in the first portion of this assignment. It will then define the 4 d’s of ethics which are namely Duty, Dereliction, Damage and Direct.
QSEN Competency of Safety A major push for the improvement of quality and safety outcomes was in 2000 when the Institute of Medicine published, To Err Is Human: Building a Safer Health System. In 2003 the Institute of Medicine (IOM) laid out the six core competencies for healthcare workers. In 2007, the Quality and Safety Education for Nurses (QSEN) project redefined the competencies to fit the care of nurses (Jones, 2013). Two of the competencies laid out in this project are quality and safety. These are often clumped together, but are in fact two separate competencies.
Much of the work defining patient safety and practice that prevent harm have focused on negative outcome of care such as modality and morbidity. Nurses are critical to the surveillance and coordination that reduce such adverse outcome. Much work remains to be done in evaluating the impact of nursing care on positive quality indicators such as appropriate self care and other measures of improved health status. {Kathryn Rhodes Ade et al
In United States, intestinal ischemia accounts for 0.1% of all hospital admissions, the incidence of this condition has increased over the last few decades ( from 1 in 1000 to 1 in 200 hospitalization for abdominal pain). In most cases, intestinal ischemia requires emergency treatment to avoid tissue necrosis, infectious outcomes, septic shock or lethal multiple organ failure [6]. Intestinal ischemia has been defined as impairment of the intestinal blood supply from celiac axis, superior mesenteric artery and inferior mesenteric artery, this results in tissue injury and a low-flow state with poor intestinal arterial perfusion [ 7]. Procalcitonin (PCT) is a 116-amino-acid (AA) precursor of calcitonin [8], that was first
Thus safety is the foundation upon which all other aspects of quality care are built [6] Patient Safety A definition for patient safety has emerged from the health care quality move that is equally abstract, with different approaches to the more specific essential components. Patient safety was defined by the IOM as “the prevention of damage, to patients.” Emphasis is placed on the system of care delivery that prevents mistake; learns from the mistake that do occur; and is built on a culture of safety that involves health care professionals, organizations, and patients. The definition of prevention of damage: “freedom from accidental or preventable injuries produced by medical care.”[6] Patient safety practices have been defined as “those that reduce the risk of adverse events related to exposure to medical care across a domain of diagnoses or conditions.” This definition is concrete but quite imperfect, because so many practices have not been well studied with respect to their efficiency in preventing or improve harm. Practices considered having sufficient evidence to include in the class of patient safety practices are as follows:
In 2000-2004 New Zealand health survey reported that, around 18% for Maori deaths are because of ischemic heart disease, whereas 23% of non-Maori (Robson & Harris, 2007). Stroke: Robson & Harris, (2007) describes that Stroke is a sudden interruption of blood flow to a part of the brain, causing damage to the brain cells is also known as ‘brain attack’. Stroke is the leading cause of mortality as well as disability in New Zealand. The main risk factors are high blood pressure and smoking. Surveys showed that around 800 Maori were admitted to hospital each year in that 140 per year die from stroke.
Medication mistakes nowadays is one of the main reasons of deaths in hospitals. About 1,5 million Americans are injured by this issue (Anderson, 2010) and it costs $3,5 billion
Studies show that the hospital stay of patients is usually prolonged approximately 2 more days due to these medication errors. As a result, this increases costs approximately $2000-$2500 dollars per patient (Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013). The patients’ physical health is at risk, including the ability to function with everyday activities, and their mental health could be altered, potentially causing anxiety and other psychological symptoms (Rejane & Goldim, 2013). Depending on the type of medication administration error performed, the patient could potentially be physically harmed, incapable of performing activities of daily living, or could potentially die. The elderly are the number one population to have death related to a medication administration errors (Brunetti & Suh, 2012).
For examples, the US government found that computer related health problems has caused high costs to employers reflected in people taking sick leave( absenteeism), which leads to a loss in productivity, but also direct costs are incurred for health care and worker’s compensation. In the US, around seventy million people see doctors each year because of computer-related health problems. In 1999, nearly 1 million people were on sick leave to recover from computer-related pain. The US government estimates that the annual cost to the economy because of computer-related health problems is between $45 and $54 billion. This is because of direct costs for health care, lost wages, and lost productivity.