Avoiding Errors in Hospitals

april-26-002Today is Saturday, July 13, 2013.

According to BBC News, if hospitals asked a series of only six questions, they could avoid operating on the wrong patient, or operating on the wrong part of the body.  It seems astounding, but an estimated 200-300 operations are done on the wrong patient every year in the United States.  Even with the checklist in place, a hospital in the UK managed to do eye surgery on the wrong patient recently.

Here are the questions that healthcare workers must be able to answer about each patient:

1)  Are you operating on the right patient?
2)  Are you performing the right operation?
3) Do you know the name and the job of every member of the surgical team?
4) Has the anaesthetic machine been checked?
5)  Are the patient’s oxygen levels being monitored?
6)  Have you removed all instruments from the patient?

Some of these questions scare the hell out of me.

I was in the hospital twice last November for a microbacterial infection in my right leg.  I wore not one, but several bracelets, all color coded, to make sure that the staff who came on duty knew who I was and what to do or not to do if I were unconscious.  As the illustration above shows, the ID bracelets nowadays have a bar code on them.  There was a computer in my room for the nurses’ use, and each time they came in to give me medications or even to rub some cream on my legs, they had to take a little laser scanner like the one a supermarket checker uses and scan my ID first.  When that was done, they would ask me to recite my full name and date of birth.  (The person who delivered my meals did this, too.)  Then they would scan the bar code on the medication or ointment they were giving me.  That way, the computer kept track of all my medications throughout the day and night.

25bracelets-600aI wore an allergy bracelet for codeine, a “fall risk” bracelet, and one that said no blood pressures or IVs were to be done on my right arm (because I had a mastectomy on the right side.)   When I was in the hospital a couple of years ago for blood clots in my lungs, I remember being asked in the emergency room whether I wanted to be resuscitated if I lost consciousness.  I said, “yes” with what little breath I had, so I did not wear a DNR bracelet (Do Not Resuscitate). In any event, with all the bracelets, I was pretty confident that they would not mistake me for someone else.

I have had numerous surgeries in the past five years, and – at least in the United States – it is common practice for the nurse to ask the patient when prepping him or her for an operation whether they know what procedure they are having.  (I remember asking her in a panic, “Don’t you know?”   Her answer: Yes, I know,  but I want to see if you know.”)

Questions #3-6 in the list above are the ones that scare me.  These have to be asked by the doctors, nurses, and technicians who are doing the surgery, and I heartily hope that the answer to each one will be, “Yes!”   :-/


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