Disagreement on Medical Error Reporting May Place Patients at Risk; New American Journal of Nursing Study Uncovers Systemic Problem.

Business Editors/Health/Medical Writers

2004 Advancing Nursing Practice Excellence: State of the Science

Congress

NEW YORK--(BUSINESS WIRE)--June 8, 2004

Journal to Convene Special Symposia to Review and Address

Challenges

Hospital administrators, physicians and nurses are not in agreement on who is in charge of patient safety; what constitutes a medical error; how these errors should be reported and, therefore, what actions are needed to prevent them in the future. The study, published in the June issue of the American Journal of Nursing, points to one of the most significant challenges facing the American health care system -- clear communication among medical professionals.

According to the Institute of Medicine, at least 100 patients die daily in the U.S. due to errors. Study authors state that clear agreement and communication among health care professionals would help eliminate many errors and improve overall patient safety.

The multi-method errors and patient safety study, conducted in 29 rural hospitals in 11 states, revealed:

-- 90 percent of hospital workers believe patient safety is

primarily the responsibility of nurses

-- Only 22 percent of study participants believe that patient

safety is a responsibility shared equally among nurses,

physicians, pharmacists and hospital administrators

-- Many administrators, who defer to physicians in determining

that an error has occurred, admit they lack expertise to

define a medical error.

Lead author, Ann Freeman Cook, PhD, associate professor of psychology and director of the National Rural Bioethics Project, University of Montana, Missoula, found in a previous study that only 8 percent of physicians consider nurses decision makers in patient care, yet most errors are classified as "nursing errors."

"The findings in this study are consistent with anecdotal accounts from nurses representing different regions, sizes and philosophies," said Ann Freeman Cook, PhD, associate professor of psychology and director of the National Rural Bioethics Project, University of Montana, Missoula.

The American Journal of Nursing is encouraging nurses use the study to work within their health systems to create a shared system and agreed communications for reporting errors in the workplace. Authors suggest that hierarchical silos may unintentionally limit health professionals' ability to define errors and take steps to offer corrective action.

Funded by the Agency for Healthcare Research and Quality, the study reports that many physicians do not consider errors to include "delays in treatment; the use of outmoded treatments; the failure to employ needed diagnostic tests; the failure to act on the results of testing; errors in administration of treatment, and the failure to communicate with staff and patients." Instead, these occurrences are often labeled suboptimal outcomes.

According to Diana J. Mason, RN, PhD, FAAN, Editor-in-Chief of the American Journal of Nursing: "These results indicate a rift between key members of the patient-care team that must be resolved if patient safety is to improve. The work environment should foster open dialogue among health care workers toward the goal of eliminating errors."

The American Journal of Nursing will explore medication error at an invitational symposium at the 2004 Advancing Nursing Practice Excellence: State of the Science Congress on July 16 in Philadelphia. The symposium will focus on medication error as it pertains to nursing and the apparent different standards set for health care professionals that affect patient safety.

Founded in 1900, The American Journal of Nursing is the official publication of the American Nurses Association and the largest and oldest circulating nursing journal in the world. It is published by Lippincott Williams & Wilkins, a unit of Wolters Kluwer Health, a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons, online information services including Ovid Technologies, Medi-Span and SKOLAR, and pharmaceutical information provider Adis International.