Reducing Medical Errors in the Modern Healthcare Setting One of the biggest challenges impacting healthcare providers are the total number of medical errors that occur on a regular basis. These areas are problematic, as they are adversely effecting the safety and quality of care provided. This is because nurses are often overwhelmed from the increasing number of responsibilities and regulations. (Orgeas, 2010)

For example, a study that was conducted by Orgeas determined that the most critical departments (such as: the ICU) are facing these challenges with him saying, " Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention. An observational prospective multicenter cohort study of these MEs was conducted from March 27 to April 3, 2006, in 70 ICUs; 16 (23%) centers were audited. Harm from MEs was collected using specific scales. Fourteen types of MEs were selected as indicators; 1,192 MEs were reported for 1,369 patients, and 367 (26.8%) patients experienced at least 1 ME (2.1/1,000 patient-days). The most common MEs were insulin administration errors (185.9/1,000 d of insulin treatment). Of the 1,192 medical errors, 183 (15.4%) in 128 (9.3%) patients were adverse events that were followed by one or more clinical consequences (n = 163) or that required one or more procedures or treatments (n = 58). By multivariable analysis, having two or more adverse events was an independent risk factor for ICU mortality (odds ratio, 3.09; 95% confidence interval, 1.30 -- 7.36; P = 0.039). The impact of medical errors on mortality indicates an urgent need to develop prevention programs." (Orgeas, 2010) This is showing how mistakes are becoming more common. To prevent them, graduate nurses must be trained to deal with the challenges in today's healthcare environment. This will be accomplished by creating a lesson plan that is focused on the rationale, target audience, developing a questionnaire, discussing the goals / objectives and the resources. Together, these different elements will show how this program can address the most pressing issues well into the future.

Description and Rationale

Medical errors are something that is a direct contributor of rising healthcare costs. In a study that was conducted by Encinosa (2008). He found that medial errors will increase expenses between $646 and $28 thousand annually. This normally occurs within 90 days after the procedure or the time a patient is discharged from the hospital. To deal with these challenges, requires using graduate nurses in conjunction with RNs and LPNs. (Encinosa, 2008)

Evidence of this can be seen with Encinosa saying, " We find that the costs of patient safety events are considerably higher when we address all of these postoperative costs following the initial hospitalization. In fact, for excess payments due to the infections PSI class, the total excess payments during the entire 90-day episode are 28% larger than the excess payments incurred during the initial hospitalization. This large difference in the return on patient safety could make many interventions much more cost-effective than previously thought. For example, we found that increasing the RN/LPN mix to the 75th percentile and raising the number of licensed nurse hours to the 75th percentile saved $6.9 billion in 2002 costs by reducing adverse events, ignoring physician and post-discharge costs. By this estimate, the investment is not cost-effective for hospitals; the cost-savings would need to be 23% higher for the hospital to break-even on the investment. It is quite possible that the post-discharge cost savings achieved by reducing adverse events might just be enough for the hospital to break-even on the investment in nursing." (Encinosa, 2008) This is showing how improved training can have an impact on decreasing errors, costs and liabilities.

In many cases, medical errors will have an impact on the emotional and mental well being of healthcare professionals. According to Boyle (2011), there is an adverse impact on physicians with him concluding that:

61% reported worried about future errors taking place.

44% stated they lost confidence after these events.

42% said they are having sleeping difficulties.

42% stated they were feeling more stressed at work and are less satisfied with their careers.

13% reported damage to their reputations from these mistakes. (Boyle, 2011)

This is problematic, as it will have a negative impact on the confidence on all healthcare professionals. As they will question their abilities and have feelings of helplessness. The close relationship between doctors and nurses means that these effects are wide ranging. To prevent these challenges, requires that more training must be provided to graduate nurses. This will help them to become capable of adjusting with numerous challenges. In many ways, one could argue that this is the key for improving quality and reducing costs...

In general, most of these people have experience and learned advanced skills in a practicum setting. The problem is that they will face difficulties given the scope of their new roles and responsibilities. At the heart of these challenges, are frustrations with the bureaucracy and ability to meet the changing needs of patients. In some cases, they are powerless to prescribe medication and cannot make adjustments to their treatment protocol.
A good example of these can be seen with a study that was conducted by the International Counsel of Nurses and Pfizer. They found a number of troubling results which are directly contributing to a rise in errors. The most notable include:

92% reporting time constraints in working with patients and other healthcare professionals.

48% believe more of the workload is passed onto them.

42% are concerned that there is a lack of training and professionalism in new and experienced nurses.

46% are viewing their careers worse than they did 5 years ago.

48% believed that they will continue to work in the field 5 years from now.

70% want to prescribe medication and make adjusts to the patient's treatment protocol. While, only 20% have the qualifications and authority to do so.

These figures are showing that the target audience is nurses who are experienced and want to expand their skills. (Cole, 2009)

However, at the same time, the training will focus on those individuals who have recently graduated from advanced nursing programs. In these situations, students are new to the field of healthcare and must learn the proper techniques when working inside a modern setting. This is because they play a major role by serving as a collaborator that understands the long-term effects on patients and other colleagues. This means they will exchange information with these stakeholders to improve quality. Throughout the process, they are striving to build upon the standards of accountability and available treatment options. In the future, they understand what is happening and the effects of treatment protocols. This improves collaboration, professionalism and teamwork. As a result, both groups are targeted based upon the role they play in a healthcare environment and the impact they will have in reducing medical errors. The psychomotor skills they learn will help them in achieving these larger objectives. This is the point, they can make a difference and enhance quality. (Masters, 2013)

Learner Questionnaire

To understand what issues are impacting students requires examining their strengths, weaknesses, attitudes and beliefs. This will be accomplished using a questionnaire that is focusing on a number of areas. The most notable include: experience, education and opinions about the field of medicine. The process will focus on using the mixed method approach to comprehend which variables are the most important.

According Odell (2009), those programs are concentrating on improving the beliefs, practices and the approach that is utilized by healthcare professionals with her saying, "Failure to recognize or act on deterioration of general ward patients has resulted in the implementation of early warning scoring systems and critical care outreach teams. The evidence of effectiveness of these systems is unclear. Possible mechanisms for low effectiveness may be inconsistent recording of patient observations by ward staff, or inconsistent application of 'calling criteria' for outreach teams, even when observations have been recorded. Three broad search categories were used: nursing observations, physiological deterioration and general ward patients. All research designs describing nursing observations (vital signs) on deteriorating adult patients in general hospital wards were included. Fourteen studies met the inclusion and quality criteria. The findings were grouped into four main themes: recognition; recording and reviewing; reporting; and responding and rescuing. The main findings suggest that intuition plays an important part in nurses' detection of deterioration, and vital signs are used to validate intuitive feelings. The process is highly complex and influenced by many factors, including the experience and education of bedside nurses and their relationship with medical staff. Greater understanding of the context within which deterioration is detected and reported will facilitate the design of more effective education and support systems." (Odell, 2009) This is showing how any program must adapt to new realities and change the way nurses are trained. Once this happens, is the point they are more responsive to the needs of stakeholders and can decrease medical related errors. In the long-term, this will improve professionalism, reduce costs and enhance quality.

Goals

The teaching plan…