Effects of to Err Is Human in Nursing Practice

¶ … Err is Human: Summarize how informatics has assisted in improving health care safety in your organization and areas where growth is still needed.

The 1999 report "To Err is Human" shocked the medical establishment with its reports of high levels of medical errors in hospitals throughout the country. Patients were worried about how fallible health providers could be, and the extent to which they often denied or ignored the fact they were at fault. However, the report always stressed that improved safety was the primary concern of the report, not to blame doctors and nurses. Today, more than ten years since the report was issued, providers are searching for ways technology can be used to improve patient safety through creating an additional barrier against error for the healthcare provider.

One of the most frequently-cited justifications for electronic medical records is the extent to which they can improve accuracy of diagnosis and treatment. EMR can provide complete information about a patient at the touch of a keypad and enables easier sharing of information between providers caring for the same patient. Technology in general has been very helpful in improving the accuracy medical care -- it can automatically monitor everything from patient's heart rate to blood sugar to how much medicine is dispensed. However, providers must know how to use the technology properly and accurately, which is no less true for EMR. Data must be completely and accurately recorded for EMR to genuinely improve patient welfare.

To understand the types of technology that can guard against errors, one must understand the types of errors healthcare providers are prone to: "the first type of task occurs when people engage in well-known, oft-repeated processes, such as driving to work or making a pot of coffee. Errors may occur while performing these tasks because of interruptions, fatigue, time pressure, anger, distraction, anxiety, fear, or boredom. By contrast, tasks that require problem solving are done more slowly and sequentially, are perceived as more difficult, and require conscious attention. Examples include making a differential diagnosis and readying several types of surgical equipment made by different manufacturers. Errors here are due to misinterpretation of the problem that must be solved and lack of knowledge" (Donaldson 2008). Technology can guard against behaviors which become rote, and which the provider does unconsciously (such as doling out medication, writing vital statistics in a chart, or checking various measurements) by forcing providers to write down all of the information in a computerized format and also guard against errors due to ignorance, such as a lack of knowledge about the patient's medical history.

However, there has been resistance to the use of EMR and other forms of health informatics. For example, some healthcare providers feel that it is impersonal to have to look at a screen when entering patient information, and that this acts a barrier to connecting with patients in a meaningful fashion. There are also the risks of what can occur when patient information is entered inaccurately, although some programs can post 'error' messages when obviously incorrect information is recorded.