Errors in the ICU

Medication Errors

One of the major challenges impact healthcare providers is medical errors. These issues are challenging, as they will have an adverse impact on quality and safety. In the case of the ICU, these challenges are becoming more pronounced. This is because of the different conditions and large number of patients they are working with. A good example of this can be seen with insights from Orgeas (2010) who said, "Although intensive care units (ICUs) were created for patients with life-threatening illnesses, the ICU environment generates a high risk of iatrogenic events. Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention. We describe the selection of indicator MEs, the incidence of such MEs, and their relationship with mortality. We selected indicator MEs using Delphi techniques. 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) These insights are showing how there are select medical errors inside the ICU which are impacting quality. To prevent this, a new approach must be utilized that is focusing on the problem, the setting and evidenced-based solutions. Together, these elements will highlight the frequency of these issues and the best way to address them in the future.

Be sure to identify how specific theory and knowledge from each of the following areas contributed to your ability to identify or solve the nursing problem: a. Specific prior general education courses - First Responder, EMT and Paramedic Certification, ADN and well my BSN upon completion of this Capstone Project

To deal with these challenges, a new approach must be utilized. It is concentrating on how there are specific courses individuals can take to deal with the issue of safety. In these cases, healthcare professionals can learn the proper techniques during training (i.e. General Health, Biology, Chemistry, Psychology, Basic First Aid, Anatomy and Psychology). However, they must be able to quickly respond to the pressures they will face inside the ICU. This means that they will be in a hurry and can overlook critical factors. Once this happens, is the point the odds increase of errors developing during the process. (McClean, 2011)

b. Specific prior nursing courses - Pharmacology

The different Pharmacology courses include: Drug Discovery & Emerging Therapeutics, Autonomic / Cardiovascular Pharmacology, Neuropharmacology and Endocrine Pharmacology & Chemotherapeutics. These areas help to identify possible side effects on the body from specific drug and forms of treatment.

c. Your nursing background and experience - 2 years ICU experience, ACLS, PALS and IV Administration certification

I have two years experience working inside the ICU. During this time, I gained various certifications in ACLS PLAS and IV administration. These areas allowed me to become an expert in performing different tasks. The result is that I am able to understand and troubleshoot challenges quickly.

2.Consider the following questions as you justify the existence of the identified problem at the setting: a. Why is this problem important to the site and to nursing?

This problem is important to the field of nursing, as patients will depend upon them to alleviate suffering and identify problems early. They will discuss these ideas with other professionals to prevent the situation from becoming worse as a part of the team. However, if this does not occur, there is the possibility the patient will become sick. This is when the facility will face higher odds of litigation and regulatory issues from failing to take these variables into account. (McClean, 2011)

b. How does this problem affect the staff/patients/clients at the facility? (Or if in the past, how did this problem affect the staff/patients in the previous facility?)

This problem affects the staff, as it is showing the tremendous amounts of pressure they are under. Too often, many healthcare facilities are increasing the total responsibilities on everyone. This is designed to deal with the larger number of patients and increasing demand for professional services. In the future, this negatively impacts quality and the types of services they are delivering. (Scruggs, 2010)

c. What is the current state of this problem in health care?

The problem is illustrating how this something that continues to have an adverse impact on the ICU. A good example of this can be seen with statistics from the Center for Disease Control. They determined that inside the ICU, there are 721,800 issues every single year. In most cases, the healthcare professional is under increasing amounts of pressure to perform different tasks. This means that they will often overlook their techniques and important notes on the patient's chart. Once this happens, is the point the odds of an errors occurring will rise dramatically. ("Data and Statistics," 2014)

d. Is it a problem in the country, globally, at other local organizations, or specifically in this facility?

This is a problem that is developing nationwide and within individual health organizations. These issues are directly related to the increasing demand for nurses and other healthcare professionals. The result is that more is being of asked of them during the process. (Marino, 2012)