Do you know that you are at a higher risk of been harmed while receiving healthcare in the hospital? Even though hospitals matter to people and they form a critical part of the community. It’s a place where people go for healing and recovery from illnesses, but it’s considered one of the most unsafe places. According to the world health organization (WHO), 1 in 3 million stand the risk of dying while traveling by airplane. In comparison, 1 in 300 stand the risk of dying or been harmed while receiving healthcare. The risk of harm is lower in the aviation industry than the healthcare due to better safety records.
In the United States and other developed nations, the risk of harm from receiving healthcare is 1 in 10, and in low and middle-income countries is 1 in 7. Over 50% of the adverse events that can lead to serious harm in the hospital are preventable.
I know that these statistics may be boring at some point because not everyone understands statistics. Hospital is a critical element of the health system at all levels. It provides coordination and the direction of the entire system to function effectively but, not many people know that hospitals could be unsafe. People do not seem to care about the dangers that exist in hospitals, including the health workers. Patients are desperate people who need help at all costs without minding the consequences. Health workers, on the other hand, are passionate people who are willing to help save lives. The hospital can become as busy as Wuse Market, especially during emergencies. Sometimes situations can be overwhelming for health workers to handle due to manpower shortages. A health worker who is overwhelmed and exhausted is prone to making a medical error that can pose a great risk for patients receiving care.
Medical errors are unintended acts that do not achieve their intended outcome regardless of whether it results in patient harm or death, and it can occur at an individual or systemic level. Medical error is the third leading cause of death in the US after heart disease and cancer. At least 98,000 people die in the hospital as a result of medical errors that could have been prevented. Every day, millions of patients suffer injury or die because of unsafe or poor quality of healthcare.
According to a study conducted in Nigeria, the most common medical errors include; diagnostic, medication, surgical complications, procedural and injection errors, among others. The study further revealed that most of the medical errors are not reported and the attitude of error disclosure to patients is negative. A significant number of health workers do not see the need of reporting such errors. Medical errors in Nigeria and Africa are not quantified due to underreporting, and poverty of research. However, current information shows that medical errors are more than expected. According to reports, globally 142,000 people die annually from preventable medical errors while in Nigeria, less than 5% of such errors get reported.
To help you understand, let’s examine some of the most common safety risks you should be aware of when visiting a hospital.
- Diagnostic error: Diagnostic error has been defined as “the failure to establish an accurate and timely explanation of the patient’s health problem(s) or communicate that explanation to the patient.” This error can further be categorized into delayed, wrong, and missed diagnostic errors. Most hospitals are equipped with highly sophisticated equipment, diagnosing patients are more of an interpretative skill than an intellectual challenge. If the physician focuses on the numbers and ignores the patient’s clinical status, vital information could be missed. Diagnostic errors can significantly impact patients’ care plans and lead to patients receiving treatments that may worsen their condition.
Health workers have a critical role in mitigating or avoiding diagnostic errors. Health workers should be advocates of their patients communicate to patients clearly when errors occur, monitor patients closely, and provide support for patients when the diagnosis is missed or yet to be determined. In middle and low-income countries, limited access to care and testing resources negatively affects diagnostic processes.
- Medication errors: Medication errors are defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer.” The most common medication errors in the hospital are wrong dosage calculation and inappropriate medication preparation.
For example; if 50mg of medication is prescribed for a patient, but the tablet comes in 100mg. The Nurse is required to cut this tablet in half before administering it to the patient. If final verification is not performed, this step can be missed and the patient may end up with the wrong dosage.
Human factors such as fatigue and poor working conditions affecting prescribing, preparation, storage, dispensing, administration, and monitoring practices can injure patients.
- Healthcare-associated infections: WHO estimates that out of every 100 hospitalized patients, at any given time, seven in high-income countries and 10 in low- and middle-income countries will acquire one or more healthcare-associated infections (HAIs). People with methicillin-resistant Staphylococcus aureus (MRSA), a bacterium increasingly found in hospital settings that is resistant to most antibiotics, are estimated to be 64% more likely to die than people with a non-resistant form of the infection.
- Sepsis: Sepsis has been defined as “the body’s extreme response to an infection.” Specifically, it causes inflammation and, if left untreated, can lead to organ failure, tissue damage, and even death. Any type of infection can cause sepsis, no matter whether it’s bacterial, viral, fungal, or parasitic. Sepsis can be dangerous especially for older adults and those with compromised immunity. Proper handwashing by caregivers can greatly reduce the risk of sepsis.
- Unsafe surgical procedures: Millions of people suffer significant surgical complications. Surgical complications in the United State is estimated at 25%, that is almost 7 million annually. Injuries can result from errors such as patients falling from beds, doctors using the wrong procedures for treatment, doctors forgetting surgical equipment in the bodies of patients, and doctors performing surgery on the wrong patient. You may wish to explore the 10 most dangerous mistakes performed during surgery compiled by Oliver Taylor
- Unsafe injection practices: Unsafe injection practices account for a burden of harm estimated at 9.2 million years of life lost to disability and death worldwide. In hospitals, these practices can transmit infections such as HIV, hepatitis B & C and can pose a direct danger to the patient and the healthcare workers.
- Radiation errors: This involves overexposure to radiation and cases of wrong-patient and wrong-site identification. It’s estimated that the overall incidence of errors in radiology is around 15 per 10 000 treatment courses
- Venous thromboembolism (VTE) or blood clot: This is when a blood clot forms in a vein. If left untreated, the clot can break free and lodge itself in the arteries of the lungs, which would block oxygen from getting into the blood. The CDC defines healthcare-associated VTE as a blood clot that occurs “as a result of hospitalization, surgery, or other healthcare treatment or procedure.” is one of the most common and preventable causes of patient harm, contributing to one-third of the complications attributed to hospitalization. Annually, there are an estimated 3.9 million cases in high-income countries and 6 million cases in low- and middle-income countries.
Patient Safety and Service Quality Units in Hospitals have been established in many institutions globally to monitor patient care and facilitate the development of clinical protocols for patient safety. However, it is regrettable that most hospitals in Nigeria and Africa are yet to establish such units to checkmate medical errors and mishaps. According to a study conducted among health workers in a tertiary hospital in Nigeria, it was revealed that patient safety awareness and practice are low and most hospitals in Nigeria do not have an effective institutional protocol for preventing medical errors.
Muhammad Ahmad Saddiq is an infection control practitioner (ICP)
at Federal Teaching Hospital Gombe, Nigeria.