8 hours ago Clinicians validated emerging concepts by applying them to cases from their clinical practice. Results: We completed 238 hours of observations during which clinicians investigated 65 suspect adverse drug events. The observed events were often complex and diagnosed over time, requiring the input of multiple providers. >> Go To The Portal
You just received a new patient who needs to be admitted to your unit, and you just finished medicating a patient with a narcotic injection with a dose greater than ordered. Clearly understanding medication errors may lead to patient injury and even death, explain why a clinician may choose to NOT report the incident.
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They may have also experienced previous side effects with the same or similar medicine. Additionally, patients report not taking their medication because they may have witnessed side effects experienced by a friend or family member who was taking the same or similar medication.
The fact that it is often difficult to decide whether to report suspected abuse does not negate one's professional and legal responsibility to protect children by doing so. Physicians are not responsible for determining whether maltreatment occurred, only for reporting reasonable suspicion.
However, there are some specific situations when mental health professionals are legally obligated to report something that a client does or says during a therapy session. “I like to tell my clients that therapy is kind of, ‘What happens in Vegas stays in Vegas.’
Many factors play a role in a physician's likelihood of reporting, including the relationship with the family, details surrounding the injury, consultation with colleagues, and previous experience with CPS.
The main reasons mentioned for underreporting were lack of effective medical error reporting system (60.0%), lack of proper reporting form (51.8%), lack of peer supporting a person who has committed an error (56.0%), and lack of personal attention to the importance of medical errors (62.9%).
Barriers to medication error reporting were thematised into five categories: reporter burden, professional identity, information gap, organisational factors and fear.
While many doctors under the guise of concern for patient welfare do not disclose medical error, such behaviour is not ethically justified. The fiduciary nature of the doctor-patient is such that the doctor is ethically obligated to disclose medical errors to patients.
Fear of punishment and legal consequences in clinical practice has always been one of the barriers to error reporting. It is estimated that about 95% of medication errors are not reported due to the fear of punishment.
Several factors are necessary to increase error reporting: having leadership committed to patient safety; eliminating a punitive culture and institutionalizing a culture of safety; increasing reporting of near misses; providing timely feedback and followup actions and improvements to avert future errors; and having a ...
David Classen, a professor at the medical school of the University of Utah – found that about 90 percent of all hospital mistakes go unreported.
Medication errors have significant implications on patient safety. Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices.
If an error occurs, the appropriate steps should be taken to address the patient's condition. It is important to document the incident or near-miss and report it immediately to the patient's primary healthcare provider and your employer.
Although it is generally agreed that harmful errors must be disclosed to patients, when the error is deemed to have not resulted in a harmful event, physicians are less inclined to disclose it.
Nurses have always played a major role in preventing medication errors. Research has shown that nurses are responsible for intercepting between 50% and 80% of potential medication errors before they reach the patient in the prescription, transcription and dispensing stages of the process.
That is, a nurse cannot be terminated for cause unless there has been willful mis- conduct or intentional dis- regard of the employer's interests. Nurses sometimes commit medication errors. Medica- tion errors always have a potential to harm patients and sometimes do harm the patient.
Consequences for the nurse For a nurse who makes a medication error, consequences may include disciplinary action by the state board of nursing, job dismissal, mental anguish, and possible civil or criminal charges.
The level of suspicion required to report suspected abuse is not clearly defined. But, with the knowledge that physicians tend to underreport suspected abuse, the following recommendations are made to increase physicians' confidence in making appropriate reports: 1 Obtain continuing education regarding child maltreatment. Routinely seeking out local and national opportunities for continuing education related to child abuse and neglect can help you maintain a current understanding of child maltreatment. 2 Know reporting laws. Familiarizing yourself with the reporting laws and to whom reports should be made in your state (i.e., CPS or law enforcement) can lessen the ambiguity in the reporting process. 3 Consult with colleagues. Establishing collaborative relationships with colleagues to consult with regarding difficult cases can assist in the decision-making process. Physicians in private practice who do not have colleagues readily available may want to create a referral process with local agencies that have teams who make these decisions. 4 Know your local CPS staff. Forming relationships with your local CPS staff members can facilitate an open line of communication and establish a better sense of the guidelines used by the agency.
Physicians reported that discussing the case with a knowledgeable colleague helped them decide whether or not to report suspicious injuries. The clinician's past experiences with CPS. Clinicians who believed that CPS involvement would result in a negative outcome for the child or family were less likely to report.
Physical abuse is any physical injury to a child that is not accidental and may involve, but is not limited to, hitting, slapping, beating, biting, burning, shaking, ...
Emotional and psychological abuse exposes a child frequently and repeatedly to behaviors that impact his or her psychological well-being, including blaming, threatening, yelling at, belittling, humiliating, name calling, pointing out faults, withholding emotional support and affection, and ignoring a child. In some cases, exposure ...
In sexual abuse, an adult or older child engages a child in sexual activities such as fondling, intercourse, oral-genital stimulation, sodomy, observing sexual acts, viewing adult genitals, and looking at, watching, or engaging in pornography.
As a result of these actions, a child may have bruises, broken bones, burns, or internal injuries that document the occurrence, as well as imprints of the specific object used to inflict the injury (e.g., belt buckle, hand, and knuckles). In sexual abuse, an adult or older child engages a child in sexual activities such as fondling, intercourse, ...
The number of children who are maltreated annually in the United States is difficult to document because: (1) definitions vary across tribal, state, and federal jurisdictions; (2) the standards and methods of collecting data vary considerably; and (3) many cases go unrecognized and unreported [5].
Medication nonadherence—when patients don’t take their medications as prescribed— is unfortunately fairly common, especially among patients with chronic disease. When this is the case, it is important for physicians and other health professionals to understand why patients don’t take their medications. This will help teams identify and improve ...
Physicians can try to simplify a patient’s dosing schedule by adjusting medicines so they can be taken at the same time of day.
A major barrier to adherence is often the cost of the medicine prescribed to the patient. The high cost may lead to patients not filling their medications in the first place. They may even ration what they do fill in order to extend their supply.
If you don’t have a true picture of a patient’s medication-taking behavior, you may needlessly escalate their treatment, resulting in potential harm to the patient, unnecessary work for the practice and increased costs overall. Most nonadherence is intentional with patients making a rational decision not to take their medicine based on their ...
Additionally, patients report not taking their medication because they may have witnessed side effects experienced by a friend or family member who was taking the same or similar medication. From seeing those side effects experienced by someone else, it may have led them to believe the medication caused those problems.
Patients who are depressed are less likely to take their medications as prescribed. Physicians and other health professionals may be able to uncover this by sharing issues and asking if the patient can relate to it. To reduce embarrassment, express that many patients experience similar challenges.
Clinicians who become patients can also experience barriers to access, such as embarrassment, lack of time due to professional constraints, and minimization of symptoms due to clinical knowledge, which can affect the quality and timeliness of care [4].
Ethical issues include respect for patient autonomy and social justice as well as nonmaleficence. Furthermore, interpersonal and professional relationships may be tested in this situation. Addressing the colleague’s concerns with empathy and respect, without compromising one’s own medical judgment, is critical in resolving these kinds of conflicts.
In fact, several medical organizations such as the American Medical Association, the American College of Physicians, and the American Academy of Pediatrics advise against caring for friends and family [10-12].
Rose does not believe is appropriate), ordering a scan could be considered unethical.
Dr. L’s clinical situation probably would not have arisen 10 years ago because until recently, she would have had no easy way to learn that Ms. X’s prescription had been filled.
What Ms. X told Dr. L implies that someone—the patient, her roommate, or both—misused a prescription to obtain a controlled substance. Simple improper possession of a scheduled drug is a federal misdemeanor offense, 12 and deception and conspiracy to obtain a scheduled drug are federal-level felonies. 13 Such actions also violate state laws. Dr.
If Dr. L still feels inclined to do something about the misused prescription, what are her options? What clinical, legal, and moral obligations to act should she consider?
“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.
“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.
A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.
For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.
“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.