Medical Errors
- Medical errors are the eighth leading cause of death in the U.S. each year.
- 98,000 hospitalized Americans die each year—not as a result of their illness or disease, but because of medical errors during their care. That’s 268 a day, also equal to a fully occupied, fatal jet crash every day.
- 84 percent of U.S. adults have heard about a situation in which a medical mistake was made.
- 42 percent of U.S. adults say they were involved in a situation where a medical error occurred.
Cost
- The total annual cost of preventable medical errors (including expense of additional care, disability, lost income and productivity) in the U.S. is estimated between $17-29 billion.
- Estimates of attributable cost-per-bloodstream infection range between $3,700 and $29,000.
Ventilator-associated pneumonia (VAP) prolongs length of stay and adds an estimated $40,000 to the cost of a typical hospital admission.
Infection
- In the U.S., annual deaths from blood infections related to central line catheters is as high as 28,000.
- Caregivers at one hospital were observed and asked how faithfully they and their coworkers washed their hands after touching a patient. They said, 85 percent for themselves but only 51 percent for their coworkers. According to observers, though, caregivers only washed up 28 percent of the time.Infections at surgical sites complicate about 780,000 procedures annually, or more than 1 in 40. For abdominal surgery, the likelihood is even higher: 1 out of 5 procedures.
- Patients with infections are two to three times more likely to die and are hospitalized an average of seven days longer than other patients.
- Antibiotics lose half their potency in two to three hours. If there’s a several hour delay in surgery, a patient could be a candidate for infection by the time he’s rolled into the OR.
Adverse Drug Events (ADEs)
- One of every three ADEs happens when a nurse administers medications.
- 56 percent of medication errors are related to prescriptions.
- One medication error occurs for every 20 administrations.
- ADEs happen 6.5 times out of every 100 admissions; 28 percent are considered preventable.
- Two-thirds of medical errors are preventable.
- One-quarter of ADEs are due to negligence.
- One study found that preventable ADEs in two teaching hospitals caused a 4.6-day increase in length of stay, at a cost of $4,685 for each hospital.
Rapid Response Teams
- In the U.S., failure to rescue accounts for 60,000 deaths each year in Medicare patients under age 75.
- Evidence of clinical worsening is present in 50 percent of codes for many hours prior to code being called.
Staffing
- Prolonged wakefulness (e.g., 17 hours without sleep) can produce performance decrements equivalent to blood-alcohol concentration of .05 percent, the level defined as alcohol intoxication.
- Researchers have found that the risk of making an error increased when hospital nurses work more than 12 hours per shift, worked overtime or worked more than 40 hours a week.
- The effects of fatigue include slowed reaction time, lapses of attention to detail, errors of omission, compromised problem solving, reduced motivation and decreased energy to successfully complete required tasks.
Sources
Centers for Disease Control and Prevention
Patient Safety & Quality Healthcare
The State of Science on Safe Medication Administration Symposium
Core Curriculum for Patient Safety
Keeping Patients Safe: Transforming the Work Environment of Nurses
Institute for Healthcare Improvement
Modern Healthcare (November 4, 2003)
U.S. News & World Report (July 18, 2005)
