A recent at Harvard-affiliated Massachusetts General Hospital (MGH) has found that medication errors during surgery are common and preventable.
The study looked at 277 randomly selected operations conducted at MGH from November 2013 to June 2014:
- About 50% of every surgical procedure involved a medication error.
- Almost 80% of the 153 medication errors and 91 adverse events were determined to have been preventable.
Writing about the study for Forbes, Robert J. Szczerba reported that clinicians were not surprised by the results:
Most of the clinicians I spoke with after the study was published were not surprised with the results. In fact, several commented that they felt the actual number of errors that occur during surgeries was probably much higher. The most disturbing aspect is that most of these errors were classified as preventable. The technologies already exist to significantly reduce these types of life-threatening errors, but many hospitals don’t take the necessary steps to address the problem.
Tell us what you think about these research results. Are you surprised or is this what you expected?
As with sharps injuries, medication errors during surgery are frighteningly frequent, costly and preventable. On airplanes, standardized checklists and redundancy are effective strategies and the captain is ultimately responsible for getting things right and held accountable if things go wrong. The OR is different, with multiple disciplines working side by side (surgery, anesthesia, radiology and others). There is no one person responsible for preventing errors and no real accountability, Still, ORs don’t use checklists uniformly, and often the ones we do use omit important items, so there is much room and great opportunity for improvement. All members of the OR team must acknowledge our frequent errors, whether they involve preventable needlesticks or medication mix-ups, and work harder to prevent them.
Great point! Checklists are really only tools to be used. Like hammers and cell phones, some better than others – and all dependent on the skill of the user.
Regarding sharps injuries, here are some tips for patients to make their surgeries safer – http://wp.me/p5JhsL-1ui