Medication errors in children's nursing huddersfield,gladiolen giftig,vomiting in type 2 diabetes - New On 2016


Kimberly Hiatt, a longtime critical care nurse at Seattle Children's Hospital, committed suicide in April, seven months after accidentally overdosing a fragile baby. Stunned, she told nearby staff at the Cardiac Intensive Care Unit at Seattle Children’s Hospital what had happened. In Hiatt’s 24-year career, all of it at Seattle Children’s, dispensing 1.4 grams of calcium chloride — instead of the correct dose of 140 milligrams — was the only serious medical mistake she’d ever made, public investigation records show. That mistake turned out to be the beginning of an unraveled life, contributing not only to the death of the child, 8-month-old Kaia Zautner, but also to Hiatt’s firing, a state nursing commission investigation — and Hiatt's suicide on April 3 at age 50.
Hiatt’s dismissal — and her death — raise larger questions about the impact of errors on providers, the so-called “second victims” of medical mistakes. It’s meant to describe the twin casualties caused by a serious medical mistake: The first victim is the patient, the person hurt or killed by a preventable error — but the second victim is the person who has to live with the aftermath of making it. No question, the patients are the top concern in a nation where 1 in 7 Medicare patients experiences serious harm because of medical errors and hospital infections each year, and 180,000 patients die, according to a November 2010 study by the Department of Health and Human Services’ Office of Inspector General. That’s nearly double the 98,000 deaths attributed to preventable errors in the pivotal 2000 report “To Err is Human,” by the Institute of Medicine, which galvanized the nation's patient safety movement. In reality, though, the doctors, nurses and other medical workers who commit errors are often traumatized as well, with reactions that range from anxiety and sleeping problems to doubt about their professional abilities — and thoughts of suicide, according to two recent studies. Surgeons who believed they made medical errors were more than three times as likely to have considered suicide as those who didn’t, according to a January survey of more nearly 8,000 participants published in the Archives of Surgery. Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. Even when they don’t think of killing themselves, medical workers who make errors are often shaken to their core, said Amy Waterman, an assistant professor of medicine at Washington University in St.
Records show that Hiatt had cared for Kaia Zautner many times since her birth, when the baby with severe heart problems was first brought to Seattle Children’s.
After the overdose, the child’s parents asked that Hiatt not care directly for their baby, but they did not appear to seek retribution, according to an investigation report by Cathie Rea, the hospital’s director of ICU. It’s not clear whether Hiatt’s mistake actually caused the death of the child, who was critically ill. Still, Hiatt was escorted from the hospital after the mistake, immediately put on administrative leave and then fired within weeks. After the incident, Hiatt "was a wreck,” recalled Julie Stenger, 39, of Seattle, a critical care nurse who worked with Hiatt at the hospital. Officials at Seattle Children’s Hospital declined to discuss specifics about Hiatt’s termination, although they said there is “more behind Kim’s case than can be made public” because of personnel and privacy policies.
They said the hospital has since 2007 followed a so-called “Just Culture” model, which recognizes the need to use errors to identify and correct systemic problems, rather than focusing on penalizing individuals.
Experts in patient safety say terminating an individual worker is rarely the answer to even the worst mistakes, unless they’re the result of repeated, willful flouting of established procedures or intentional harm.
It’s far better to identify and address the problems in the system that contributed to the error, said Mary Z. Of those, two-thirds reported anxiety about future errors and half reported decreased job confidence and satisfaction, the study found.
There are other options to punitive actions, including education, supervision, reparations to the patient or family — and allowing the person who made the mistake to help craft specific systems to make sure it can't happen again, Scott said.
In some ways, however, those who’ve made mistakes might be even safer than those who haven’t, she added. On the day of Hiatt’s error, she admitted the mistake in a report submitted on the hospital’s electronic feedback system — and vowed not to repeat it. A co-worker had filed a sexual harassment claim against Hiatt, who was a lesbian, in 2008, alleging Hiatt acted inappropriately by hugging her and kissing her on the cheek. Seattle Children’s officials denied that Hiatt’s personal life had anything to do with her dismissal.
Records show that Hiatt was stunned to be terminated for what she believed was a single medical error in nearly a quarter-century of service. A storm of media attention followed news of the error, spurring state nursing commission officials to open an investigation into whether Hiatt’s license should be revoked.
After fighting to keep her license, Hiatt didn’t think she’d find another position in Seattle, family members said. Faced with the prospect of not working again as a nurse, Hiatt was overcome with despair, family members said. Hiatt’s death has unleashed a storm of reaction from her family, her colleagues — and from fellow nurses.


A survey of WSNA nurses in the months after Hiatt’s case became public found that half of respondents believe their mistakes will be held against them personally.
Across the country, patient safety advocates — speaking both generally and about public reports of Hiatt's case — worry that firing providers after they make mistakes leaves patients at greater risk. Officials at Seattle Children’s say armchair safety experts don’t know the details of Hiatt’s case. For Hiatt’s friends and family, all the debate in the world is useless unless it actually serves to change the circumstances that led to two tragedies: the loss of a fragile baby and the death of a nurse who loved her job. Ita€™s no secret that preventable medication errors injure a€“ and even kill a€“ hundreds of thousands of people each year. Medication and prescription errors often occur in Missouri hospitals or under the care of physicians or other healthcare providers who make mistakes in prescribing or administering drugs. Boardwalk babies born premature saved part, Bizarre tale boardwalk babies: thousands premature infants saved death part coney island entertainment sideshow. Boardwalk babies born premature saved part, Bizarre tale of the boardwalk babies: how thousands of premature infants were saved from certain death by being part of a coney island entertainment sideshow. Entertainment news, celebrity pop culture - abc news, Get latest entertainment news, celebrity interviews pop culture pulse movies, tv music abcnews.
14, the moment she realized she’d overdosed a fragile baby with 10 times too much medication. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.
Louis, who studied the issue in a 2007 survey of more than 3,100 practicing doctors in the U.S. The mistake “exacerbated cardiac dysfunction” in the baby and led to her decline, according to a statement by cardiologist Dr. Waterman, the Washington University researcher, found that 92 percent of the doctors she surveyed said they’d experienced a near miss, a minor error or a serious error — and 57 percent confessed to a serious mistake. Although the survey focused on doctors, researchers said they believed the results could apply broadly to nurses and other health care workers as well.
When harm occurs, the providers are haunted by every detail of the mistakes, often for years, said Susan D. Hospital officials said that Hiatt should have recognized that the dose was far too large for such a small child, and that Hiatt violated other dosing protocols. In a letter, Hiatt denied there was anything sexual about the action, which she said was meant to comfort the co-worker during a tough time, and described the investigation as a “witch hunt.” She said the Human Resources department had a history of discriminating against her because of her sexual orientation with one document dating to 1994.
Ultimately, the agency imposed sanctions instead, including a $3,000 fine, 80 hours of new coursework on medication administration and four years of probation in which any supervisor would be required to report on Hiatt's work every 90 days. After Hiatt's firing, the Washington State Nurses Association, which represents nurses at Seattle Children's, grieved her dismissal and negotiated a confidential settlement with the hospital on her behalf. Even more worrisome, nearly a third say they would hesitate to report an error or patient safety concern because they’re afraid of retaliation or harsh discipline. They indicated they changed the way calcium chloride is dispensed in response to Hiatt’s error to make it safer, even though a state investigation found that appropriate safeguards were already in place.
But while many of these mishaps occur within hospitals and nursing homes, a fact that has precipitated numerous policies and programs to prevent such errors, many others occur at home, especially among older adults and children. When a medication error occurs and causes you or someone you love to suffer harm, you may be able to take legal action against those responsible for the error. Legal consultation, case assessments, and examinations from an experienced personal injury attorney are important when you are working with insurance claim agents or other insurance company representative. Contact Horn Law at 816-795-7500 free of charge for legal consultation. Albert Wu, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
Scott, a registered nurse and patient safety director at the University of Missouri Health Care. Investigation records show that officials worried that Hiatt didn't fully recognize her role in the error. Since then, WSNA officials have heard from many nurses worried about making mistakes themselves.
They say critics haven't contacted them to ask about procedures for reporting and correcting errors, or for supporting staff when mistakes occur.
An analysis by prescription benefit manager Medco Health Solutions revealed that those over age 65 experience a drug error rate nearly seven times greater than those younger than age 65. That hospital is among a handful in the country to have established a formal support system to help providers cope with difficult patient outcomes or errors.


30, 2010 evaluation identified her as a “leading performer,” earning a mark of 4 on a 5-point scale, records show. And according to a recent study reported in the journal Pediatrics, a child receives the wrong medication or the wrong dosage of a medication every eight minutes in the United States.What can you do to protect yourself a€“ and those you love from medication errors? However, state lawyers said the child’s fragile condition and poor prognosis would have made it difficult to prove legally that the overdose caused her death five days later, records show. Make an up-to-date list of all of your medications, with names and ideally dosages and frequency of administration, including prescription and over-the counter (OTC) meds, herbal supplements and vitamins. Put the list on a small card to keep in your wallet a€“ and take it with you to show your doctor during an office visit or to the pharmacist when getting a prescription for a new medication. Dona€™t assume that vitamins and supplements are not medicine, said Kathryn Boling, MD, a family medicine doctor who practices at a Mercy Medical Center physician site in Baltimore, Maryland. Boling, is vitamin E, which in pill form may increase the risk of heart failure in people with diabetes, make bleeding disorders worse (as it inhibits blood clotting), and interact with other medications such as cholesterol-lowering drugs and blood thinners. Johna€™s Wort, a popular herbal supplement used for depression, can increase the effects of prescription antidepressants such as Zoloft, Celexa or Paxil.3. When picking up a new medication, consider listening to the pharmacista€™s instructions about how to take the medication rather than assuming you know it all and hurriedly signing the pharmacist consult declination. You may not realize that your medication is not meant to be crushed, cut or chewed (and doing so may release too much of the drug into your body all at once), or that certain foods or drinks may interfere with its effectiveness.
Gattas, to establish a relationship with one pharmacist to whom you can direct your medication questions. These days, she explained, people tend to shop around for the best deal and often go with a new prescription to a pharmacy that offers free or discount deals on antibiotics or diabetes medications. But if the new pharmacy is unaware of your other prescription medications, an error is more likely to happen.
Gattas, a€?when you drop off your prescription, drop off your medication list, too, so the pharmacist can check it before filling the prescription.a€?5. One of the most common active ingredients in multi-symptom products such as cough, cold and allergy medications, pain relievers like Tylenol and sleep aids is acetaminophen, a medication which in excess, can cause irreversible liver damage. If youa€™re not aware of this, ita€™s easy to treat your cold with an acetaminophen-containing cold medication, then several hours later, take a dose of Tylenol for your headache or body aches, upping the risk for an overdose of acetaminophen. Gattas, a practice that both protects the medication and also allows you to double check the label before taking it. That said, if youa€™re on multiple medications and youa€™re less likely to take them if theya€™re in the original bottles, ita€™s okay to fill a pill box with no more than a week worth of medication and leave it where youa€™re most likely to see it and remember to take the meds.7. But taking a medication in the dark or without your glasses increases the likelihood for a mix-up.8. When you share medication you have no idea if there is an ingredient that may be benign to you and cause extreme harm to another.a€? ------DECLUTTERING YOUR MEDICINE CABINETHave you taken a good close look at your medicine cabinet lately? A search of the contents may reveal the rest of that narcotic cough medicine you were prescribed a year ago for a respiratory infection (along with the last three antibiotic capsules you forgot to take), an expired inhaler, 900 of the 1000 count acetaminophen you got a deal on at your local Walmart a few years back a€“ maybe even a crumbling antianxiety pill you got at the emergency room when you had a panic attack. While we regularly de-clutter our houses, clothing closets a€“ even the garage a€“ the medicine cabinet is less likely to be cleaned, and it often contains unused, unwanted or expired medications.Whata€™s wrong with keeping medications for the next time you need them? While a department of defense study showed that many drugs stored in ideal conditions retain their potency long after their expiration dates, most people dona€™t store them in ideal conditions, which is in a cool, dry place out of direct sunlight, according to Kathryn Boling, MD, a family medicine doc who practices at a Mercy Medical Center physician site in Baltimore, Maryland. Not only do these medications pose a risk for accidental ingestion by children or pets, they are a temptation for curious and experimenting teens.
But how to dispose of them?Your best option, according to the Environmental Protection Agency (EPA), is to take advantage of a medication take-back program in your area. Many pharmacies have registered with the Drug Enforcement Administration to establish a collection program, which may include collection receptacles or mail-back package distribution. Unused prescription drugs thrown in the trash, even if mixed with used kitty litter or coffee grounds, as recommended by the U.S. Food and Drug Administration (FDA), can be retrieved and abused or illegally sold (not to mention, contaminate the landfill). And while flushing dangerous medications such as narcotics is a foolproof way of disposing of them, the EPA warns that this method can end up polluting ground, surface and marine waters, harming aquatic life. Developed by a pharmacist in the UK, the system is a hard resin bottle about the size of a pop can, with a powdery substance inside and a child resistant lid.



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