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August 04 News Briefs

August 2004

Published in the August 2004 issue of Today’s Hospitalist

Malpractice fears keep most hospitals from reporting errors to patients

A survey of more than 200 hospitals found that while 75 percent have formal, board-approved policies to disclose medical errors to patients, 72 percent say that fears about malpractice keep many errors from being reported.

Hospitals responding to a survey by the Premiere hospital alliance’s Safety Institute said that only 37 percent of errors that cause serious or short-term harm are regularly disclosed to patients. Fifty-seven percent said those errors are frequently disclosed, and 6 percent said they are sometimes disclosed.

The hospitals also reported that when they do disclose an error, 99 percent explain the error, 90 percent offer an apology, and half promise to reveal any investigation results to patients.

Is the focus on patient safety hurting efforts to retain nurses?

The pressure on nurses to ensure patient safety combined with relatively little autonomy in clinical decision-making may be a critical factor in the nation’s ability to retain experienced nurses.

According to a study in the June issue of the American Journal of Nursing, 90 percent of physicians, administrators and pharmacists put responsibility for patient safety squarely on the shoulders of nurses. Ninety-six percent of nurses agreed that they are ultimately responsible for patient safety.

At the same time, less than 10 percent of physicians identified nurses as part of the decision-making team. The results come from a survey of hospital staff at 29 small rural hospitals over a three-year period.

The study pointed out that while mistakes typically related to nursing, such as giving patients too much medicine, are reported as errors, misdiagnoses by a physician are more likely to be viewed as differences in “clinical judgment.”

The article tries to draw connections between the job satisfaction of nurses and the focus on errors. It points out that 40 percent of nurses report job dissatisfaction, and that 20 percent of nurses plan to leave their jobs within a year.

Updated self-assessment survey reviews safety of medication practices

The Institute for Safe Medication Practices has updated its self-assessment survey to help hospitals review the safety of their medication administration practices.

The 37-page Medication Safety Self Assessment for Hospitalists asks users to review nearly 200 practices that can make medication use safer. It is designed to help hospitals identify opportunities to change how they administer medications by developing educational and training tools.

Hospitals that submit their data can compare themselves to similar institutions throughout the nation. The institute expects to release an overview later this year, but all hospital-specific data will be kept confidential.

The survey was released in partnership with the American Hospital Association and the Health Research and Educational Trust.