Mistakes Still Prevalent in Hospital Care, Study Finds

Efforts to make hospitals safer for patients are falling short, researchers report in the first large study in a decade to analyze harm from medical care and to track it over time.

The study, conducted from 2002 to 2007 youth nfl jerseysin 10 North Carolina hospitals, found that harm to patients was common and did not decrease. The most common problems were complications from procedures or drugs, followed by hospital-acquired infections.

“It is unlikely that other regions of the country have fared better,” Oakland Raiders Jerseysaid Dr. Christopher P. Landrigan, the lead author of the study and an assistant professor at Harvard Medical School. The study is being published on Thursday in The New England Journal of Medicine.

The study is one of the most rigorous efforts to collect data about patient personalized nfl jerseyssafety since a landmark report in 1999 found that medical mistakes caused as many as 98,000 deaths and more than one million injuries a year in the United States. That report, by the Institute of Medicine, an independent group that advises the government on health matters, led to a national movement to reduce errors and make hospital stays less hazardous to patients’ health.

Among the preventable problems that Dr. Landrigan’s team identified were severe bleeding during surgery, serious breathing trouble caused by a procedure being performed incorrectly, a fall that dislocated a patient’s hip and damaged a nerve and vaginal cuts caused by a vacuum extraction device used to help deliver a baby.

Dr. Landrigan’s team focused on North Carolina as the best place toBuffalo Bills Jersey look for improvements because its hospitals, compared with those in most states, have been more involved in programs to increase patient safety.

But instead of improvements the researchers found a high rate of problems, and no change over time. About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of the injuries were judged to be preventable. Most of the problems were temporary and treatable, but some were serious and a few, 2.4 percent, caused or contributed to a patient’s death, the study found.

The findings were a disappointment but not a surprise, Dr.Cincinnati Bengals Jersey Landrigan said. Many of the problems were caused by the failure of hospitals to use measures that had been proved to avert mistakes and prevent infections from urinary catheters, ventilators and lines inserted into veins and arteries.

“Until there is a more coordinated effort to implement those strategies proven beneficial, I think that progress in patient safety will be very slow,” he said.

An expert on hospital safety who was not associated with the study said the findings were a warning for the patient-safety movement.

“We need to do more, and to do it more quickly,”Atlanta Falcons Jersey said the expert, Dr. Robert M. Wachter, the chief of hospital medicine at the University of California, San Francisco.

A recent government report found similar results, saying that in October 2008, 13.5 percent of Medicare beneficiaries — 134,000 patients — experienced “adverse events” during hospital stays. The report also said that extra treatment needed as a result of the injuries could cost Medicare several billion dollars a year. In 1.5 percent of the patients — 15,000 patients in the month studied — harm from medical treatment contributed to their deaths. The report, issued this month by the inspector general of the Department of Health and Human Services, was based on an analysis of a sample Medicare records of patients discharged from hospitals in October 2008.

Dr. Landrigan’s study reviewed the records of 2,341 patientsWashington Redskins Jersey admitted to 10 hospitals — in both urban and rural areas and involving large and small and teaching and nonteaching medical centers. (The hospitals were not named.) The researchers used a “trigger tool,” a list of 54 items regarded as red flags in a patient’s record, indicating that something might have gone wrong. Triggers included certain drugs that were used only to reverse an overdose, the presence of bedsores or readmission to the hospital within 30 days of being sent home.

The researchers found 588 instances in which a patient was harmed by medical care, or 25.1 injuries per 100 admissions.

Not all the problems were serious. Most wereMiami Dolphins Jersey temporary and treatable, like a bout with severe low blood sugar from too much insulin or a urinary infection from a catheter. But 42.7 percent required extra time in the hospital for treatment of problems like an infected surgical incision. In a few cases, 2.9 percent, patients suffered permanent injury — for example, brain damage from a stroke that could have been prevented after an operation. Certain problems (8.5 percent) were life-threatening, like severe bleeding during surgery. A small number, 2.4 percent, caused or contributed to a patient’s death — like bleeding and organ failure after surgery, or pneumonia caused by inhaling food, saliva or stomach contents.

“A third of the errors in the intensive care unit disappear when residents work 16 hours or less,” Dr. Landrigan said, although New York Jets Jerseyhe noted that senior residents often work longer hours.

Computerized systems for ordering drugs can cut medication errors Green Bay Packers Jerseyby 50 percent to 80 percent by correcting doses and alerting doctors if they request a drug that a particular patient should not take, Dr. Landrigan said. But only 17 percent of hospitals have such systems.

For the most part, reporting of medical errors or harm to patients by hospitals is voluntary.