RISK MANAGEMENT Article

RISK MANAGEMENT

Medical risk is an preventable increase in the probability of harm developing to a individual Clinical Risikomanagement (CRM) is usually an approach to improving the quality and safety of healthcare by simply: п‚·

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placing exceptional emphasis on figuring out circumstances that put people at risk of damage acting to stop or control those hazards

CRM assists the hospital: to take care of and boost quality of services increase patient security

reduce consistency of a lawsuit

help maintain trust in profession

prevent staff reduce

Medical Error

It is the failing of a prepared action to become completed because intended (i. e. error of delivery e. g. error of drug dose calculation) or maybe the use of incorrect plan to achieve an goal (I. at the. error of planning at the. g. wrong lab result leading to incorrect management)

Medical errors potentially have for physical, emotional and financial burden on the sufferer. Types of Medical Problems

1) Classification errors: elizabeth. g. make use of outdated checks resulting in false diagnosis 2) Treatment mistakes e. g. giving intramuscular injection instead of intravenous, problem in functionality of method, error in drug medication dosage

3) Reduction errors e. g. failure to provide prophylactic treatment such as heparin for embolism, patient not really informed of post-surgical proper care

4) Other e. g. communication failure, equipment failure

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Misdiagnosis plays a role in 40% of errors, medication errors contribute 28% and medical procedure problems contribute 22%

Most mistakes take place in ICU and A& E because there are many techniques taking place therefore the risk of problems is excessive, the staff work under stress because of heavy workload, patients are fully reliant as they may unconscious, pressured

Differentiation of adverse effects

A. Around miss: this is when an error ends in a close call because only by chance no patient personal injury was developed e. g. doctor recommended penicillin to a patient with penicillin allergic reaction but the pharmacist just happened to ask the patient if he previously any hypersensitivity B. Undesirable event: an injury resulting from a medical involvement i. at the. not as a result of underlying condition e. g. wound infection after surgery

C. Sentinel event: this really is an unexpected and unacceptable event involving death or significant physical or perhaps psychological problems for a patient at the. g. an operation done for the wrong section of the body

SWITZERLAND CHEESE VERSION (by Adam Reason)

Explanation proposed precisely what is referred to as the " Swiss Cheese Model” of system failure. Just about every step in a process has the prospect of failure, to varying levels. The ideal system is analogous to a stack of slices of Swiss parmesan cheese. Consider the holes to get opportunities for a process to fail, and each from the slices because " shielding layers” in the act. An error may allow problems to pass through a hole in one layer, in the next layer the holes are in various places, as well as the problem ought to be caught. Every layer can be described as defence against potential error impacting the outcome.

For a devastating error to occur, the holes need to line up for each step up the process allowing all defences to be defeated and resulting in an error. In case the layers are set up with the holes arranged, this is an inherently mistaken system that will allow a problem at the beginning to progress throughout to detrimentally affect the outcome. Each cut of parmesan cheese is a chance to stop a blunder. The more defences you put up, the better. Also the fewer the holes and the smaller the holes, the much more likely you are to catch/stop errors that may take place.

Factors to get Human Problems

Human elements examines the relationship between individuals and the devices with which that they interact by focusing on improving efficiency, creativeness, productivity and job fulfillment, with the objective of minimizing errors. An inability to apply man factors concepts is a key aspect of most adverse events in medical care.

Individual

Factors

Environmental

Factors

Fatigue

Noise making it tough

to focus on activity

Stress...



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