Transcript Preventing Errors in Oncology: Physician`s Perspective As A Cancer

Preventing Errors in Oncology:
A Physician’s Perspective as a
Cancer of the Neck Patient
Itzhak Brook MD, MSc.
Professor of Pediatrics and Medicine
Georgetown University School of Medicine
Tracheo-esophageal speech with
a voice prosthesis
Overview
1
• Hospitalization after surgery
• Physician's errors
• Nurses errors
• Preventing errors
• Advocacy
• Suggestions for improving
care
Hospitalization after
Laryngectomy
• Emotional unpreparedness
• Pain, weakness & complete
dependency
• Tube feeding
• Connected to lines
• Humidified oxygen & suctioning
• Blood drawn almost daily
• Unable to talk ( writing only)
Medical errors
• Occur at all levels-nurses,
physician
• Reluctance to complaint
(dependency)
• Laryngectomees more vulnerable
and less able to abort errors
because their inability to speak
Physician’s Errors
• Failure to detect cancer
recurrence
• Early feeding
• Removal of scar tissue instead
of the tumor
• Forgetting to write down orders
Nurses’ Errors (1)
• Not responding to calls
• Forgetting to connect the call
button.
• Not washing hands or using gloves
• Not placing the oral thermometer in
a plastic cover
• Using an inappropriately sized
blood pressure cuff
• Administer an incorrect dose of a
medication
Nurses Errors (2)
•Administer medications orally
instead of an NG tube
•Administer medications through
the NG tube dissolved in hot water
(causing esophageal burn)
•Connecting suction machine to
wall without a bottle of water
•Not rinsing the hydrogen peroxide
after cleaning the tracheostomy
tube (causing severe irritation)
Preventing medical errors (1)
• Better & uniform training.
• Adhere to established standards
• Perform regular records review to
detect and correct errors
• Employ only well trained medical staff.
• Counsel, reprimand, and educate staff
who make errors. Dismiss those who
continue to make mistakes.
• Develop & meticulously follow
algorithms, set procedures & bedside
checklist for all procedures.
Preventing medical errors (2)
• Increase supervision & communication
between health care providers
• Educate patients & caregivers about patient
condition & treatment plans
• Encourage patient advocacy (family/friend)
to ensure appropriate management
• Respond to complaints. Admit responsibility
when appropriate & discuss these with the
family and staff
• Investigate all errors and take preventive
action
Advocacy
• Choosing the appropriate treatment
(laser, conventional surgery)
• Get a second opinion
• Look for an expert in your type of
surgery
• Do not confuse friendliness with
expertise
• Ask for the true prognosis
Be Your Own Advocate
• Decrease chances of medical errors by
being informed and not hesitating to
challenge & ask for explanations
• Become an “expert”
• Have a family or friends with you in the
hospital
• Get a second opinion
• Educate your medical caregivers about
your condition and needs (prior to and
after surgery)
Improving surgeons’ attitude
after laryngectomy
Patient should ask
• that they be patient, allow more
time for communication
• Explain what will happen
• Understand the challenges of
life as a laryngectomee
Improving surgeons attitude
after laryngectomy
• Need patience and sensitive, allow
more time for communication
• Explain what is happening
• Understand the tremendous life
changing event of becoming a
laryngectomee
• Examine all parts of the body
Patient’s post surgical care can
be improved by:
• Educating patient and family about
the short & long term medical &
social implications of the
procedures
• Greater personal attention by
surgical team (spending more time,
provide information)
• implementing standard techniques
of nursing care
Patient’s post surgical care can
be improved by (2):
• Greater vigilance & better
communication among staff to
avoid medical errors
• Educate surgeons: proper medical
and psychological post surgical
care, special needs of patients
after major surgery
Blog site for book:
http://dribrook.blogspot.com
Thanks for your attention!
Any Questions?
Itzhak Brook MD,
Professor of Pediatrics and Medicine
Georgetown University School of Medicine
[email protected]
http://dribrook.blogspot.com
Phone: 202-744 8211