Hospitals can be dangerous places. Previous studies have shown that more than 700,000 Americans contract healthcare-associated infections each year, according to the CDC, and medical errors are responsible for anywhere from nearly 100,000 to over 400,000 U.S. deaths annually.
So it's tragic, if not much of a shock, to learn that a mistake or adverse event occurred in every other surgery performed at Massachusetts General Hospital and in 5 percent of observed drug administrations, according to new research from the same hospital.
Drug delivery protocols for hospital in-patients are rigorous and thorough, often involving a series of drug and dosage checks by all the involved providers, including the attending physician, pharmacist and nurses.
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But in the operating room, things often move much faster, and conditions can change rapidly, creating more room for error.
The most frequent errors involved labeling mistakes, incorrect dosage and failing to treat an emerging issue based on the patient's vital signs, reported the trained observers, who watched 225 anesthesia providers during nearly 300 surgeries.
In turn, 30 percent of the adverse reactions triggered by these medication mistakes were deemed "significant." Sixty-nine percent were considered "serious," and between one and two percent were deemed life-threatening (though none resulted in death).
The different providers - residents, nurse anesthetists and anesthesiologists - made mistakes at the same rate, and the longer the surgery and the more medications delivered, the more errors were observed.
The error rate was "much higher than has previously been reported" in operating rooms, Karen C. Nanji said in a press release. Nanji is a doctor at the MGH Department of Anesthesia, Critical Care & Pain Medicine and the lead author of the report.
"We definitely have room for improvement in preventing perioperative medication errors, and now that we understand the types of errors that are being made and their frequencies, we can begin to develop targeted strategies to prevent them," she added.
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Meanwhile, those headed into surgery are right to feel vulnerable; you cannot serve as your own advocate when you're sedated.
One cause for optimism, however, is the presence of dedicated perioperative circulating nurses in many major surgery centers. These nurses are specifically tasked with advocating for patients while they are under anesthesia.
Any concerned patient should ask about these advocates, as well as any other people who will be in the operating room, before a procedure.