March 8-14 is Patient Safety Awareness Week to encourage the community to learn more about healthcare safety.
The term ‘primum non nocere’ is often misattributed to Hippocrates, the ancient Greek physician. Translated into ‘first, do no harm’, it misunderstands the actual meaning of Hippocrates’ sentiment in Of the Epidemics, wherein he writes, loosely translated, that a physician must “have two tasks, namely, to do good, or at least to do no harm”.
The truth is that medicine has never been about prioritizing “no harm” – it has always been about trying to “do good”, understanding that sometimes, doing good has its merits as well as its risks. These risks, sadly, are sometimes realized, in part resulting in deaths and injury caused by adverse drug effects and postoperative complications, as well as errors that lead to roughly 5,000 annual deaths in the US between 1990 and 2016.
These deaths are caused by medical errors and hospital-derived illnesses, including healthcare-associated infections. Many of these deaths are preventable, while others are part of the risk associated with the treatments and procedures that have cured and saved millions, from various surgeries to a whole host of medicines with harmful side effects, yet powerful medicinal benefits.
As we move to observe Patient Safety Awareness Week this March 8-14, 2020, let’s focus on some of the things we can do to bring patient safety issues to light, and help prevent some of these preventable deaths.
Physicians and Nurses are Human
To err is human, and as of yet, all the brave men and women who dedicate themselves to healthcare are entirely human, with their own flaws and problems. This is no excuse for medical errors, but it’s a statistical impossibility to completely eliminate medical errors, given that the human element means there will always be at least one mistake for every few thousand right decisions.
However, these mistakes have been drastically minimized over the centuries, and there is a lot to be thankful for in modern medicine, from the drastic reduction in infection and postoperative mortality with the introduction of Lister’s antiseptic practices, to more reliable anesthesia that doesn’t cause a death every few thousand applications.
Nevertheless, it’s important to give our healthcare professionals a little slack, and to think with them.
One of the major preventable causes of death and poor outcomes is medication nonadherence, for which there may be several reasons including an inability to pay for current prescriptions, lack of time or willingness to seek refills, a lack of understanding on how to self-administer the medication, as well as forgetfulness.
Medication nonadherence is more common than most people might realize, and whatever the reason might be, it’s estimated that about 40 to 50 percent of patients who are prescribed medication for a chronic condition (wherein medication nonadherence is often at its most harmful) fail to properly adhere to the advice and instructions relayed upon them by their physician or medical professional.
Do not be afraid to speak up about anything that might get in the way of you adhering to your medication regimen. Speak up about your price concerns, or any details you might have missed, or something you did not understand. Make sure to write instructions down if they are too complicated to remember, and even if they aren’t, it helps to tell your relatives about them just so someone else can keep an eye on you in case you begin to forget.
Physicians are beginning to become aware of the dangers that medication adherence pose, but it is still up to patients to air their thoughts and worries and work out the best course of action with their healthcare provider. If you cannot afford a certain medication, your physician may be able to find a cheaper generic alternative, or a different solution. If you have a history of mental health conditions that might get in the way of adherence (including depression or dementia), your doctor may be able to help inform your family of how and when to medicate.
Some issues are caused by incomplete or lacking medical information. One’s medical history is not always up-to-date or comprehensive, and there are many details that can be and are overlooked when treating a patient. When first meeting with a new specialist or physician, be sure to inform them of your medical history yourself on top of any data they might have.
Go through all your medication, your dosages, any known allergies, treatments you’ve gone through, surgeries you’ve had, and anything else that might be relevant to your health and history. Medication information is particularly important, as doctors need to know what their patients have been on and are currently on whenever they plan to write a prescription, to avoid adverse effects.
Keeping Hands Clean & Other Preventative Measures
Healthcare-associated infections (HAIs) might have become far less frequent over the decades, but they are not entirely rare. While there are ways to help reduce infections with inventions like antimicrobial fibers and disposable medical materials, more frequent disinfection and hand washing can drastically reduce many infections, as can a continued awareness of how illnesses might spread and who might be more prone to infection, and thus in need of special contact (oncology patients, patients on immunosuppressants, patients with immune system disorders, diabetics, etc.)
Hospitals and practices throughout the country have been implementing these measures for years, and have made headway in reducing infections – as a patient, you can do your best to advocate for your safety by double-checking that all your nurses and doctors have washed their hands between patients.
Ask for a Follow Up
Good and great doctors automatically follow up with their patients after they’re out of their care and have moved on to live a healthy life. But if your doctor hasn’t decided to do so, schedule a follow up anyway.
Not only is it a good idea to schedule at least one normal checkup a year, but a follow up appointment can help your physician or specialist rule out any signs that a treatment or procedure hasn’t completely done what it’s meant to do, and potentially help catch early signs of a mistake. Sometimes, that mistake might have just been missing a certain symptom because of an incomplete first diagnosis, or something rare and far more severe, like forgetting an object inside a patient after their surgery.
Ask Your Questions
If you have a question, always feel free to ask it. If you’ve got a gut feeling that something isn’t right, air out your concerns. It’s always better to be potentially redundant than to risk the chance to avoid what might have become a serious medical error.
This Patient Safety Awareness Week, reach out to your team. Your healthcare workers have spent years of their lives studying and working hard to become professionals who dedicate themselves to preventing the spread of illness and performing life-saving procedures. They are well-equipped to handle your questions and will appreciate anything that might help them avoid accidentally doing unnecessary harm.