Introduction
The World Health Organization has campaigned for the improvement of patient safety practices in hospitals and healthcare systems because medical errors impact 1 in every 10 patients around the world (World Health Organization, 2012). Medical errors are hostile effects of care that bring harm to patients. These errors can be prevented with the proper execution of patients’ healthcare needs by doctors and nurses. This paper aims to analyze an event that occurred in the past while addressing the National Patient Safety Goals. In order to improve patient safety, the goals focus on healthcare safety problems and how to solve them. The case of Christine Lofthouse, a 67-year-old woman in the United Kingdom who died from 140 medical errors, will be the focus of this paper.
Case Analysis
On New Year’s Eve in 2010, 67-year-old Christine Lofthouse was brought to St. James Hospital in Leeds, West York because of a urinary infection. Mrs. Lofthouse was on a long-term medication regimen where she was taking antibiotics for her gall stones and steroids for her breathing difficulties. Prior to her death, she suffered a stroke in 2009. When Mrs. Lofthouse was admitted to St. James, she was given antibiotics for her condition but she had been left alone for 4 hours in the corridor of the hospital before she was given a bed space. The patient was not given proper care and attention. According to her son, “she was left for nearly 24 hours without the appropriate people seeing her and giving her medication” (Hough, 2012). More problems occurred when the patient was transferred to another ward. The medical notes of the patient lacked information and her medications were delayed. The medical team’s failure to check and monitor Mrs. Lofthouse’s condition, together with the provision of incorrect medicine to the patient contributed to the deterioration of the patient’s health. “In this case, a delay in medical clerking and prescription of medication, inappropriate antibiotic selection and failure to accurately monitor physiological observations during first 24 hours of admission contributed to the deterioration of the patient’s condition” (Hough, 2012). She was taken to St. James Hospital on January 3, 2011. Mrs. Lofthouse died of a urinary infection 3 days later. The patient’s death was caused by 140 medical errors committed by the medical team in attempts to treat her (Hough, 2012).
Christine Lofthouse’s death could have been prevented if the medical team had appropriately practiced patient safety methods. St. James Hospital must improve its healthcare system to ensure that patients are safely taken care of. Medical staff must identify patients correctly to avoid the provision of incorrect medication and treatment. In the case of Ms. Lofthouse, the patient was given the wrong antibiotics for her condition. Identifying a patient can be based on their names and dates of birth. Upon blood transfusion, the medical staff must make sure that patients get the correct blood when they undergo the procedure. Medical staff at St. James could have taken the time to check the patient’s information to avoid confusion about prescribing her the wrong medication and treatment. When the patient was transferred to another ward, the medical information of the patient was not properly recorded thus Mrs. Lofthouse did not receive the proper care she needed with her critical condition. Test results of patients must be given to the right staff on time in order to keep track of patients’ conditions. When Mrs. Lofthouse was transferred to another ward, the medical personnel from the previous one could have taken time to provide the staff with information on the patient’s condition especially her medication and her monitoring schedules. The use of medicines must be executed safely. In order to avoid confusion, medicines must be labeled before a procedure. Patients taking antibiotics must be properly monitored. Information on the patient’s activities in terms of medication and treatment must be correctly passed along to the medical staff responsible for the patient’s care. Mrs. Lofthouse’s information was incomplete and incorrect because medical personnel did not take the responsibility of recording her medical status, thus, when she was transferred to another ward, instead of treating her, the next group of personnel only alleviated her pain which caused her untimely death. The new group of medical practitioners did not even take time to investigate what medication and treatment the patient was going through. Mrs. Lofthouse’s son, Tim, informed the medical team about his mother’s condition and the medicines she was consuming. He took time off from work to take care of his mother. The medical staff could have asked Tim for more information about the condition of his mother and what medication and treatment she was undergoing. Mrs. Lofthouse was admitted to St. James hospital because of a urinary infection. With such information, medical staff could have prevented the spread of the infection and treated it using proven guidelines to prevent infection provided by the Centers for Disease Control and Prevention or the World Health Organization. It seemed that the staff was preoccupied with other hospital concerns that Mrs. Lofthouse was not given the proper attention in terms of preventing and curing her infection, thus, her health suffered from such ignorance of the medical team. Through the proper analysis and observation of the patient’s condition, mistakes can be avoided especially in terms of surgery. Utmost attention should be provided to patients who are undergoing surgery. The medical team should ensure that surgeries are performed on the correct patient and at the correct place of the patient’s body. In the case of Mrs. Lofthouse, no surgery was done but doctors could have paid more attention to her since her condition had already been critical.
If I were the medical personnel responsible for Mrs. Lofthouse’s caring, I would have paid great attention to her upon her admission to the hospital. When she first came in, and A&E staff gave her antibiotics. I would have taken note of such and would not have let her wait for 4 hours to avail a bed space. I would have assisted her in looking for a room and would have properly checked her medical history and the medicines she was consuming. When Mrs. Lofthouse was transferred to another ward, I would have made sure that the staff in charge of the patient was fully aware of the patient’s condition and medication as well as treatment schedules so that the patient would be properly monitored by the medical team.
Conclusion
Medical errors have affected many patients over the years. The lives of such patients could have been saved instead of meeting untimely deaths caused by ignorance and mistakes of medical staff. The World Health Organization has identified patient safety as an epidemic concern where the improvement of healthcare systems in terms of safety is given utmost attention. National Safety Goals have been drafted to further remind medical practitioners of their roles in saving lives.
References
Hough, A. (2012). Grandmother died because of NHS hospital’s catalogue of errors. The Telegraph. Web.
World Health Organization. (2012). WTO African Partnerships for Patient Safety. Web.