I need two replies answered:

Kaleah Singleton

Reviewing this week’s discussion prompt and engaging in the topic was an eye-opener and a tragedy. According to Nwosu (2015), medical errors are a common cause of mortality and morbidity among patients” (p.4). However, after reviewing both cases, it is evident that these errors do happen, and with all the providers’ academic training and knowledge, they may happen again. The question then becomes, how do the physician and the surgical staff mitigate these erroneous wrong-site surgeries or mistakes? Ojeda (2015) in research spoke about accuracy as an important factor for registration and identification of the correct patient. According to research by the Institute of Medicine in 2000, “To err is human: building a safer health system,” which was later quoted in several journals recently, highlighted the fact that in health care, building a safer system means designing processes of care to ensure that patients are safe from accidental injury. When an agreement has been reached to pursue a course of medical treatment, patients should be assured that it will proceed correctly and safely so they have the best chance of achieving the desired outcome. The article also highlighted that of the two cases, the patients involved and the procedures that ensued in the lower extremities was not reported as incident officially to the hospital administration, which in retrospect may be an in-action caused by denial and shame, consequently, no audit or root because the analysis was instituted (Nwosu, 2015). Surprisingly, within the USA, research has shown that a small number of these wrong-site surgeries get traction to litigation in the courts. In fact, according to Ojeda (2015), only 2% of these orthopedic malpractice claims in the USA get an award from successful litigation. The Institute of Medicine has identified that up to 98,000 patients die each year as a result of poor decision-making in healthcare (Panesar et al., 2016). Decision-making is essential to nursing practice (Panesar et al., 2016). Decision-making in acute care nursing practice is a complex process. Nurses must consider numerous potentially competing factors when meeting patient and family needs. This process is further complicated because nurses may care for five or more patients in an acute care environment (Ragusa et al., 2015).

Research identifies other factors associated with decision-making challenges for acute care nurses. For instance, critical care nurses can make decisions every 30 seconds. Nurse decision-making in acute care is highly demanding. An improved understanding of decision-making research in this environment may help to guide future efforts to support nursing practice (Nibbelink, 2018). Incorrect or missing data in electronic health records is among the top 10 patient safety concerns identified in a recent Institute report (Ragusa et al., 2015). Inaccurate registration information can harm patients in a few ways; test results might be sent to the incorrect physician, the wrong patient’s information might be added to another patient’s account, and incorrect dosages can be given if outdated weights in registration systems are shared with pharmacy systems. Also, registration accuracy is “a very significant issue regarding patient safety.

A recent survey of states conducted by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) found that at least one-third of states have some form of adverse event reporting system. The committee also believes that voluntary reporting systems play a valuable role in encouraging improvements in patient safety and complement mandatory reporting systems (Rajasekar, 2015). Research on decision-making has emerged from various fields, including economics, nursing, and medicine (Rajasekar, 2015). Nursing research explored elements important to nurse decision-making, including experience and intuition, the context of the decision-making situation, knowing the patient, interpretation, and reflection (Panesar et al., 2016). The complexity of decision-making for nurses continues to increase with patient acuity and technological advances (Rajasekar,2015). In addition, nurse decision-making can vary significantly based on the nurse practice setting. Understanding nurse decision-making in the medical-surgical environment is essential for enhancing patient outcomes. A literature review was conducted to summarize the factors and processes identified in research on nurse-patient care decisions in the medical-surgical setting (Rajasekar,2015). The Bible sternly warns us, “Do not follow the crowd in doing wrong… do not pervert justice by siding with the crowd” (Exodus 23:2, NIV). As we can see from the Bible, consensus and opinions crucified Christ. Additionally, to judge actions as right or wrong based on their results, in this case, we see that the powers in charge did not responsibly advocate litigation and make proper representation for the wrongfully operated patients. ‘What is right is what leads to the best outcome.

Jermaine Ocean

I actually got upset while reading this case study. There are certain professions that must get it right. This case study spells out how doctors can have years of schooling, years of experience, and still make lifechanging, or life ending mistakes. Not only are these major mistakes being made, but often they are not being reported. Imagine the small mistakes that goes unnoticed, or unreported. I tried to look at this from the perspective of the medica staff, and I cannot see how errors of this magnitude is possible. Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States, making medical errors the third leading cause of death (Anderson & Abrahamson, (2017).

The case study also mentioned the percentages for dentist extracting the wrong teeth. Although the number of malpractice cases are significantly lower for dentist, it is still unacceptable. Common mistakes include misdiagnosis of tooth decay, failure to take x-rays before treatment begins, performing unnecessary procedures, and incorrect filling placement or extraction techniques (Guelph, 2020). With the advanced technology we have, the amount of schooling, and the massive amount of money dentist are paid, these errors should not be happening. I wonder how much complacency plays on the errors that could be avoided. All patients are not the same and should be given the same level of care.

This has always been a huge fear of mine. I understand that we all have bad days at times, and this could affect our job performance. However, there are some jobs that cannot make mistakes, event on bad days, and being a surgeon is one of those jobs. I have had four surgeries, with one being just two weeks ago, and possibly two more coming before the end of this year. The frighten part about going into surgery is that you are completely vulnerable. Laying on a bed naked with only a hospital gown on. Once the anesthesia is administered, you are in a room full of strangers expecting them to not only protect you, but to make you better than you were prior to coming in.

Surgery is already nerve wrecking, and there is always a possibility that something could go wrong. Now imagine waking up not only still with the injuries that you were supposed to be treated for, but the wrong procedure was done. After an event such as that, how could you trust the health care system again? What level of comfort would you have if you had to go have a different procedure done later in life? Imagine the anxiety.

If the military taught me anything, it taught me the importance of paying attention to the details. The registration process is just as important as the services being provided by the physicians. Life saving measures may be decided based on the information entered in a patient’s data. There are some people that will believe anything their physician says about that treatment without question. If the information is entered incorrectly, the physicians could possibly prescribe the wrong medicines, miss key symptoms that could go untreated, or even overlook life threating conditions. All of which could bring harm or death to a patient.

Mark 2: 17 reads, and when Jesus heard it, he said to them, “Those who are well have no need of a physician, but those who are sick. I came not to call the righteous, but sinners.” Those who are sick, injured, or in medical need seeks the physician for heeling. If the physicians are not competent enough to provide a safe space for patients to feel comfortable, then the system is a complete failure.