4 - Practitioner Behavior

Question 1

What are common sources for Rx errors?

Answer 1

• Incomplete Information - allergies, other meds, lab results
• Miscommunication - poor handwriting, similar names, zeroes, decimal points (10 vs 100 mg, etc)
• Lack of Labeling - drugs repackaged and units not updated
• Environmental Factors - distractions

Question 2

What are issues with the traditional solution to mistakes?

Answer 2

• Find person, blame them
• Re-train (fix) the person
• Kick them out if fixing isn’t possible
• Issues: Promote secrecy, prevents analysis, limit potential for prevention

Question 3

What is a systems view for risk management?

Answer 3

• Using system (processes) to prevent errors
• Outcome conferences
• Gaining data; organize processes so errors become less likely and less possible
• Policies have to promote openness and discussion

Question 4

What is necessary for system changes?

What are some fail-safes?

Answer 4

• Good communication
• Simplify and standardized processes
• Forcing Functions - procedures that won’t work until all necessary information is included (like an online form without an “ * “ filled out)
• Build in redundancies as fail-safe measures; example would be flashing and buzzing to indicate errors (multiple senses); use of checklists

Question 5

What are errors vs adverse events?

Answer 5

• Errors: Failure to complete planned action; mistakes
• Adverse Events: Harm resulting from process of normal medical care; usually not due to error; ex. medication reaction

Question 6

What are two basic skills for dealing with difficult patients?

Answer 6

• Nondefensive Inquiry
  
  • Bring things our without diverting attention to making sure you’re not blaming unfairly
• Confrontation Without Attitude
  
  • Be direct and not hostile or judgemental

Question 7

What are two useful concepts for dealing with difficult pts?

Answer 7

1. Content Vs Proccess - Think of what you say bs how you say it
2. Personality Disorders - Maladaptive patterms of behavior that are pervasive and inflexible

Question 8

What is the difference between Emotion-Focused and Problem-Focused coping?

Answer 8

Emotion - changing the way we feel

Problem - changing the situation