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Running head: HEALTHCARE ERROR AND IMPACT ON PATIENT SAFETY 1 Real World Healthcare Error and its Impact on Patient Safety Dr. Rani Priyanka Vasireddy HCM 520 – Quality and Performance Improvement in Healthcare Colorado State University – Global Campus Dr. Marie Jay Maningo-Salinas January 25, 2017
HEALTHCARE ERROR AND IMPACT ON PATIENT SAFETY 2 Real World Healthcare Error and its Impact on Patient Safety Medical errors are the third most leading cause of death in the United States, after cardiovascular disease and cancer. Every year, more than 250,000 deaths occur due to lack of proper patient safety efforts and it is an under-recognized epidemic (Sternberg, 2016). Medical errors are neglected, there has been not much knowledge and research into patient safety efforts because there have been no active efforts to study the patterns and reasons behind these errors, and no effective interventions are in place to address them. Medical errors may range from a simple lapse in judgment to a lack of skill or inappropriate coordination of care, wrong or misdiagnoses and even equipment failures that lead to patient deaths or anything resulting in preventable complications of care. This paper identifies and analyzes one such medical error that resulted in the threat to patient safety, also provides appropriate recommendations for performance improvement to prevent such errors in the future. Evaluation of a Real World Medical Error The medical error that this paper focuses on is about mistaken identity of the patient. Identifying a patient correctly seems like a straightforward task, but it is not so easy in many situations. As illustrated by this case, there can be a variety of circumstances that may contribute to patient identification errors causing harm to patients. Kerry Higuera case Kerry Higuera was a mother of four who lived in Peoria, Arizona. She went to the emergency room at Banner Thunderbird Medical Center in Glendale, Arizona in February of 2008 for the first trimester bleeding. Kerry suspected that she might have a miscarriage and was worried she would lose her baby. Kerry was asked to wait in a room for a nurse, soon a nurse visited her room and asked if she was Kerry, without any doubt Kerry replied yes and soon they
HEALTHCARE ERROR AND IMPACT ON PATIENT SAFETY 3 were in a hallway walking towards a CT scan room. Kerry was not sure why she needed a CT scan and acknowledged if that was ordered by her doctor and the nurse immediately assured that her doctor wanted to look at the CT scan of her abdomen. Once the test was done Kerry was

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