Medical Errors in Haemodialysis Unit and Patient Outcomes: A Study

This report presents a research proposal focused on medical errors within haemodialysis units and their subsequent impact on patients. The introduction provides background information on haemodialysis, highlighting the critical role of the procedure in managing kidney failure, while also acknowledging the potential risks and challenges faced by nurses. The problem statement outlines the study's objective: to analyze the different types of medical errors occurring in haemodialysis and their effects on patients. The research objectives include understanding the concept of haemodialysis, identifying challenges nurses face, assessing medical errors, and determining ways to address these challenges. The significance of the proposal is emphasized, underscoring its contribution to understanding haemodialysis, challenges in care, and the potential for future research. The report then reviews relevant literature, discussing errors such as incorrect dialysis solutions, patient falls, medication errors, and fluid imbalances. It also addresses challenges faced by nurses, including caregiver interference, staff shortages, and lack of skilled staff. The study's potential influence on the wider community is highlighted, emphasizing the importance of understanding and mitigating risks associated with haemodialysis. The report concludes by summarizing the key findings and emphasizing the importance of addressing medical errors to improve patient outcomes.

Nursing Research
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CONTENTS
TITLE – “Medical errors in Haemodialysis unit and their impact on patients undergoing
haemodialysis”.................................................................................................................................3
INTRODUCTION...........................................................................................................................3
Background of the problem.........................................................................................................3
Research Problem Statement.......................................................................................................3
Research Objectives.....................................................................................................................3
Research Questions......................................................................................................................3
Significance of the proposal........................................................................................................4
Literature relevant to problem identified.........................................................................................4
Potential influence of proposed study on wider community...........................................................6
REFERENCES................................................................................................................................7
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TITLE – “Medical errors in Haemodialysis unit and their impact on patients
undergoing haemodialysis”
INTRODUCTION
Background of the problem
Haemodialysis is referred as the way of replacing some functions of Kidney (in situation of
Kidney failure) by using machine to clean and filter the blood. Machine is used to pump out
blood from the body where it passed through various tiny tubes in a dialyzer or artificial kidney.
At the time of performing the process of haemodialysis, there are various challenges facing by
the nurses (Chen, Su, & Huang, (2018). Apart from this, there are some potential risks associated
with the process and if not performed carefully, the chances of errors are increases. Some of the
risks are apparent in clinical facilities including faulty machine and equipment, inadequate hand
hygiene, water quality etc. This is a proposal report based on the title "medical errors in
haemodialysis unit as well as their impact on the patients undergoing haemodialysis. There are
some medical errors which is analysed in the report along with determining their impact on the
patients who are undergoing haemodialysis.
Research Problem Statement
The problem statement in relation to this particular study is “To analyse the different
medical errors occurs in Haemodialysis unit and their impact on patient undergoing
haemodialysis.”
Research Objectives
The objectives associated with this particular investigation are as follows:
1. To understand the concept of haemodialysis.
2. To identify the various challenge face by nurses in delivery of care for haemodialysis
patients within clinical settings.
3. To assess different medical errors occurs in Haemodialysis unit and their influence on
patient undergoing haemodialysis.
4. To ascertain various ways through which the challenges facing by nurses can be address.
Research Questions
The research questions linked with this specific study are as follows:
1. What is the concept of haemodialysis?
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2. Which are the various challenge face by nurses in delivery of care for haemodialysis
patients within clinical settings?
3. What are the different medical errors occurring in Haemodialysis unit and their influence
on patient undergoing haemodialysis?
4. What are the various ways of addressing the challenges facing by nurses in
haemodialysis?
Significance of the proposal
This project is based on the title “Medical errors in Haemodialysis unit and their impact on
patients undergoing haemodialysis”. It intends to examine the distinct medical errors occurs in
Haemodialysis unit and their influence on patient undergoing haemodialysis. Developing this
proposal is highly significant as it assist in gaining in-depth understanding about concept of
haemodialysis and the different challenges that are facing by nurses in delivery of care for
haemodialysis patients (Tennankore, & et. al., (2015). Apart from this, it also assists in assessing
the different medical errors and the ways to address the challenges in an effective way. This
overall study will contribute in improving the knowledge base of researcher and provide an
opportunity to carry out further study on the topic.
Literature relevant to problem identified
Haemodialysis is the blood purifying process which is undergoing by the patients with
kidney failure. In this process, a machine filter salts fluids and wastes from blood in the body of
an individual when the kidneys are not healthy enough to perform its functions adequately.
Haemodialysis can help body of a person to control blood pressure as well as maintain the
appropriate balance of fluid and several minerals — like sodium and potassium — in body.
Normally, haemodialysis starts well before the kidneys have shut down to the point of instigating
life-threatening complications. As per the view point of Mashkoor, & Biro, (2015), there are
different medical errors happening in haemodialysis unit. Some of the errors are as follows.
1. Incorrect dialysis solution or dialyzer and water quality issues: The process of
haemodialysis eliminates small solutes from patients, utilising a system in which the
blood of a patient is pumped by semipermeable membrane as well as dialysis solution
flows counter current to blood, outcomes in movement of solutes. The potential sources
for medical errors exist throughout the system involves utilisation of incorrect dialysis
solution for a given patient, contamination of dialysis solution or water utilised to make
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dialysate, dialyzer leaks, issues with access of patient and ill-fitting lines connecting
dialyzer. This may result into accumulation of toxins and transmission of infection.
2. Patient falls and medication errors: in the haemodialysis unit, patient falls and
medication error can also be an issue of safety. As per the survey performed, it has been
found that 87% of dialysis unit employees acknowledged error or mistake in dialysis
treatment (Thomas, & et. al., (2016). Patient fall is a common adverse event at dialysis
centres. The risk factors for falls involved number of commodities, patient age, history of
falls and having low systolic blood pressure prior to starting dialysis. Moreover, after the
session of dialysis, haemodynamic shifts may lead to dizziness and transient hypotension.
The risk of fall is very high in the patients of haemodialysis than general population. On
the other hand, the medication errors happened the most due to errors of omission.
3. Fluid imbalance: this is the another error in haemodialysis unit. In renal failure, the
capacity of patient to excrete a fluid load is declined or absent. The balance of fluid is
maintained through removal of fluid by the process of dialysis coupled with water
restriction and sodium. Noncompliance with either may lead to volume overload, that
presents in similar way as heart failure, with pulmonary and peripheral oedema
(Schwappach, (2015). Overload of fluid may also cause hypertension in Kidney disease
patient and there is no response to diuretics. The correct treatment is removal of fluid by
dialysis. Depletion of fluid is less common however may cause due to over vigorous
removal of fluid at the time of dialysis or vomiting or by inter current diarrhoea.
As per the view point of Monir Nobahar and Mohammad Reza Tamadon, (2016), there
are various challenges faced by nurses at the time of delivery of care for haemodialysis patient.
These barriers lead to reduction in care quality for the patients who are undergoing
haemodialysis. This involves:
1. Interference by caregivers of patient: this is a barrier which occurs due to the presence
of caregivers of patient in haemodialysis ward as in many cases, show some issues in
delivery of care process to patients as well as maximize the risk of infection (Barriers to
and facilitators of care for hemodialysis patients; a qualitative study, 2016).
2. Heavy workload and shortage of staff: while deliver care to the patients, inadequate staff
may to develop several issues. Not having sufficient nursing personnel to provide care to
the patients on time can results into not mitigating the needs of patient. It also increases
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the workload on the existing staff due to which they get stressed and pressurised and not
able to deliver high quality care services to the patients within haemodialysis unit
(Himmel, Lam, & Fralick, (2016).
3. Unskilled staff: if the staff working in dialysis ward is not getting proper training, then it
creates issues. Providing services to patients from an unskilled staff may create the life of
patient into the risk and may also developed some other issues.
Potential influence of proposed study on wider community
The proposed study highly influences on wider community as with the help of the study, the
medical errors occurs in haemodialysis unit can be analysed and their impact on the patients
undergoing haemodialysis can be assessed by undertaking this proposal. This is study supports in
determining the potential risks related to the process of haemodialysis and aware the community
about those so that they can adopt appropriate measures which help in eliminating the risks or
reducing the impact (Agar, Culleton, Fluck, & Leypoldt, (2015). Apart from this, the scope of
study is wide as this study acts as a base for performing further research by the scholars.
CONCLUSION
As per the above mentioned report, it has been concluded that haemodialysis is the
process of purifying blood of an individual whose kidneys are not performing its functions
normally. While performing the process, there may be chances of occurring various medical
errors which leads to impact on health of patient. These medical errors need to be considered by
the nurse and healthcare professionals so that these can be reduced effectively.
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REFERENCES
Books and Journals
Chen, X., Su, Y., & Huang, M. (2018). Comparison and analysis of application effect of
traditional paper operation method and digital information system in
hemodialysis. Matrix Science Medica (MSM), 2(2), 1-3.
Tennankore, K. K., d’Gama, C., Faratro, R., Fung, S., Wong, E., & Chan, C. T. (2015). Adverse
technical events in home hemodialysis. American Journal of Kidney Diseases, 65(1),
116-121.
Mashkoor, A., & Biro, M. (2015). Towards the trustworthy development of active medical
devices: a hemodialysis case study. IEEE Embedded Systems Letters, 8(1), 14-17.
Thomas, A., Silver, S. A., Rathe, A., Robinson, P., Wald, R., Bell, C. M., & Harel, Z. (2016).
Feasibility of a hemodialysis safety checklist for nurses and patients: a quality
improvement study. Clinical kidney journal, 9(3), 335-342.
Schwappach, D. (2015). Patient safety: what is it all about?. In Patient Safety in Dialysis
Access (Vol. 184, pp. 1-12). Karger Publishers.
Himmel, M. E., Lam, K., & Fralick, M. (2016). Hemodialysis in a Healthy Patient—A Case of
an Erroneous Laboratory Result: A Teachable Moment. JAMA Internal Medicine, 176(4),
431-432.
Agar, B. U., Culleton, B. F., Fluck, R., & Leypoldt, J. K. (2015). Potassium kinetics during
hemodialysis. Hemodialysis International, 19(1), 23-32.
Dangerous Dialysis, 2010. [Online]. Available through:
<https://psnet.ahrq.gov/web-mm/dangerous-dialysis>
Barriers to and facilitators of care for hemodialysis patients; a qualitative study, 2016. [Online].
Available through: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827385/>
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