Assessment of Clinical Errors in Druhi Neupane's Hospital Care

This presentation analyzes the case of Druhi Neupane, a 48-year-old patient with a language barrier, highlighting her increased risk of clinical errors during hospital care. The presentation identifies three key clinical errors: medical reconciliation errors due to communication difficulties, unsafe discharge potentially caused by inadequate assessment, and informed consent errors resulting from misunderstandings. It details the potential consequences of each error, such as medication mistakes, patient readmission or mortality, and incorrect treatment decisions. The presentation emphasizes the importance of collaboration with healthcare practitioners, the use of interpreters, seeking clarification, and obtaining informed consent from both the patient and family members to mitigate these risks. The content provides valuable insights into the challenges of providing safe and effective healthcare to patients with language barriers, demonstrating the importance of proactive strategies to minimize clinical errors and improve patient outcomes.

Identification of the patient
Druhi Neupane is a 48 year old patient who is likely to be at a risk of clinical errors because of language barrier. The fact that
Druhi, her family members and regular visitors speak minimal English makes communication with the nurse difficult. This is
posing a risk to the health and well-being of Druhi because there is high chances of misunderstandings and
misinterpretations. Language barrier will therefore affect the quality of care offered to Druhi.
Clinical errors
Medical reconciliation error-This
is a shared responsibility between
the nurse and the patient and
families. The patients are the
central resource of communicating
their personal medication taking
practices. Druhi is at risk of
medical reconciliation error
because she may not bee able to
give detailed explanation about
her medical history (Verghese,
Charlton, Kassirer, Ramsey, and
Ioannidis 2015). The
consequences of this error are
omissions, drug interactions,
duplications and dosing errors.
Clinical errors
Unsafe discharge-Druhi may be discharged before
she is clinically ready to leave the hospital. Due
to language barrier, she may not be properly
assessed. The consequences of unsafe discharge
include patient mortality, morbidity or
readmissions. Informed consent error- nurses are
required to disclose risks, benefits and alternatives
of treatment to patients. However, due to language
barrier, Druhi may agree to treatment that may
affect her wellbeing or refuse to take essential
treatments. The nurse may also make judgements
without her consultation. The consequences of
informed consent error include wrong
prescriptions, allergic reactions, and the nurse may
be charged with malpractice.Fig 1: (Neira 2018)
Fig 2: (White 2016)
Strategies
1. Collaborate with other healthcare
practitioners
2. Request the hospital to get a reliable
interpreter (Latimer, Hewitt,
Stanbrough, and McAndrew, 2017)
3. Seek more clarification on what is not
clear or well understood
4. Seek informed consent from the patient
and family members
Clinical Errors in Druhi Neupane’s treatment
Author’s Name
List of References
Latimer, S., Hewitt, J., Stanbrough, R. and McAndrew, R., 2017. Reducing medication errors: Teaching strategies that increase nursing students' awareness of medication errors and their
prevention.
Neira, L., 2018. The importance of addressing language barriers in the us health system: Duke center for personalized healthcare. Retrieved from
https://dukepersonalizedhealth.org/2018/07/the-importance-of-addressing-language-barriers-in-the-us-health-system/
Verghese, A., Charlton, B., Kassirer, J.P., Ramsey, M. and Ioannidis, J.P., 2015. Inadequacies of physical examination as a cause of medical errors and adverse events: a collection of
vignettes. The American journal of medicine, 128(12), pp.1322-1324.
White, J., 2016. 5 strategies for hospitals to prevent medical errors: healthcare business & technology. Retrieved from http://www.healthcarebusinesstech.com/medical-error-prevent/