Knowing how medical errors occur is the first step. But the bigger concern is preventing them. The easiest way to do that is to remember those four causes of medical errors and to use the following steps.

Good Communication

As mentioned previously, good communication basically involves good documentation: that is the first and most important rule of good communication.  Documentation in health care is a separate topic. However, in terms of preventing medical errors, documentation can be quickly summed up: write it down.

Do not trust your memory, or the memory of someone else. Anything that is important and that must e documented should be documented as soon as possible; this is crucial. And you must be sure to record everything that is important. You are communicating what has happened, what needs to be done, and what the plans are for the client, so make sure you include all important details.

One of the simplest ways to make sure your documentation and your communication are accurate is to review your notes. After you have finished documenting, go back and make sure everything that needs to be documented was documented. You will be surprised how often a quick review will reveal that you forgot to include some important information in a note you have just written.

Of course, if you take too seriously the concept that everything that is important must be documented, documentation would be a never ending task. And if you take to heart the old saying used in health care, “If it wasn’t documented, it wasn’t done,” documentation would truly be endless. Documentation is separate topic. As regards documentation and prevention of medical errors, use your professional judgment about what to include and what to leave out and use this standard to decide: is what I am documenting important in terms of patient care?

Good Judgment

Exercising good judgment can be tricky for several reasons. First, the need for good judgment often occurs in situations in which you don’t have all the facts, or the facts may be open to interpretation. Think about it: if you had all the facts you needed and all of the information was clear, making the right judgment would be easy! Second, the need for good judgment often arises when you are faced with a new and unfamiliar situation. It is easy to make the right choice if you are in a situation you have encountered before. But as many people have pointed out, good judgment comes from experience, but experience  often comes from bad judgment!

So what is the answer? How do you use good judgment to avoid making medical errors? Fortunately, there are some simple things you can remember to help you make good judgments:

• Ask for help: You may not have the information you need to make a good

judgment, but one of your co-workers may. You should also have supervisors that

can provide help. So it is important to remember that you almost always have

resources. This seems very obvious, but there is often a feeling among health care

professionals that they should know everything and have all the answers. It is

unrealistic, but it is surprising how common this attitude can be. One of the most

helpful things to remember when you are practicing as a CNA is that is okay to

say: I don’t know. If you aren’t sure, ask; you are not alone.

• Being attentive: Being a health care professional is a big responsibility. Part of that responsibility means being vigilant and paying attention: you cannot make good judgments without lots of good information, and you can’t get that information if you are not paying attention. As a CNA and a health care professional, you must constantly be monitoring your work situation and your clients. You are looking for changes, abnormal signs and symptoms, possible unsafe situations. You are, basically, on the “front lines,” acting as a sentinel. You often have the most constant and most direct contact with the client. Because of that, you will often be the first one to notice if something is wrong, so you need to be watchful at all times.

• Good planning: Another way to help you make good judgments is to make a conscious effort to plan. Planning involves thinking ahead so that you are prepared for what might happen.

Lack of Knowledge

Preventing medical errors that occur because of a lack of knowledge is relatively simple. Only you can determine if you have the knowledge to do your job correctly and safely. You must make an honest assessment of what you know and if there are areas that need improvement, you need to address them. Hopefully, the health care setting in which you work will have educational resources that can help you learn. If not, there are almost unlimited on-line learning opportunities.

But honesty, not avoidance, is the key. It is better to realize that you lack knowledge about an important clinical issue and try and improve. Many people will simply hope that they will never have to be in a situation in which they don’t have the knowledge they need.  This approach will work – until it doesn’t.

Stress

There has been a lot written about stress on the job, and a lot written about the unique stress faced by health care workers. Stress can definitely affect your job performance. Everyone has his/her own way of dealing with stress. How can you deal with the stress you encounter when working as a CNA?

• Take your time: Being advised to slow down and take your time when you are under stress is easy advice to give but difficult advice to put into practice. But remember this: true emergencies in health care settings are actually very rare. An emergency is a situation in which immediate action is needed to prevent a catastrophe. In your entire career as a CNA, you may never encounter a situation in which only immediate action will prevent a disaster. Most problems that are perceived as “emergencies” are actually simply changes in the daily routine or brief disruptions in the schedule. However, if you are not prepared these situations may look like an emergency and that is where the trouble begins. If you feel that you are involved in an emergency situation you will feel a self-imposed pressure to do something, and do something immediately. But 99.9% of these “emergencies” are just unfamiliar disruptions. Yes, you may need to do something and it may not be immediately clear what you have to do. But if this happens the best course of action is to slow down and think. Reacting to situations causes mistakes and errors. You almost always have more time to respond than you think you do.

• You are not alone: This was mentioned in a previous section, but it applies here, too. Co-workers can be a valuable source of support, knowledge, and experience. Trying to deal with stress by yourself can actually make you less productive. Your co-workers can help you deal with stress in a variety of ways. They can assist you with tasks, provide advice and knowledge, and give moral support.

• Understand what an error is: Accept that errors are inevitable. Don’t try and make every day at work a perfect performance. It’s impossible, it will only add to your stress, and this attitude will make mistakes more likely to happen. It is also helpful if you keep the definition of a medical error in mind. You may feel stressed because you are ten minutes late taking a client’s vital signs. But ask yourself: is this likely to cause harm? Are you being stressed because there is a possibility you might make a medical error? Or are you stressed because you are behind on an unrealistic schedule that you have set for yourself?

Be prepared: Being prepared involves having a clear understanding of the challenges and requirements if your job and  The most effective way of handling stress is to know your job; you can’t be stressed if you are prepared. Remember, a medical error is considered to have occurred if a healthcare professional did not have proper knowledge, did not exercise good judgment, or used poor planning