It is not enough to just say that errors happen because we are all human, and humans make mistakes. That is true and medical errors can never be entirely eliminated. But it has been proven that the number of errors can be greatly reduced. The first step in accomplishing this goal is to identify the four most common reasons why medical errors occur.

Communication Errors

Poor communication is one of the biggest causes of medical errors. Many studies have documented that poor communication or a lack of communication are significant contributors to medical errors. If you have already started working as a CNA, you know that hospitals, clinics, doctor’s offices, skilled nursing facilities, etc. – almost all health care settings – are very busy places. Written records have always been used to make sure communication is accurate. Computers have also helped to reduce communication errors. However, these written records may not be complete or accurate and if they are not, that is poor communication.   The risk of poor communication is compounded by the need for oral communication.  This is often in the form of a conversation or a message delivered from one person to another and then to someone else: this type of communication is very common in health care settings and it happens all the time. However, it is very easy (especially when the pace of the work day gets hectic) for undocumented oral communication to be misinterpreted, forgotten, etc.  And if the communication among

health care professionals about client care issues is not documented, there are real risks. There is no reliable way to determine what needs to be done, what should be done, or if a procedure has been performed or a treatment delivered, etc. Depending on your memory or on someone else’s memory is not a safe way to practice your profession.

Learning Break: Good communication essentially means good documentation: that is a basic rule you need to remember. All important conversations and information relating to client care need to be documented.

Poor Judgment

Poor judgment is also a very common cause of medical errors. Poor judgment can mean that someone made an incorrect assessment: he/she may have decided that a patient’s pain was not serious, or a patient’s elevated blood pressure or fever did not represent a risk. Poor judgment can mean that you had a range of tasks to accomplish, and you made a poor choice as to which was the most important. Poor judgment can mean that you had some warning signs that a dangerous situation was developing, but you did not notice them or interpret them correctly, or take the proper course of action. Poor judgment could mean that your planning was in error.

Medical errors that arise from poor judgment basically indicate that a poor decision was made or an incorrect action was taken, and another healthcare professional who was acting reasonably and prudently would not have made the error.

To express this in simpler terms: a medical error caused by poor judgment means that if you had to do something over again, you would have done it differently. Whether or not poor judgment was use can be somewhat subjective. But the standard for determining what is, and what is not poor judgment is this: What would a reasonable person who had the same level of educational preparation and clinical experience do in the same situation?

Lack of Knowledge

As a healthcare professional, you are expected to have a certain level of specialized knowledge. Your schooling and your training should have provided you with all the information that you need to do your job. When you are working, you need to apply that knowledge. But educational preparation is not all the same and for different reasons, not everyone learns everything they need to know. You will also forget things you learned. Or there may not be sufficient reason to remember a specific fact: if you have not worked with a diabetic client for a while, you may forget some of the information you need to provide good care for them.

Although most programs teach the students the necessary curriculum, and most students do a good job of learning it, it is inevitable that you will forget some of what was taught. You can’t be expected to know everything, but what you need to know should be clearly outlined in your job description. You job description should clearly outline what you are expected to know, and it is your responsibility to have this knowledge or gain this knowledge if you do not have it.

Stress

It is a lot easier to do your job if you have unlimited time. It is also easier if there is no pressure. But there will definitely be times in your career as a CNA when you will be under pressure and the time you have to do your job will be limited. Pressure and a lack of time cause stress, and stress is a major reason why medical errors occur. Very few people perform at their best when they are under stress. Although stress is a part of almost every job, being responsible for the health and safety of other people is something that is especially difficult. As a CNA you can expect a certain level of stress in your job.

    So in summary, there are four basic reasons why medical errors happen: poor communication, poor judgment, lack of knowledge, and stress. But underlying all of those is a more basic reason why a medical error occurred: someone failed to use appropriate levels of attention, knowledge, and planning. Remember: the chain of events that leads to a medical error looks like this.

Poor planning/Lack of knowledge/No communication/Inattention

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Adverse effect/Harm

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Preventable Event