BEHAVIOR
September 22, 2008

Fatal Medication Errors at Home on the Rise

Patients or their caregivers often leave the hospital with at least one critical misunderstanding related to their further care.

Over three-quarters of patients or their caregivers left the emergency room with at least one critical misunderstanding related to their further care. Over half left with at least two misconceptions. The study was done on English speaking adults, so confusion due to use of multiple or non-native languages was minimal.

Anyone who's been in a hospital emergency room knows that they're confusing places. A Chicago study shows that they're even more confusing than you think they are.

If a patient thinks they understand the discharge orders when they don't, simply asking them about if they understand won't do any good.

Dr. Kirsten G. Engel of Northwestern University and colleagues attempted to shed some light on the communication process between medical personnel and patients. One hundred forty adult English-speaking patients or their caregivers were interviewed after their discharge from emergency departments at two teaching hospitals. The subjects were asked questions about four important areas: their diagnosis and the cause of their symptoms, the care they received, their discharge recommendations and return instructions.

Fully 78% of the subjects had misunderstandings about one of these subjects and 51% showed confusion over two or more. The highest rate of mistakes involved after-care (34%). Even worse, 80% thought they understood the instructions, but the interviews showed this to be untrue; they were confused about their confusion!

If a patient thinks they understand the discharge orders when they don't, simply asking them about if they understand won't do any good.

Dr. Engel's team recommends that medical personnel test the patient's understanding of discharge instructions by asking them to state the instructions in their own words. Improving the quality of the discharge instructions given to patients was also suggested.

The study was published in the July 7, 2008 online edition of Annals of Emergency Medicine.

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