Active Errors

• Medication errors: These are errors in the prescribing, dispensing, or administration of medication. They can include giving the wrong medication, the wrong dose, or the wrong route of administration. For example, a nurse might accidentally give a patient the wrong medication because the labels on the medication vials were similar.
• Communication errors: These are errors in the exchange of information between healthcare providers. They can include miscommunications between doctors, nurses, and other healthcare professionals, as well as miscommunications between healthcare providers and patients. For example, a doctor might not properly communicate a patient’s medication regimen to the nurse, which could lead to the patient taking the wrong medication.
• Procedure errors: These are errors that occur during a medical procedure. They can include wrong-site surgery, wrong-patient surgery, and retained foreign objects. For example, a surgeon might operate on the wrong side of a patient’s body because the surgical markings were incorrect.
• Falls: Falls are a common type of medical error that can lead to serious injury or death. They can be caused by a variety of factors, including environmental hazards, patient factors, and medication side effects. For example, a patient who is taking a medication that causes drowsiness may be more likely to fall.

Latent Errors

• System design: This refers to the way that healthcare systems are designed. Latent errors in system design can make it more likely that active errors will occur. For example, a hospital that uses multiple different types of infusion pumps makes it more likely that a nurse will make a programming error.
• Work environment: This refers to the physical and social environment in which healthcare providers work. Latent errors in the work environment can make it more difficult for healthcare providers to avoid errors. For example, a hospital that is understaffed and has high patient turnover rates can make it more difficult for nurses to provide safe care.
• Culture: This refers to the values and beliefs that are shared by a particular healthcare organization. Latent errors in culture can make it more difficult to identify and correct errors. For example, a hospital that has a culture of blame is less likely to have a system in place for reporting and learning from errors.

Examples from Clinical Experience

In my clinical experience, I have seen examples of both active and latent errors. For example, I once saw a patient who was given the wrong medication because the labels on the medication vials were similar. This was an active error that was caused by a lack of attention to detail. I have also seen patients who have fallen because they were not properly assessed for fall risk. This was a latent error that was caused by a lack of communication between the nurse and the doctor.

How to Avoid Errors

There are a number of things that can be done to avoid errors in medicine. Some of these include:

• Standardize processes: This can help to reduce the number of errors that are caused by human factors. For example, hospitals can standardize the way that medications are ordered, dispensed, and administered.
• Use checklists: Checklists can help to ensure that important steps are not forgotten. For example, a surgical checklist can help to prevent wrong-site surgery.
• Create a culture of safety: This means creating an environment where errors are not punished, but instead are seen as opportunities to learn and improve.
• Educate healthcare providers: Healthcare providers need to be educated about the risks of errors and how to prevent them.

By taking these steps, we can help to reduce the number of errors in medicine and improve patient safety.

In addition to the above, here are some other specific things that can be done to avoid active and latent errors in medicine:

• Use technology: There are a number of technological tools that can help to prevent errors, such as barcoding systems and electronic health records.
• Invest in training: Healthcare providers need to be trained on how to identify and avoid errors.
• Create a team approach: Healthcare providers should work together to prevent errors.
• Be vigilant: Healthcare providers should be constantly vigilant for potential errors.