Tuesday, June 19, 2012

Patient’s Perspective: Adverse Events


             The text describes patient safety as freedom from accidental injury. The patient is the center of the healthcare experience. Providers strive to ensure the best for their patients. Providers must understand that patient’s safety is the upmost of priorities. In such a delicate field, healthcare professionals deal with the lives of people. It is up to the providers to ensure that they are free from harm, pain, injury, suffering, and the least negative experience as possible. When patients unfortunately experience harm, pain, injury and suffering from a health care encounter, that is considered to be an adverse affect. Patients, the center of healthcare, determine whether an adverse event has occurred.
                A provider will only know if an adverse event has occurred if the patient has informed him of any pain they are experiencing. Providers are unable to feel or experience what the patient experiences. They must rely on the accounts of the patients to determine if they have been adversely affected.  Sometimes if the patient is not in a position to express any pain, this may be considered a way a provider has determined the occurrence of an adverse affect. An example I have in mind is from an episode of Grey’s Anatomy. Although the story was fictitious, it is real life situation that has the possibility to occur. A patient underwent a brain procedure. The attending physician was called out of the latter part of the surgery. He allowed for his two residents to complete the surgery, which they had the capabilities to do successfully. The residents took upon themselves to remove more from the brain than that was authorized. When the patient woke up from the surgery, the residents’ unauthorized removal affected the speech of the patient. The patient was unable to speak properly, and even though they literally could not express their suffering, by being unable to communicate have confirmed an adverse event.
                 Providers may believe they are in a position to judge the occurrence of an adverse event; however, it is a very subjective topic. What one patient may perceive to be painful may be tolerated by another patient. What may be a traumatic outcome for one patient may not be for another. With such high subjectivity, it is ultimately up to the patient to inform the provider.
                The determination of adverse events is not always in clear black and white. It must be understood that some medical interventions cause harm. Chemotherapy, for example, is very difficult to endure. Although the radiation kills the cancerous cells in the body, the side effects leave the patient with characteristics of an adverse event. They experience pain, physical and emotional suffering. However, the goal of the intervention is being achieved. In this case, it is difficult to determine if the patient is experiencing an adverse event.  However, even though these side effects are known to occur, does not make the procedure acceptable as is. Scientists and researchers need to be hard at work to create treatments that will not leave the patients physically distraught. It serves as a contradiction, in order to get better in one area they must deteriorate in others. Adverse events should be used to motivate researchers to continue to improve the patient experience. 

Reference:

Ranson, E. R., Joshi, M. S., and Nash, D. B. (2011). The healthcare quality book. 2nd ed.  Chicago: Health Administration Press.

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