Hospital’s “Quiet Zone” Found to Decrease Medication Errors

Medication errors injure approximately 1.3 million Americans each year and cause, on average, at least one death every day. All told, these errors cost over $3.5 billion each year.

The Federal Drug Administration lists several common causes of the errors, including poor communication, poor procedures or techniques, confusing packaging and ambiguities in product names or abbreviations. Unfortunately, many medication errors can be traced to the same route cause – medical professionals who make mistakes because they are stressed-out, exhausted or distracted.

“Quiet Zone” an Intentional Response to Dangerous Errors

A new initiative at Egleston children’s hospital in Atlanta is attempting to reverse this trend. The hospital has set up a dedicated quiet zone that nurses can use to place medication orders without being interrupted. Hospital leaders created the zone two years ago after noticing that distracted staff members were making potentially dangerous errors when ordering medicine.

Since the zone has been implemented, medication errors at the hospital have been reduced by two-thirds.

Egleston’s example is being held up by Medicare and Medicaid chief Dr. Donald Berwick as an example for the rest of the nation to follow – not only because it will reduce costs and promote efficiency, but because it will save lives. Dr. Berwick has witnessed dangerous medication mistakes at even the most renowned hospitals. In fact, as a young resident he mistakenly gave the wrong transfusion to a baby, nearly killing the child.

Fatigue Increases Risk of Error

Dr. Berwick attributed his error to the sleep-deprived schedule most young residents continue to face. There is mounting evidence to show that fatigue plays a huge role in medication errors. In studies, fatigue and sleep deprivation have been linked to decreased vigilance, poor memory, delayed reaction time, slower information processing and poor decision making. In relation to those performance measures, staying awake for 24 hours has been found to be the equivalent of having a blood alcohol level of .10 percent.

Hopefully, the increased awareness of issues of fatigue and distraction combined with innovative responses, such as Egleston’s quiet zone, will help increase patient safety throughout the country.

Source: Los Angeles Times, Pressing for better quality across healthcare, Noam N. Levy, 4 October 2011