TUGBA KAVALALI ERDOGAN, TUGBA CINARLI, ZELIHA KOC. Ondokuz Mayıs University Health Science Institution

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1 TUGBA KAVALALI ERDOGAN, TUGBA CINARLI, ZELIHA KOC Ondokuz Mayıs University Health Science Institution

2 Medical error corresponds to inflicting harm to a person who receives services as a result of health professionals who work in the field of medicine and related disciplines not being able to use their skills and competencies which they normally would (Cebeci et al. 2014).

3 Medical error can also be defined as an expected outcome arising from an unintended fault occurring while providing health care services for a patient; adverse or unexpected event consisting of serious physical or psychological harm or risk of harm (Tansuyer 2010).

4 Medical error occurrence depends on numerous factors. Medical errors are examined based on three main factors ; including human, organizational, and technical factors.

5 HUMAN FACTORS INCLUDE ; lack of education, knowledge, and experience among health care professionals; insufficient communication skills; reckless and negligent acts; not taking necessary precautions; and acting inattentively due to fatigue. (Ozcetin 2016; Tansuyer 2010).

6 ORGANİZATİONAL FACTORS CONSIST OF, the economic structure of the organization, organizational policies, and recruiting health professionals at inappropriate positions. (Ozcetin 2016; Tansuyer 2010).

7 TECHNİCAL FACTORS; use of inappropriate devices, not calibrating devices, and insufficient automation (Ozcetin 2016; Tansuyer 2010).

8 PURPOSE OF THE STUDY During the provision of health care services, medical errors are encountered from time to time, which result in death, injury, disability or delayed treatment. This descriptive study was conducted in order to determine the prevalence and etiology of malpractice.

9 What is the prevalence of malpractice in health care practice? What is the etiology of malpractice in health care practice?

10 MATERIAL AND METHOD The current study was conducted at the central library of a university between January, 1 st and April, 30 th of the year 2015 by examining every issue of 17 archived newspapers published in 2014.

11 Study universe and sample; A specific sampling strategy was not utilized and every issue of 17 newspapers, which were published within 12 months of the year 2014 and archived, was reached. During data collection, 105 news about malpractice were found in the newspapers. The study was carried out based on data obtained from these news (n=105).

12 Data was collected using a questionnaire form which was developed in accordance with the literature. The questionnaire form consisted of 19 descriptive questions. Data was analyzed using the SPSS 15.0 software. Percentages were calculated and findings were presented as frequency and percentage.

13 RESULTS In the current study, 105 news about malpractice were reached after examining newspaper archives of the year 2014 and these news were included in the study.

14 According to information obtained from the newspapers, it was determined that 35.2% of medical errors were fatal harmful events, 18.1% were diagnosis errors, 10.5% were delays in treatment and not implementing treatment, and 9.5% were drug administration errors.

15 It was found that 22.9% of medical errors occurred due to negligence, 21% due to lack of attention, and 9.5% occurred due to imprudence. Among the medical errors, 28.6% were associated with the International Patient Safety objective related to the provision of accurate side, accurate procedure, and accurate surgery.

16 It was found that 67.6% of people committing medical errors were doctors, 5.7% were 112 emergency service providers, 4.8% were surgery team members, and 4.8% were nurses. It was determined that 29.5% of medical errors took place at public hospitals and 23.8% at private hospitals; while 33.3% of medical errors occurred at surgery room, 16.2% at the emergency service, and 14.3% at the obstetrics service.

17 It was found that 48.6% of medical errors resulted in death and 13.3% resulted in loss of an organ or limb and that in 63.8% of cases, the event was submitted to the court.

18 DISCUSSION In the current study which aimed to determine the prevalence and etiology of malpractice in health care practices, it was found that 35.2% of medical errors were fatal harmful events, 18.1% were diagnosis errors, 10.5% were delays in treatment and not implementing treatment, and 9.5% were drug administration errors.

19 In a study by Kivrak (2014), it was indicated that 61% of medical errors resulted from erroneous treatment, 17.8% from erroneous/late diagnosis, and 5.9% from drug errors. In a study by Tansuyer, which was conducted in 2010, it was reported that 48.2% of health personnel witnessed errors related to drug administration errors, 47.6% witnessed erroneous diagnosis, and 44.5% witnessed errors related to system shortcomings.

20 In the present study, it was found that 22.9% of medical errors occurred due to negligence, 21% due to lack of attention, and 9.5% due to imprudence. In a study by Kiymaz, which was conducted with emergency nurses, it was reported that 82.7% of medical errors occurred due to heavy work load, 78.2% due to limited number of nurses, 75.7% due to stress, and 66.2% due to burnout, fatigue, and tiredness (Kıymaz, 2015).

21 Ertem et al. (2009) carried out a study using data obtained from newspaper news and found that 62.1% of medical errors occurred because of lack of knowledge-being inexperienced at the job, 16.9% because of inattention-imprudence, 7% because of negligence, and 3.5% because of extreme tiredness.

22 In a study by Er and Altuntas (2016), it was determined that 78.6% of nurses committed medical errors due to tiredness, 75.6% due to heavy work load, and 74.8% due to working too much and long working hours.

23 Parallel findings obtained from research on the topic can be explained by the fact that health care professionals have similar working conditions and settings. In the current study, it was found that 67.6% of people committing medical errors were doctors, 5.7% were 112 emergency service personnel, 4.8% were nurses, and 4.8% were surgery team members.

24 In Kivrak s study (2014), it was reported that 83.9% of specialist doctors, 5.9% of nurses, and 4.2% of allied health personnel committed medical errors. In a retrospective study conducted by Ertem et al. (2009), it was indicated that 65.2% of medical errors was committed by doctors, 12.2% by nurses, and 2.3% by laboratory personnel.

25 Parallelism of these findings can be explained by the insufficient number of health care professionals, doctors and nurses in particular, high number of patients, and inappropriate working conditions.

26 In the current study, it was determined that 33.3% of medical errors occurred in surgery rooms, 16.2% in emergency, and 14.3% in obstetrics service. In Kivrak s study (2014), it was reported that 58% of medical errors occurred in surgery rooms, 26% in delivery rooms, 12% in polyclinics, and 9% in the emergency service.

27 Ertem et al. (2015) found that 43.6% of medical errors occurred in surgery rooms or the surgery division, 13.4% in obstetrics, 11% in pediatrics, and 6.4% in the emergency service. It is thought that the parallelism of findings may be related to the fact that these services have intense working conditions.

28 CONCLUSION In the present study, it was concluded that medical errors occurred due to negligence and inattention; that errors were committed by doctors, nurses, surgery team, and 112 personnel, respectively; that errors most frequently took place at public hospitals; that errors occurred in surgery rooms, emergency, and obstetrics services; that medical errors were seen as current news but have insufficient news content.

29 The most important practice for medical errors prevention is the determination of medical errors types and factors leading to medical errors. It is crucial to determine the scope of medical errors which health care professionals have a tendency for.

30 According to the study findings, it may be suggested that health care professionals attend inservice training programs, congresses, and seminars. It is also suggested to reduce the work load and working hours of health personnel and to provide an appropriate work environment.

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