Adverse events and medical errors in veterinary and human medicine are inevitable, and research has only just begun to shed light on the prevalence of these incidents.1 Medical errors can include those involving medications (eg, wrong medication, wrong dose, or failure to recognize an allergy), misidentification of patients, and errors or delays in diagnosis. Surgical errors (eg, wrong surgical site or procedure) are also possible, as are judgment errors that lead to an unnecessary surgery or delay of a necessary operation.2
A medical error can be defined as “a commission or omission with potentially negative consequences for the patient that would have been judged wrong by skilled and knowledgeable peers at the time it occurred, independent of whether there were any negative consequences.”3 Such errors can therefore be distinguished from complications or unpreventable AEs, which are an acknowledged risk of medical care and surgical procedures.4,5 This definition of medical error also includes actions that do not actually result in direct harm to patients, referred to as NMs.5,6 An NM can be defined as an incident that could have had adverse consequences but did not, and is indistinguishable from a full-fledged AE in all but outcome. Examples of NMs include incorrect selection of a potentially harmful drug that was never administered, prescription of the wrong drug that resulted in no harm to the patient, or scheduling of surgery for the wrong body part but catching this error before surgery begins.
The effect of these errors on patient outcomes is staggering. Findings in a 2016 study1 suggest that 251,454 patient deaths/y in US hospitals are attributable to medical error. Although much research has been conducted to explore the impact of medical errors on patient outcome, the impact of these errors on physicians has received much less attention in the literature.3,7–9 However, data are emerging regarding the impact of these errors on the health-care providers and on patients treated by providers involved in an error.10
Health-care providers involved in an AE or NM can be considered secondary victims, defined as those who are involved in an unanticipated adverse patient event, medical error, or patient-related injury and are traumatized or negatively impacted by the incident.11 Such health-care providers can consequently experience shame, guilt, anger, self-doubt, fear, anxiety, grief and depression, withdrawal or agitation, impaired concentration, and poor memory and can reexperience the incident itself.7,12–14 Physicians have also reported adverse impacts on their job satisfaction, ability to sleep, relationships with colleagues, and self-worth.7,14 These effects can be short or long term and can sometimes result in considerable functional impairment.9,11,14 In a recent study,15 approximately one-third of physicians reporting an AE or NM in the United States and United Kingdom indicated feeling that their work performance or personal life had suffered.15 It has been suggested that physicians who become distressed after an error are at an increased risk of making medical errors in the future.16–18
Although medical errors, including AEs and NMs, represent an important area of study within medicine, no studies have been reported regarding the impact of such errors on veterinarians. To assess this issue and help guide the creation of programs to support veterinarians following medical errors, an understanding is needed of the impact these incidents have on veterinarians. Therefore, the purpose of the study reported here was to survey veterinarians to determine the impact of AEs and NMs on their well-being as well as their experiences regarding decisions to disclose these errors and their perceived availability of support.
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IBM SPSS Statistical Software, version 21, IBM Corp, Armonk, NY.
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