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Nurses may have to admit drug errors to patients

  • 22 Comments

Nurses could soon be legally bound to inform a patient after they have made a drug or other treatment error, under plans being considered by the Department of Health.

Nursing Times has learnt that discussions are about to begin on a proposal to introduce a “corporate duty of candour” on treatment errors, which was included in the government’s coalition agreement document published last month.

The move, which also formed part of the Liberal Democrats original health manifesto, “will require hospitals to be open about mistakes and always tell patients if something has gone wrong”.

The charity Action against Medical Accidents has told Nursing Times it is meeting with the Department of Health and other interested parties next week to discuss the proposal.

The charity’s chief executive Peter Walsh said trusts failing to demonstrate compliance with it should have their registration reviewed by the Care Quality Commission..

He said a “duty of candour” should not be specific to clinical staff but should apply to trust chief executives and all board members involved in healthcare provision.

A Department of Health spokeswoman said it was “essential” to be honest with patients when things went wrong and that a decision on how to take the proposal forward “will be reached in due course”.

A survey on drug errors, carried out by Nursing Times, suggests that such a move would be supported by a majority of nurses.

Of the 1,900 nurses who responded to the online survey on medication administration, 45 per cent said it should become mandatory for patients to be made aware of drug errors, whether or not the error resulted in harm to the patient. Only 7 per cent of respondents were completely against the move, while 34 per cent said patients should only be informed if they were harmed or their condition changed as a result of the error.

Foundation of Nursing Studies chief executive Theresa Shaw said:  “Although it may be hard to admit to a patient that a drug error has been made, if patients feel [nurses] are being honest with them it could increase trust in the longer term. Trying to hide it will inevitably backfire.”

  • 22 Comments

Readers' comments (22)

  • rovergirl6@hotmail.com

    i am not too sure about this one , surely telling the patient that you have made a drug error will cause them stress, are doctors going to have to admit errors in surgery also.

    i really do not know where this is going.

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  • i would want honesty if i was the patient, but i can see stress it may cause to someone who is not educated in medicine... i'm sure my bank wouldn't own up if they made a bad investment with my money... business and ethics huh!

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  • They can forget that! Not unless every patient signs a waver on entry saying they will not sue us personally or destroy our careers!

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  • I've been a nurse for 9 years, and I honestly thought we already had to tell patients if we made a drug error to them. Surely it is what is right and ethical! I DID make a drug error, and I DID tell the patient. It was the hardest bit of the process, but I did not go in to nursing to cause others harm, intentional or otherwise. I treat others as I wish to be treated! Yes of course it could cause stress, and the information should be delivered in an appropriate way, outlining the possible side effects and what monitoring will be required. My patient was also aware of the consequences to my actions, I was disciplined, and systems were changed as a result. He was happy with the outcome, and also felt I was a little harshly delt with! Surely we are supposed to be creating a culture of trust!

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  • Unless Trust's and the Government are seriously going to addresss the factors that can contribute to drug errors, then we may as well put a set of stocks outside the ward and we can be pilloried there. drug errors are not always down to the nurse.

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  • I don't think this is a good idea...

    If the patient takes this out on the nurse it could very easily be career ending.

    As a patient, unless it was going to kill me, I'd prefer to remain blissfully unaware of the error.

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  • To Anonymous @ 2-Jun-2010 12:16 pm:

    You say 'we are supposed to be creating a culture of trust' but would you honestly trust a nurse who you'd just been told had made a drug error? I cannot believe for a second you would not have the thought "they're going to kill me" in the back of your mind.

    I'm an HCA, soon to be student nurse and so I understand entirely what nurses go through and the awesome things they do daily. I know for a fact though that if I was told about an error they'd made, at my most vulnerable time, I would not trust them again.

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  • Sounds like an ideal world - again! You are never going to change people's levels of honesty - even nurses. Regrettably, I cannot see it working.

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  • i think that being open and transparent would be the best way forward in the nhs, yes it may cause distress but if approached accordingly to each individual case and not notified in a manner that causes even more stress, i would like to be told if an error had been made and not to be fobbed off or found out later an error had been made that would give me stress.

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  • "Anonymous | 2-Jun-2010 7:58 pm

    Sounds like an ideal world - again! You are never going to change people's levels of honesty - even nurses. Regrettably, I cannot see it working."

    I take it your impression is that nurses tend to be dishonest? Or is this a neutral statement saying that people cannot become more or less honest?

    Anyway, I found it interesting to hear at the RCN Congress this year about a trust which had changed its approach to incident reporting - looking at the wider picture instead of going after the individual. Maybe this should be more widely adopted before asking staff to land themselves in it even more, if we realistically want a chance of this potential new rule (which some already follow anyway) working?

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