Nurses are afraid to speak up when they see doctors making mistakes in the operating rooms, researchers say in a study that helps define some of the difficulties ahead for politicians, bureaucrats and medical professionals trying to reform the U.S. health care system.
According to the American Association of Critical Care Nurses, the safety protocols in operating rooms are not sufficiently protecting patients from harm. The study released on Tuesday involved interviews with 6,500 nurses, many of whom blamed the hierarchical nature of the hospital for their own failure to speak up when doctors ignore standard precautions.
Eighty-five percent of those surveyed said safety tools in the operating room have warned them of a potential hazard to a patient, yet 58 percent admitted they did nothing about it.
Not only do errors contribute to fatalities -- a frequently cited Institute of Medicine study estimates that as many as 98,000 Americans a year die as a result of preventable mistakes -- but they also add to the system’s ever-increasing cost of maintenance.
When its study was published in 1999, the Institute of Medicine estimated that hospitals were losing between $17 billion and $29 billion per year when paying for the unfortunate patients’ additional care, lost income, productivity, and disability. “Errors also are costly in terms of loss of trust in the health care system by patients and diminished satisfaction by both patients and health professionals,” reported the Institute of Medicine.
Since then, many safety procedures, such as operating-room checklists, have become mandatory in hospitals. But the nurses study found that more than four out of five nurses still have concerns about the “dangerous shortcuts, incompetence and disrespect” they see at work.
More than half of those who reported safety violations say “near misses” or actual harm occurred as a result, but only 17 percent voiced their concerns.
Still, said Kristin Peterson, cardiac clinical nurse specialist and president of the association that sponsored the study, progress has been made.
“Compared with what we learned in 2005, nurses now speak up at much better rates,” Peterson said. “They are now nearly three times more likely to have spoken directly to the person and shared their full concerns.”