Illness Behavior
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Iatrogenic Conditions
Description
Building a Safer Health System estimated that preventable medical errors resulted in 44,000 and 98,000 deaths per year at a cost of up to $29 billion in unnecessary health-care expenses, disability, and lost income (Kohn, Corrigan, & Donaldson, 1999). The second report, Crossing the Quality Chasm emphasized the need to reengineer health-care delivery, and defined six aims of health care. The report called for care to be safe, effective, patient-centered, timely, efficient, and equitable (Institute of Medicine, 2001). The rate of preventable adverse events continues to increase. In a study published in 2011, the National Center for Policy Analysis estimates that there are as many as 187,000 preventable iatrogenic deaths in hospitals and as many as 6.1 million injuries, both in and out of hospitals (Goodman, Villarreal, & Jones, 2011). Iatrogenic complications, in general, are related to medications (adverse drug events), therapeutic or diagnostic interventions, nosocomial infections, and environmental factors.
Iatrogenic conditions may be both preventable (e.g., medical error, negligence, consumer decisions) and unpreventable (e.g., the side effects of chemotherapy). The study of iatrogenic conditions has largely been in the acute care hospital. Two Institute of Medicine reports describe the staggering prevalence and ramification of medical errors and elevated patient safety as a major concern in health care and among policymakers. The first report, To Err is Human:
Adverse Drug Events Inappropriate drug prescribing, polypharmacy, administration errors, and suboptimal adherence by the patient are common preventable causes of adverse drug events (ADEs). Medication reconciliation upon admission, transfer, and discharge is a key strategy to maintain medication safety. The use of electronic medical records that provide information (e.g., past diagnoses and lab studies), educational prompts, and warnings
Marie Boltz College of Nursing, New York University, New York, NY, USA
Synonyms Nosocomial medical errors
Definition Iatrogenesis refers to any unintended adverse patient outcome due to a health-care intervention not related to the natural course of an illness or injury (Agency for Healthcare Research and Quality).
M.D. Gellman & J.R. Turner (eds.), Encyclopedia of Behavioral Medicine, DOI 10.1007/978-1-4419-1005-9, # Springer Science+Business Media New York 2013
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(e.g., allergy alerts and contraindications) are used to reduce errors in prescribing. The Institute for Safe Medication Practices provides guidelines for the use of well-designed standard order sets, safe automated dispensing, and medication labeling both in acute and community settings (The Institute for Safe Medication Practices Guidelines). Guidelines for rational drug prescribing, particularly critical in the older adult, are another strategy to prevent ADEs. The Beers criteria address two key areas: (1) medications or medication classes that should generally be avoided in persons 65 and older and (2) medicat
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