A 2016 Johns Hopkins study found more than 250,000 people in the United States die every year from medical errors, making it the third leading cause of death after heart disease and cancer.
Another study reported higher figures and estimated numbers of premature deaths associated with preventable harm to patients at more than 400,000 per year.
This actual number could be larger still. The U.S. Department of Health and Human Services reported in 2012 that 86 percent of all hospital bedside mistakes are not reported because they were events “that staff did not perceive as reportable (61 percent) or as events that staff commonly report but did not report in this case (25 percent).”
More recently a report from the National Healthcare Safety Network published by Cambridge University Press in September 2021 found significant increases in the leading preventable causes of hospital death during the pandemic. For example, central line-associated bloodstream infections increased 97–148 percent in reported hospitals in several states in quarter three of 2020 compared to quarter three of 2019.
In 2016 authors of the Johns Hopkins study appealed to the Centers for Disease Control and Prevention (CDC) to change how it collects data from death certificates to capture medical errors. As of 2022, the CDC still does not include medical errors as a cause of death in the national health statistics report.
Because medical errors are not “counted” as a leading cause of death, they aren’t getting the public health investment or attention they merit, experts say. Just like we invest billions of dollars of funding in preventive care for heart disease, these health advocates say we need to invest in the systems and training needed to prevent medical errors.
Knowing how we can advocate for our health and work with healthcare professionals while in the hospital to avoid the leading preventable causes of hospital death can be the difference between life and death.
Ann Hester, M.D. is the author of “Patient Empowerment 101.” Her book outlines the most common causes of preventable hospital death and what we can do to stay safe in the hospital. Hester is a board-certified internal medicine doctor with over 25 years of clinical experience, spending most of her career as a physician assistant providing direct in-hospital patient care.
“While you’re in hospital you need to make wise decisions and you need to be a partner in your care,” said Hester in my recent interview with her on Discovering True Health.
Each year, thousands of Americans die from preventable hospital-associated infections and those numbers skyrocketed during the pandemic.
“If you get an infection while in hospital they’ll put you on antibiotics,” says Hester.
Taking antibiotics can increase your risk of C. diff by seven to 10 times. C. diff is a germ (bacterium) that causes diarrhea and colitis (an inflammation of the colon) and can be life-threatening.
Also, drug-induced acute kidney injury (AKI) has been implicated in eight percent to 60 percent of all cases of in-hospital AKI and is a recognized source of significant morbidity and mortality.
Because of this Hester says, “You want to be exposed to the fewest number of chemicals as possible.”
Bacterial infections from central line IVs and catheters are two avoidable significant healthcare-associated infections that can be fatal.
Intravenous lines (IVs) placed in a large vein in the neck, chest, or groin area are called central lines.
A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line.
Hester outlines several ways we can help prevent CLABSI:
Among the number of urinary tract infections acquired in the hospital, approximately 75 percent are associated with a urinary catheter.
Urinary tract infections also lead to bloodstream infections that can be potentially life-threatening. It is estimated that over 13,000 deaths each year are associated with healthcare-associated urinary tract infections.
Hester explains that you do not want to have a bladder catheter unless you “absolutely need it.” This is because the longer the catheter is in, the higher the potential is for an infection in the bladder.
“Get up and go to the bathroom if you are able. If you feel unsteady on your feet, ask for assistance. You can also request a bedside commode and assistance moving from the bed to the commode whenever needed,” she recommends.
When you lie in a hospital bed for too long, there is an increased risk of developing blood clots. According to the CDC, pulmonary embolism is a leading preventable cause of hospital death. About half of all blood clots happened during or within three months of a hospital stay or surgery and do not receive proper preventative measures.
If a blood clot occurs in the leg, some of the signs and symptoms can be swelling, pain, and redness. Typically, a blood clot in a leg (deep venous thrombosis) breaks off and travels through the bloodstream to an artery in a lung, which can be immediately fatal.
A blood clot in a lung (pulmonary embolism) typically causes shortness of breath and/or chest pain but can go unnoticed and the first outward sign can be a cardiac arrest.
This is why “when you go to a hospital you need to ask what the plan is to decrease your risk of blood clots,” said Hester.
Many of these blood clots can be safely prevented and Hester gives the following guidance on the different preventative options:
Medication errors harm an estimated 1.5 million people every year. Hester shared some basic guidelines around medication prescribed in the hospital:
Hospitals are full of germs. “There is an issue with healthcare professionals not really washing their hands in hospitals,” Hester said. “If a doctor or nurse walks into your room and you did not see them wash their hands, you need to ask them if they did.”
It’s also important for loved ones visiting you to wash their hands upon entering your room and upon leaving the hospital as well.
Bedsores or pressure ulcers are another consequence of not moving enough. More than 2.5 million people in the United States each year develop pressure ulcers. These skin lesions are associated with a risk of serious infection and increased health care utilization.
If you (or a loved one) are too sick to move around in the hospital bed, make sure to get turned regularly by your nurse or nursing assistant and that you are getting proper nutrition.
Rest is an important part of recovery. Hester’s tips to ensure we are helping our bodies get adequate sleep while in the hospital are as follows: