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Quantum Units Education

Medical Errors for Mental Health Professionals

1. Which is an inaccurate statement concerning the FDA's role in attempting to minimize medication errors?

A. FDA reviews about 400 drug names per year submitted by drug companies to minimize drug name confusion, rejecting about a third of the proposals.

B. FDA requires all OTC drug products (over 100,000) to have a standardized 'drug facts label' and works with drug companies to minimize similar looking labels/packaging.

C. FDA in 2004 required bar codes for certain drugs and biologics.

D. FDA reviews about 1,400 reports of medication errors PER YEAR to determine cause and type of error.

E. FDA spreads medication errors message through public health advisories and outreach partnering with other organizations.

2. From the examples of medication errors in the FDA report, which is not an accurate synopsis?

A. Tussionex, containing the narcotic ingredient hydrocodone, being erroneously prescribed for patients younger than 6 or more frequently than the labeled dosing interval - life threatening breathing problems result.

B. Acetaminophen, found in Tylenol and Datril, leading to serious liver damage when accidentally overdosed or taken for more days than recommended.

C. Fentanyl patches, containing the opioid fentanyl, being administered to patients who were not opioid tolerant or being replaced too frequently by the patient or with added heat.

D. Methadone, which like other opioids slows breathing and affects heart rate, being overdosed because it stays in the body longer than it provides pain relief.

E. Edetate disodium and edetate calcium disodium, both commonly referred to as "EDTA", being mistaken for each other for appropriate use in the FDA-approved chelation therapies.

3. Which statement about the scope of the problem of medical errors and what is considered a medical error is inaccurate?

A. A 2010 Dept of Health and Human Services study found 1 in 7 Medicare recipients were harmed by hospital-acquired infections, poorly administered meds and faulty bedside care in hospitals.

B. Deaths attributable to medical errors represent only 0.58% of annual hospital admissions.

C. The failure of a planned action to be completed as intended or using a wrong plan to achieve an aim, when resulting in harm to a patient, is automatically considered a malpractice or negligence candidate.

D. Adverse medical events which in retrospect are considered preventable are labeled sentinel events - those which signal a need for immediate investigation.

E. Root Cause Analysis provides the opportunity to identify the need for improvements in processes or systems.

4. Which of the following is considered a sentinel event signaling the need for investigation and review by the Joint Commission?

A. Surgery on the wrong body part

B. Discharge of an infant to the wrong family

C. Administration of radiotherapy to the wrong body region

D. The rape or abduction of a patient

E. All of the above are subject to review

5. Florida law defines an adverse incident as one where healthcare personnel could exercise control and that is associated with the medical intervention versus the original condition.

A. True

B. False

6. Florida Administrative Code Rule 64B19-13.003 considers all of the following among the most serious potential errors in a psychological or behavioral setting except:

A. Inadequate assessment of suicide risk

B. Use of cognitive therapies in lieu of pharmacotherapy

C. Non-compliance with mandatory abuse reporting laws

D. Failure to detect a medical condition presenting as a psychological disorder

7. Which is not correctly stated concerning suicide and its risk assessment:

A. Most inpatient suicides occur in psychiatric hospitals or behavioral health units of general hospitals, and rates are highest among those 65 and older.

B. Lack of risk assessment training and inadequate or lacking documentation of assessments are reasons cited for the suicide risk assessment medical error.

C. General hospitals are inherently safer for suicidal patients than psychiatric hospitals.

D. In the case of clients deemed at high risk for suicide, confidentiality is not breached by consulting a supervisor or colleague.

E. Factors such as severe personal injury (e.g., traumatic brain injury and chronic pain) increase the incidence of suicide ideation.

8. Which statement is NOT correct concerning abuse and failure to report abuse:

A. Of the 700,000 unique child abuse cases reported in the US in 2009, 81% of the perpetrators were parents and 1800 deaths resulted.

B. Since social workers, psychologists and mental health professionals are designated "professionally mandated reporters of abuse", failure to report is not only unethical but could have legal consequences.

C. The Florida Department of Children and Families recognize abuse of self, domestic abuse and abuse by a caregiver of a vulnerable individual as categories of adult abuse.

D. A vulnerable adult is defined as with mental,emotional, long-term physical or developmental disabilities and this population has an abuse rate 4-10 times less than that of the general population.

E. Telephone is the method of preferred contact for reporting abuse and abuse reported online carries no guarantee of anonymity.

9. Which are the telltale signs of abuse and neglect cited from the Michigan Dept of Human Services Guide:

A. Cigarette burns or burns in the shape of an object

B. Missing clumps of hair

C. Bruises in various stages of healing

D. Emotional changes

E. All are mentioned

10. Concerning errors in identifying medical conditions presenting as psychosis, which is not mentioned:

A. CNS disorders, infections, metabolic disorders, reactions to medications and illicit drug use can all cause psychiatric symptoms.

B. One study showed that infections are the number one medical condition presenting as psychosis.

C. One in 10 people is estimated to be admitted as a psychiatric patient who really has an underlying medical condition.

D. Older patients with urinary tract infections can be misdiagnosed with dementia due to their age.

E. All of the above are mentioned

11. The informed patient who is able to become involved in his or her own care with the assistance of loved ones and friends is highly recommended toward insuring safety.

A. True

B. False

12. This paper advocates the use of staff who are fluent in a patient's native tongue and downplays the use of an interpreter for reducing medical errors.

A. True

B. False

13. Which of the following is not a concluding comment made by the author:

A. Medical errors contribute significantly to morbidity and mortality.

B. Medical errors are usually unanticipated and preventable.

C. Findings generated by root cause analysis provide information for improving systems and processes in the care facility.

D. Florida legislature has mandated reporting requirements for specific medical errors above and beyond the Joint Commission.

E. All of the above are concluded at the end of this paper.

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