Limiting Harm in Health Care A Nursing Perspective

by Milligan, Frank; Robinson, Kate

• ISBN13: 9780632059966
• ISBN10: 0632059966
• Edition: 1st
• Format: Hardcover
• Copyright: 2003-04-18
• Publisher: Wiley-Blackwell

Summary

Limiting Harm in Health Care highlights the potential for unnecessary harm in health care practice. This harm is mostly unintentional, but it can result from many different aspects of medical treatment in a wide range of practice areas. Adverse events, events or omissions during clinical care resulting in physical or psychological injury, are increasingly being recognised as significant problems in health care.Following clarification of the nature and extent of medical harm in health care, separate chapters explore the potential for medical harm in diverse areas of practice. Topics include problems in the use of medication, the treatment of acute heart disease, the role of hospital routine and the potentially negative role of medically dominated treatment in mental illness and palliative care. The book includes recommendations for reducing unnecessary harm within the expanding boundaries of nursing practice. The reader is challenged to assess the potential risks inherent in the health care system, to reconsider established methods of treatment, and to re-examine professional working relationships.

Author Biography

Frank Milligan is the editor of Limiting Harm in Health Care: A Nursing Perspective, published by Wiley.

Kate Robinson is the editor of Limiting Harm in Health Care: A Nursing Perspective, published by Wiley.

Table of Contents

Preface	p. xi
Contributors	p. xii
Acknowledgements	p. xvi
Introduction, Aims and Mapping Health Care	p. 1
Introduction	p. 1
The aims of this book	p. 3
Doctors and nurses	p. 3
Seeing the limits of medicine - maps as knowledge	p. 5
The map of western medicine	p. 7
Mapping medical harm	p. 8
Examples of harm	p. 9
Expanding nursing roles in health care	p. 10
The chapters	p. 11
References	p. 14
Defining Medicine and the Nature of Iatrogenic Harm	p. 17
Introduction	p. 17
Western medicine - the world-view of a profession	p. 17
The body and the 'gaze'	p. 19
Discourse - talking medicine	p. 23
The dominant discourse of western medicine	p. 24
Iatrogenesis and iatrogenic harm	p. 25
Recent evidence on iatrogenic harm	p. 29
Conclusion	p. 36
References	p. 37
Being a Professional - A Defence Against Causing Harm?	p. 42
Introduction	p. 42
The professionalisation agenda	p. 44
Being a profession	p. 47
A changing climate of opinion	p. 51
Options for the future	p. 52
A new sort of profession?	p. 52
Conclusion	p. 57
References	p. 59
Harm Reduction in Context - The Scope of Nursing Practice	p. 61
Introduction	p. 61
Nursing in the contemporary health care context	p. 62
The professional regulation of nursing	p. 65
Accountability of nurses beyond professional regulation	p. 69
The dynamic and expanding role of nursing	p. 70
Conclusion	p. 75
References	p. 76
Expanding Nurse Prescribing and the Hidden Harm within Modern Drug Therapy	p. 79
Introduction	p. 79
Adverse drug reactions - what are they and can they be prevented?	p. 80
Alternative and complementary therapies	p. 83
Interactions between conventional drugs and herbal remedies	p. 85
Compliance and concordance	p. 86
Drug errors	p. 89
Nurse prescribing	p. 93
Drug calculations	p. 97
Do nurses have the necessary knowledge?	p. 98
Conclusion	p. 99
References	p. 100
Shifts in the Care of Hyperactive Children	p. 107
Introduction	p. 107
Background	p. 107
What is ADHD?	p. 109
Labelling	p. 111
If ADHD does exist, what current interventions are on offer?	p. 112
Is intervention always needed?	p. 118
Other issues	p. 119
Conclusion	p. 121
References	p. 124
The Medicalisation of Mental Health Practice - Lessons from the Care of Patients Who Deliberately Self-harm	p. 127
Introduction	p. 127
Suicide and deliberate self-harm	p. 127
The medical model and the nurse	p. 129
Failings of the medical model	p. 130
Psychological care and mental health nursing	p. 132
Inpatient psychiatric care: models and frames	p. 133
The medical frame	p. 135
Alternatives to the medical model	p. 135
Inpatient care: the patient's perspective	p. 137
Relationships and incidents of self-harm	p. 139
New models: the role of the nurse researcher	p. 143
Conclusion	p. 145
References	p. 147
Complaints as a Measure of Harm - Lessons from Community Health Councils	p. 149
Introduction	p. 149
Complaints and the NHS complaints procedure	p. 150
The work of Community Health Councils in supporting complainants	p. 153
Community Health Councils, primary care and the private sector	p. 155
Supporting complainants	p. 156
The nature of complaints	p. 157
Disabling complainants	p. 159
The NHS - moving towards a culture of openness?	p. 160
Beyond complaints: specific Community Health Council initiatives	p. 161
Expanding information technology	p. 163
Limits and reform of Community Health Councils	p. 164
Conclusion	p. 166
References	p. 168
Nurse Diagnosed Myocardial Infarction - Hidden Nurse Work and Iatrogenic Risk	p. 171
Introduction	p. 171
Thrombolysis for acute myocardial infarction	p. 172
The nurse's role in thrombolysis	p. 172
The doctor-nurse relationship	p. 174
Expanding the role of the nurse	p. 176
Is thrombolysis just another task?	p. 178
Experience and the advanced practitioner	p. 179
Reasons for delay in thrombolysis	p. 182
Early thrombolysis: the iatrogenic risk	p. 186
Conclusion	p. 189
References	p. 190
Talking Harm, Whispering Death - An Exploration of Iatrogenic Harm in Palliative Care	p. 194
Introduction and background	p. 194
The people	p. 196
Medicine's grand-narrative	p. 198
Imposing a medical narrative	p. 199
Shattered living and shattered dying	p. 201
To see a voice: the struggle between personal and professional discourses	p. 203
Visualising and voicing self: integrating discourses	p. 205
The not-knowing stance: integrating dying with living	p. 207
Space and time: the gift relationship	p. 210
Conclusion	p. 212
Author's note	p. 213
References	p. 213
NHS Direct - Reducing Unnecessary Harm in Health Care through Information Technology and Shifting Nurse Roles	p. 216
Introduction	p. 216
The drivers for change	p. 216
What is NHS Direct?	p. 218
The technological infrastructure	p. 221
Telephone triage	p. 222
The NHS Direct software systems	p. 223
The utilisation of health services	p. 225
Expanding information technology in health care	p. 226
The role of the nurse in NHS Direct	p. 227
The clinical governance agenda	p. 228
NHS Direct and the gate-keeping role of GPs	p. 230
The future	p. 230
Conclusion	p. 232
References	p. 233
Avoiding Harm in Health Care - A Doctor's Perspective	p. 236
Introduction	p. 236
Health and disease	p. 236
Health care delivery	p. 238
Health and health care advice	p. 240
Iatrogenic harm in history	p. 241
Medical education and training	p. 241
Sustaining autonomy and confidence	p. 243
Professional requirements	p. 243
Health care delivery systems	p. 244
Quality in the UK National Health Service	p. 245
UK national quality structures	p. 246
Quality in practice	p. 247
Doctors and their conduct	p. 249
Conclusion	p. 252
References	p. 253
Limiting Harm in Future Health Care - The Role of Nursing	p. 255
Introduction	p. 255
Current UK government initiatives	p. 256
Clinical negligence and compensation	p. 260
Limiting medical harm in health care	p. 261
Reducing harm: the role of nursing	p. 268
Conclusion	p. 269
References	p. 271
Index	p. 274
Table of Contents provided by Rittenhouse. All Rights Reserved.