• Isabel Dietz, Anke Plog, Ralf J Jox, and Christian Schulz.
• 1 Department of Palliative Medicine, Ludwig-Maximilian-University , Munich, Germany .
• J Palliat Med. 2014 Mar 1;17(3):331-7.

ContextPatient safety is a concern in medicine, and the prevention of medical errors remains a challenge. The definition and understanding of an error is particularly difficult in palliative care, with scarce empirical evidence about the nature and causes of medical errors in that discipline.ObjectivesThis study explored incidents palliative care professionals perceive as typical errors in their practice, and descriptions of such events.MethodsIn the context of an exploratory, cross-sectional survey on errors in palliative care among professionals of palliative care institutions in Bavaria, Germany (n=168), participants described a typical case in which an error occurred. Data from free-text answers was qualitatively analyzed, and categories for areas and causes of errors were extracted.ResultsThe questionnaire was returned by 42% (n=70) of the sample. Two-thirds of respondents (n=46, 66%) gave a free-text answer describing a typical error in palliative care. Seven potential areas for errors were identified in the qualitative analysis: drug treatment, palliative sedation, communication, care organization, treatment plan, end-of-life care, and history taking. Six categories emerged as causes of errors: miscommunication, system failure, dysfunctional attitudes, lack of knowledge, wrong use of technology, and misjudgement.ConclusionData showed that medical errors in palliative care, as seen by professionals in the field, primarily affect medication and communication, and miscommunication and system failures are perceived as the leading causes of errors. A better understanding of the characteristics of errors within palliative care and further qualitative research are warranted to prevent errors and enhance patient safety.

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