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Diagnostic errors in paediatric cardiac intensive care.

Priya N Bhat1, John M Costello2, Ranjit Aiyagari3

  • 11Department of Pediatrics,Divisions of Pediatric Cardiology and Critical Care Medicine,Washington University School of Medicine,St. Louis,Missouri,USA.

Cardiology in the Young
|February 8, 2018
PubMed
Summary
This summary is machine-generated.

Diagnostic errors in paediatric cardiac intensive care units (ICUs) are common, with many practitioners reporting permanent patient harm. System and process failures, not cognitive errors, are seen as primary causes.

Keywords:
Diagnostic errorspaediatric intensive care

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Area of Science:

  • Pediatric Cardiology
  • Intensive Care Medicine
  • Medical Error Research

Background:

  • Diagnostic errors in healthcare lead to significant patient harm and increased costs.
  • Limited data exists on diagnostic errors specifically within the pediatric cardiac intensive care unit (ICU) population.

Purpose of the Study:

  • To investigate the perceived frequency and types of diagnostic errors in the pediatric cardiac ICU.
  • To identify factors contributing to diagnostic errors and potential strategies for prevention.

Main Methods:

  • A survey was distributed to pediatric cardiac ICU practitioners (physicians, nurse practitioners, physician assistants, registered nurses) at three North American tertiary cardiac centers.
  • The survey was conducted between October 2014 and January 2015, with a 46% response rate (N=200).

Main Results:

  • 81% of respondents perceived diagnostic errors harm patients >5 times/year; 65% reported permanent harm.
  • Medication side effects, psychiatric conditions, and misdiagnosis of viral as bacterial illness were common errors.
  • Inadequate care coordination, data assessment, high workload, and delayed diagnostics were cited as key contributing factors.

Conclusions:

  • Pediatric cardiac ICU practitioners perceive frequent diagnostic errors causing permanent harm.
  • These errors are attributed more to systematic and process breakdowns than to individual cognitive limitations.
  • Improving teamwork and feedback pathways are recommended strategies for error prevention.