When Vets Make Mistakes: The Three Most Common Veterinary Errors
Although we all make mistakes sometimes, it certainly doesn’t feel good to do so.
The problem is, in a fast-paced field like veterinary medicine, errors are inevitable. This can make vets (particularly inexperienced ones) feel guilty, anxious, and dejected. Serious blunders (around 15% of veterinary errors lead to patient harm) may result in individuals leaving the profession entirely¹ ².
And whilst many vets feel comfortable reporting and sharing errors, not many feel confident about the industry attitude towards making mistakes overall³.
But in what circumstances do vets make mistakes? And which types are the most common?
Why Do Veterinary Mistakes Happen?
When vets make mistakes, there are typically a few core reasons why.
In a study exploring the causes and types of veterinary blunders, researchers found that 80% of errors could be attributed to cognitive limitations, owner interference, and a lack of knowledge/skill.
Other causes included:
Productivity problems (7%)
Communication failures (5%)
Leadership failures (4%)
Cognitive limitations were commonly associated with clinicians. These ‘absent-minded’ errors often led to surgical mistakes (such as leaving equipment inside patients) and medical mishaps (such as forgetting to administer oxygen during surgery).
Other types of cognitive errors resulted due to failures in short/long-term memory, confirmation bias, and diagnostic tunnel vision.
Problems associated with owner interference could not be attributed to vets themselves. Poor health outcomes were primarily due to owners’ refusal to accept recommendations.
Alongside these causes, poor supervision of younger vets and nurses was flagged as a major cause of veterinary errors.
What Are The Most Common Veterinary Mistakes?
Surgical Mistakes
Errors during surgery are among the most common. They account for about 50% of veterinary mistakes and are made most frequently by interns.
One review of 74,485 veterinary cases found that almost 40% of adverse events could be linked to operations. Of these cases, the majority were from general surgery and orthopedics.
Poor communicative practices have been associated with 43% of surgical errors.
Further, leadership failures (in terms of neglecting to promote patient safety by forgoing safe surgery checklists and pre-opt briefings) have also been shown to lead to surgical blunders. Interns, somewhat unsurprisingly given their lack of experience, may be more prone to making mistakes when supervision is lacking or absent.
Errors Involving Drugs
Of non-surgical errors, drug-related mistakes are prevalent. Drug incidents are responsible for 15.1% of adverse events in veterinary medicine, cardiovascular drugs, analgesics, and hypoglycaemic agents account for 86.5% of preventable drug incidents⁴.
One study examining veterinary hospital processes found that 54% of errors were drug-related. Primarily, these events occurred due to poor administration processes (i.e. giving the wrong dose or even the wrong drug to a patient)⁵.
Medication errors tend to occur when:
Labeling is unclear or obscured (i.e. lack of color contrast makes it difficult to read).
Drug dosage devices were designed poorly.
Veterinary professionals use error-prone abbreviations or symbols on prescriptions.
Medication is stored/disposed of improperly (leading to accidental exposures or overdoses)⁶.
Diagnostic Errors
Diagnostic errors are fairly common in practice. This is particularly true for graduate vets, who are inexperienced and therefore more likely to make mistakes. Graduates commonly forgo undertaking the appropriate diagnostic tests- leading to wrongful judgments⁷.
Conversely, more experienced vets may experience cognitive bias, resulting in similar errors. Cognitive bias occurs when we utilize ‘mental shortcuts’ in our decision-making. Vets may ignore obvious symptoms in patients and instead opt to undertake improper tests that lead to misdiagnosis’.
Although some professionals think that teaching clinicians to recognize their own cognitive bias may reduce the occurrence of such events, research has shown that it has little to no effect. Alternatively, vets should develop their clinical knowledge, as this is one of the few proven ways to improve medical reasoning performance⁸.
Takeaway
Humans are not infallible, and in high-pressure/fast-paced environments (like vet med), mistakes will be made.
However, by no means should vets see this in a negative light. Mistakes are the building blocks on which success is built. With every slip-up, we become better and more capable of being able to take on challenges.
Instead of beating yourself up next time something bad happens in practice, try to move past the error by viewing it as a learning experience. Perhaps not a very nice one, but an education nonetheless. Just try not to make the same mistake again next time round by reviewing your work with a senior colleague and adopting a reflective approach to the acquisition of knowledge.
One of the best ways to avoid mistakes in practice is by developing your non-clinical skills. I offer a complementary non-clinical skills course (sign up here) which can help build confidence in practice.
References:
1- ‘Medical Errors Cause Harm in Veterinary Hospitals – NCBI – NIH.’ 5 Feb. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370638/. Accessed 21 May. 2021.
2- ‘(PDF) Survey of mistakes made by recent veterinary graduates.’ https://www.researchgate.net/publication/8093314_Survey_of_mistakes_made_by_recent_veterinary_graduates. Accessed 18 May. 2021.
3- ‘The 2019 survey of the veterinary profession – Royal College of ….’ https://www.rcvs.org.uk/news-and-views/publications/the-2019-survey-of-the-veterinary-profession/. Accessed 18 May. 2021.
4- ‘(PDF) We need to talk about error: causes and types of error in ….’ 15 Feb. 2021, https://www.researchgate.net/publication/283073082_We_need_to_talk_about_error_causes_and_types_of_error_in_veterinary_practice. Accessed 21 May. 2021.
5- ‘Medical Errors Cause Harm in Veterinary Hospitals – NCBI – NIH.’ 5 Feb. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370638/. Accessed 21 May. 2021.
6-‘Veterinary Medication Errors | FDA.’ 2 Apr. 2020, https://www.fda.gov/animal-veterinary/product-safety-information/veterinary-medication-errors. Accessed 21 May. 2021.
7- ‘(PDF) Survey of mistakes made by recent veterinary graduates.’ https://www.researchgate.net/publication/8093314_Survey_of_mistakes_made_by_recent_veterinary_graduates. Accessed 21 May. 2021.
8- ‘Clinical reasoning in veterinary practice | Veterinary Evidence.’ 21 May. 2020, https://veterinaryevidence.org/index.php/ve/article/view/283. Accessed 21 May. 2021.
9- ‘The Cognitive Biases Tricking Your Brain | The Atlantic.’ https://www.theatlantic.com/magazine/archive/2018/09/cognitive-bias/565775/. Accessed 25 May. 2021.