Table 3 Table of all 96 categories, subsumed to umbrella-terms and levels
Level | Umbrella term | Category | Classification |
|---|---|---|---|
1 | Definition (n = 21) | Interpersonal subjectivity Intrapersonal subjectivity To err is human Wrong reaction Wrong decision Wrong assessment Deviation from a plan Harm Wrong outcome Difficult | comprehensive |
Error of a person Doing nothing | exclusive: general error | ||
Violation of learned facts Deviation from a standard Need for progress Not maximizing the best for a patient | exclusive: medical error | ||
Patients personal opinion Dignity Consideration of the physician Acceptance of symptom management without diagnosis Difficult | exclusive: error in palliative care | ||
Differences (n = 4) | Weight Standards | general error/medical error | |
Existing differences No differences | medical error/error in palliative care | ||
2 | Types (n = 23) | Diagnosis Therapy Missed alternative treatment options Medication administration (wrong administartion or mix-up) Medication dosage Medication - useless or not meaningful Depersonalization Not perceived as an informed patient Help not fast enough Confidentiality | not palliative care specific |
Breach of the patient’s wishes or patient’s advance care directives Trust/empathy Psychologically Communication Information Resuscitation Prognosis Nursing measures Insufficient symptom management Preparation for death not possible Involvement of relatives Sedation Patient as guinea pig | palliative care specific | ||
3 | Causing person (n = 6) | Physicians Nurses Carers in general Patients Relatives Others | |
Causes (n = 20) | Uninfluenceable Character traits Environmental factors Chain reaction | causes for errors in general | |
Rigidity Ambition Paternalism Infallibility of the physician Acceptance of errors due to imminent death | related to the physician | ||
Lack of time Lack of personnel Teamwork Communication Coordination Antipathy Training/knowledge Human weaknesses Lack of evidence Inadequate care motivation | related to the nurses/carers | ||
Lack of patient resources | related to the patient | ||
Affected person (n = 3) | Patients Professionals Others | ||
Consequences (n = 9) | Shortening of life Mental burden Distressing symptoms Physician-patient-family-relationship strain Limitation of mobility/autonomy | affected person: patient | |
Judiciary Physician’s reputation Disciplinary actions | affected person: physician | ||
Compensation | no certain affected person | ||
Meaning (n = 5) | Exceptional circumstances of the patient Eppraisal in the context of approaching death Death caused by an error - terrible Death caused by an error - less terrible Individually different | ||
Recogintion (n = 1) | Recognition of errors by the patient | ||
Handling (n = 9) | Culture of errors Public disclosure Disclosure to the team Disclosure to the patient Reparation Apology Learning from errors Discussion Cause analysis | ||
Prevention (n = 10) | Teamwork Communication Information Advanced directives Education/knowledge Work routine Staff Time Patient collaboration Patients’ resources |