Omission of medications is a common issue in the field of nursing. When patients miss their scheduled dosage of medication, it can cause harm. Nurses take an oath to do no harm to their patients. When a nurse purposely omits a medication, they are not properly acting within their nurse’s scope of practice. A nurse cannot make the decision to hold a medication based on ones believes, because they were interrupted, or because of time constraints. “The administration of medications is a major part of the role of the clinical nurse and is an activity prone to error” (Johnson, Tran, & Young, 2011 p. 553). Administrating medications is an important part of my job as a nurse. Usually, I only have five or six patients on my shift however, we were short staffed due to an emergency another nurse had. I had to add a few more patients to my workload. My colleagues and the patient’s family members distracted me. “Distractions are a major cause of error in healthcare, especially during the process of medication delivery” (Hohenhaus & Powell, 2008, p. 108). The drug I omitted was not one that would cause harm or put the patient’s life in jeopardy, it was an antacid medication, calcium carbonate. This is why I felt justified in omitting the drug. It was time to administer medication. My patient was on the unit because he had a schedule test. “ Omission of medication was the most frequent often related to patient absences from the unit” (Johnson, et. al., 2011, p. 548). Upon his return, I was no longer administering medication but I had documented that I gave this medication to the patient. All medications must be accurately documented to ensure all prescribed medications are being given to the patient. I know my shift was ending soon and tha... ... middle of paper ... ... References Hohenhaus, S. M., & Powell, S. M. (2008). Distractions and Interruptions: Development of a Healthcare Sterile Cockpit. Newborn and Infant Nursing Reviews, 8(2), 108-110. Frith, K. H., Anderson, E. F., Tseng, F., & Fong, E. A. (2012). Nurse staffing is an important strategy to prevent medication errors in community hospitals. Nursing Economics, 30(5), 288-94. Retrieved from http://search.proquest.com/docview/1112217903?accountid=28076 Johnson, M., Tran, D., & Young, H. (2011). Developing risk management behaviours for nurses through medication incident analysis. International Journal Of Nursing Practice, 17(6), 548-555. doi:10.1111/j.1440-172X.2011.01977.x Jones, S. W. (2009). Reducing medication administration errors in nursing practice. Nursing Standard, 23(50), 40-6. Retrieved from http://search.proquest.com/docview/219876884?accountid=28076
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
Some method such as audits, chart reviews, computer monitoring, incident report, bar codes and direct patient observation can improve and decrease medication errors. Regular audits can help patient’s care and reeducate nurses in the work field to new practices. Also reporting of medication errors can help with data comparison and is a learning experience for everyone. Other avenues that has been implemented are computerized physician order entry systems or electronic prescribing (a process of electronic entry of a doctor’s instructions for the treatment of patients under his/her care which communicates these orders over a computer network to other staff or departments) responsible for fulfilling the order, and ward pharmacists can be more diligence on the prescription stage of the medication pathway. A random survey was done in hospital pharmacies on medication error documentation and actions taken against pharmacists involved. A total of 500 hospital were selected in the United States. Data collected on the number of medication error reported, what types of errors were documented and the hospital demographics. The response rate was a total of 28%. Practically, all of the hospitals had policies and procedures in place for reporting medication errors.
...ck, T., Anen, T., & Soto, E. M. (2013). Nurse staffing: The illinois experience. Retrieved from http://www.medscape.com/viewarticle/815065_3
Agyemang, REO, and A While. "Medication errors: types, causes and impact on nursing practice." British Journal of Nursing (BJN) 19.6 (2010): 380-385. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
It is not unheard of for a nurse to accidentally make a medication error by not following the five rights of medication administration; this could potentially harm a patient. If the nurse reports the mistake right away to their supervisor, regardless of the consequences and makes sure the patient is safe they are being honest and acting in the best interest of their pat...
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
On Wednesday, April 18th, I attended my Acute Care evening clinical at Hays Medical Center. At the beginning of the clinical, Professor Keil assigned us to a nurse and patients. I followed a nurse with 5 patients. We then went down to the floor to wait for report. My nurse, Brittany, and I received report on all five patients from the day shift nurses. After receiving report, we went through patient’s medications and wrote down the medications that we would be passing that evening and at what time. After receiving report and writing down medications, we began.
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
Many aspects can enhance or impede medication safety and nursing care. Communication proves to be a crucial part of ensuring patient safety. Another way to provide patient safety is to limit distractions while calculating and delivering medication. A huge impairment of medication administration is not taking on the responsibility fully. As a nurse, one must keep in mind aspects that can help or impede medication safety and nursing care.
If a patient is confused or thinking of altering their medication regimen the nurse and/or physician should be informed
In response to concerns about staffing and quality of care, the American Nurses Association (ANA) launched the Patient Safety and Nursing Quality Initiatives in 1994 to address the impact of health care restructuring on patient care and nursing. To facilitate the initiative, ANA established the National Database of Nursing Quality Indicators (NDNQI) in 1997, with two goals: (1) to develop a database that would support empirical monitoring of the impact of nurse staffing on patient safety and quality of care across the nation, and (2) to provide individual hospitals with a quality improvement tool that includes national comparisons of nurse staffing and patient outcomes with similar hospi...
Team coordination could be the best solution to prevent such medication errors. When Lawanda was assigned a duty in the ICU to give physician ordered medications to the patient, it would be the duty of other nurses in the team to check whether the things in medication drawer are properly arranged and also to recheck the appropriate medication before handing it over to Lawanda. This lack of coordination and improperly assigned duties among team members finally lead to death of the patient. The issue clearly shows that not Lawanda alone, but it is the team that is responsible for the medication error. Balanced participation and sharing responsibilities equally among the team members to achieve the tasks would help resolve this issue (Gordon,
I was also responsible for monitoring medication orders and reviewing patient profiles to ensure that the proper drugs and dosages were prescribed and that the pharmacy technician had prepared them properly. In many instances there were mistakes made in the preparation phase and sometimes even before, with incorrect dosages or drugs being prescribed and prepared, which could result in serious adverse effects for the patient. A clinical pharmacist’s role, however, is to make sure that these mistakes never reach the