a. Provide an analysis of the drug administration process used in your facility. b. Identify any potential issues in the system in which a mistake could be made. c. What strategies could a RN use to prevent such drug errors? (20 points) When the patient is admitted to acute rehabilitation and physical therapy, the patient will arrives with a packet with transport service that contains a typed med reconciliation from their discharging location. The nurse may manually enter (typing each drug name, each dose, route, times and special instructions) all these drugs as “home meds” into MEDITECH system. This may cause confusion as the drugs may not necessarily be the home meds the patient was taking at home before their hospital admittance, just their newly prescribed hospital drugs. The nurse will ask the patient (if they are alert and oriented, or else a family member if available at bedside) if they recognize the drugs and know their indications. If the patient is from a HCA hospital (which is common,) the drugs will already be in their electronic record and the admitting nurse will review last time administered for each drug before calling the doctor to review, edit or continue the current drugs for the patient. The doctor here has the opportunity to change route, dose, timing, or give additional drugs here. Pharmacy then is to check for interactions and appropriate med times (like cholesterol meds in evening). Some drugs (usually the very expensive or rare) are not stocked by pharmacy and so it is a drug that is continued under an order labeled “okay for patient to take own drug”, which means the patient’s family can bring in the unavailable drug and nursing brings it to be reviewed and barcoded by pharmacy, or else the drug is discontinued. After all is said and done, pharmacy reviews the drug list and then uploads all drug entries linked electronically to computer EMAR and the OMNICELL machine. After 5 pm, the nursing supervisor may have to track down the drug due to pharmacy not being in house. If they are unsuccessful to find it within the building, the patient may miss a dose that night, unless it is considered to be an emergent need, in which the drug can be transported over from main campus hospital by transport service. All admits after 5 pm are managed by the pharmacy at main campus hospital, who are easily accessed by phone.
The risk that the auditor or audit firm will suffer harm after the audit is completed, even though the audit report was correct,
This technology assist the nurse in confirming patients identify by confirming the patients’ dose, time and form of medication (Helmons, Wargel, & Daniels, 2009). Having an EHR also comes with a program that allows the medical staff to scan medications so medication errors can be prevented. According to Helmons, Wargel, and Daniels (2009) they conducted an observational study in two medical –surgical units one in the medical intensive care (ICU) and one in the surgical ICU. The researchers watched 386 nurses within the two hospitals use bar code scanning before they administrated patients’ medications. The results of the research found a 58 % decrease in medication errors between the two hospitals because of the EHR containing a bar code assisted medication administration
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
Lack of proper risk management process: NASA was using a simple risk classification system and the methods used were only qualitative. There was a lack of proper technical and quantitative risk management methods that could have helped them identify the risks and eliminate them.
To provide appropriate care, long-term care admissions must be well thought-out and explicit tasks fulfilled prior to the patient’s arrival. There should be a smooth transition between facilities to promote continuity of care (LaMantia, Scheunemann, Viera, Busby-Whitehead & Hanson, 2010). If discharge planning is inadequate, patient safety and health can be compromised. For example, scheduled drug regimens, such as antibiotics and controlled medications, must be available within a timely manner. Most long-term care facilities do not support an in-house pharmacy. In addition, many pharmacies require original hard scripts before filling controlled medications. If admitting orders are inadequate or cannot be carried out within the appropriate time span, the admitting facility may be unable to meet critical needs. I have experienced this first hand on more than one occasion. The most recent o...
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
As per PCAOB standard 12 it is our responsibility to identify internal and external risks to the business and risks that could result in material misstatement. The Newham
The six steps of the model are as follows: Identify the ethical dilemma, collect information, state the options, apply ethical principles to those options, make the decision, and implement the decision (Beemsterboer, 2010). The first step is to identify the ethical dilemma, which Beemsterboer describes as the most critical step in the model. To identify the ethical dilemma, one must recognize that the problem is an ethical dilemma with no one clear answer, and expound upon what the ethical question is. The next step is to collect information about the situation and values involved “as a basis for an informed decision.” (Beemsterboer, 2010, para. 8). After defining the ethical dilemma and gathering information about it, one must then state as many options as possible which may resolve the problem (Beemsterboer, 2010). Due to that fact that more than one decision may remedy an ethical dilemma, it is important to discuss all available options to better understand all angles of the situation and how to deal with as many of them as possible. Once all alternatives have been stated, each must be weighed against ethical principles. Beemsterboer suggests in the discussion of each option a list of pros and cons be made to demonstrate how the option may protect of violate ethical principles and values (2010).?? After analyzing each alternative it is much easier
In order to address the above components, five decision making steps have to be put in place, these are; being attentive, being intelligent, being reasonable, being responsible, and being reflective. The first step, being attentive, involves evaluating the whole situation and coming up with the data and information about the problem at hand. In so doing the following questions are viewed; what facts to bear in mind, what direction to take so as to get the expected solution, and what is the main issue to work on. In the second step, being intelligent, the information is clearly studied to determine whether the collected data is revealing the correct details concerning the problem. Determine the stakeholde...
Currently, through observations and clinical experience on Med/Surg at Cary Medical Center, medication is administered by the nurse. Nurses are responsible and accountable for administrating medications to patients. Patient me...
INTRODUCTION There are many things that affect a student’s enrolment as a nurse the student must be competent in the many registration standards that the Nursing Midwifery Board of Australia have set. The stigmas attached to students with Impairments and or Criminal histories and the ineligibility to register. Nursing is defined by the International Council of Nursing (2014) as collaborative care of individual’s any age health or ill of all communities, groups, in all situations. Health promotion, illness prevention and the care of unwell, disabled and dying people are included in the nursing practice. Encouraging a safe environment, research, contributing to shape health policies and health systems management, and education are also key nursing
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,
Care planning is one of these tasks, as expressed by, RNCentral (2017) in “What Is a Nursing Care Plan and Why is it Needed?” it says, “Care plans provide direction for individualized care of the client.” A care plan is for an individual patient and unique for the patient’s diagnosis. It is a nurse’s responsibility to safely administer a patient’s medication prescribed by the doctor. Colleran Michelle Cook (2017) in “Nurses’ Six Rights for Safe Medication Administration,” she says, “The right patient, the right drug, the right dose, the right route and the right time form the foundation from which nurses practice safely when administrating medications to our patients in all health care settings.” Nurses must be safe when dealing with medications, and making sure they have the right patient. Nurses document the care that is given to their patient, as said by, Medcom Trainex (2017) in “Medical Errors in Nursing: Preventing Documentation Errors,” it states, “Nurses are on the front lines of patient care. Their written accounts are critical for planning and evaluation of medical interventions and ongoing patient care.” Nurses must provide an exact, complete, and honest accounts of everything that happens with a patient. Doing this allows for the proper evaluation, and medical interventions for the patient. The typical tasks a nurse involves care planning, administration of treatments and medication, and documenting the care given to a
Identify the potential risks which affect the company and manage these risks within its risk appetite;
As the first step, identify potential risks plays a crucial role in the risk management process. The core purpose of identifying risk is to figure out causes of risk and analyze result caused by the risks and its probability . Hence, risk identification can begin with the source of problem, or with the problem itself. The chosen method of identifying risk may depend on culture, industry practice and compliance. The identification