Medication Errors
Jake Callahan
Baker School of Nursing
Medication Errors Medication errors are a significant nursing problem that still exist to this day. Did you know that medication errors are preventable but still remain a high cause of death in hospitals?
First we will discuss the problems of medications errors, safety precautions, uses of electronic devices in aiding management of medications and related statistics to medications being given. Furthermore, medication errors are a huge part of the nursing community. Nurses are in charge of giving medications and they are to be held accountable if things are to go wrong. However, sometimes it not exactly the nurses fault if a medication error is to occur. To go a little bit
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As mentioned above with the bar code technology, getting nurses trained on the equipment is the number one priority. If the nurses don’t know how to use the technology, medication errors are more than likely to reoccur. Most medication errors, about 49%, are related to a dose not given or the wrong amount of the dose which is around 21%. There are many aspects as to why medication errors occur and they can include a high workload, being interrupted frequently, lack of training on certain technologies or items, staff not sticking around and not being familiar with patients on the floor. (Nazarko, 2015). Some of these are easy fixes. A high workload would require more staff and sometimes that is not feasible. Lack of training on technology needs to be a number one priority to reduce medication errors and every patient should have a least some sort of identifying picture within their medical chart. That would also help in misidentifying patients. As mentioned above, during the morning rotation, most medication errors occur during the morning. This could also be a staffing issue, workload and not being familiar with patients. Each patient should be given their medications before/after meals and before they do anything else. I believe that this would reduce the amount of time errors or interruptions the nurse may face. A massive amount of errors occurs due to not knowing or re-checking the …show more content…
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Nazarko, L. (2015). Medication management: Eliminating errors. Nursing & Residential Care, 17(3), 150-154. http://web.b.ebscohost.com.bakeru.idm.oclc.org/ehost/detail/detail?vid=115&sid=7d1a7ff0-47e6-4393-abaf-dba8f3afa50d%40sessionmgr120&hid=106&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=103760680&db=c8h
Taylor, C., Lillis, C., Lynn, P. (2015). Medications. (8th ed.). Fundamentals of Nursing. chapter 28 (pp. 750-851) Philadelphia: Wolters
For my research paper, I will be discussing the impact of medication errors on vulnerable populations, specifically the elderly. Technology offers ways to reduce medication errors using electronic bar-coding medication administration (BCMA) systems. However, skilled nursing facilities (SNFs) are not using these systems. Medication is still administered with a paper or electronic medication administration record (eMAR), without barcode scanning. In contrast, every hospital I have been in: as a patient, nursing student, and nurse uses BCMA systems. The healthcare system is neglecting the elderly. Nursing homes should use BCMAs to reduce the incidents of medication errors.
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
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
Baccalaureate nurses are responsible for providing and ensure our patients safety. The knowledge from others mistakes can help informs nurses of extra precautions that we can take to ensure our patient’s safety. Risk Analysis and Implication for practice course helped me understand the steps I as a nurse can take as well as the facilities I work for to help reduce the number of medication errors that occur. Interviewing the pharmacist help me get a better insight to what facilities already have in place to help prevent medication errors. However like most things you have to have educated and compassionate caring staff to enforce and follow the guidelines set in place.
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.
Properly implemented and medication-use technology has the potential to moderate these costs. Bar-code-assisted medication administration (BCMA) has been shown to reduce medication administration errors by as much as 54-86%. BCMA, along with computerized electronic prescriber order entry and an electronic medication administration record, closes a technological loop that extends from the transmission of the order to the administration of the medication at bedside (Strykowski, Hadsall, Sawchyn, VanSickle, Niznick,
Furthermore, short staffing affects the quality direct care each patient receives. The National Coordinating Council for Medication Error Reporting and Prevention (2012) states an estimated 98,000 individuals die every year from medical errors in the United States. One out of many significant tasks nurses do within their scope of practice is medication administration. Research shows a relationship between short staffing on medication errors: the longer the hours nurses work, the higher the chances of medication errors (Garnett, 2008). (include definition of medication error) Administering medications requires knowledge of patient rights, pharmacological information on the drug, adverse effects, proper dosage calculations, and hospital protocols. When nurses are assigned more patients, they are pressured to give due medications on time. Sometimes due to hunger or fatigue, nurses give the wrong medication to the wrong patient (Frith, Anderson, Tseng, & Fong, 2012).
Collaboration with Others, a key principle of the NMBI Code, applies to the standards of medicines management. Nurses and midwives share responsibility with colleagues from other health care disciplines for providing safe quality health care. Additionally, collaborating and working together helps to achieve safe and effective management of the patient’s medication. Any authorised person administering a medicine to a patient or checking the administration must be satisfied that she or he knows the therapeutic uses of the medicine, its normal licenced dosage, side effects, precautions and contra- indications[ref]. It seems to be a best practice that a second suitable person to check all medicines for accuracy before administering.
Young, J., Slebodnik, M., & Sands, L. (2010). Bar code technology and medication administration error. Journal of Patient Safety, 6(2), 115-120. doi:10.1097/PTS.0b013e3181de35f7
Medication errors made by medical staff bring about consequences of epidemic proportions. Medical staff includes everyone from providers (medical doctors, nurse practitioners and physician assistants) to pharmacists to nurses (registered and practical). Medication errors account for almost 98,000 deaths in the United States yearly (Tzeng, Yin, & Schneider, 2013). This number only reflects the United States, a small percentage in actuality when looking at the whole world. Medical personnel must take responsibility for their actions and with this responsibility comes accountability in their duties of medication administration. Nurses play a major role in medication error prevention and education and this role distinguishes them as reporters of errors.
Computerized provider order entry systems, or CPOE, was designed as a computer application that would allow physicians to input their medical orders over a secured network and transmit the data to other healthcare professionals to carry out the orders. This system has the capabilities to include standard physician orders, clinical decision support for patient specific conditions, safety alerts, point of care utilization, and a method to securely keep permanent records (Moniz, 2009). With the safety guards provided by CPOE it has the potential to reduce the number of medical errors thus increasing the medical field’s efficiency in patient care. CPOE’s main focus surrounds the nursing utilization of electronic medical administration records,
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
I am truly amazed by the positive impact of bar-code medication administration (BCMA). Since we have a fully integrated electronic health record, it is a true closed loop-system, with medication order entry, pharmacy validation of medications, and clinical decision support. Implementing technology such as BCMA is an efficient way to improve positive identification of both the patient and medication prior to administration. It is estimated that the bar-code medication charting can reduce medication errors by 58% (Jones & Treiber, 2010). Even though we have good adoption of BCMA, nurses still make drug administration errors. In many of the cases, errors are caused by nurses, because they do not validate and verify. The integration of technology
Administration of medication is a vital part of the clinical nursing practice however in turn has great potential in producing medication errors (Athanasakis 2012). It has been reported that over 7,000 deaths have occur per year related to medications errors within the US (Flynn, Liang, Dickson, Xie, & Suh, 2012). A patient in the hospital may be exposed to at least one error a day that could have been prevented (Flynn, Liang, Dickson, Xie, & Suh, 2012). Working in a professional nursing practice setting, the primary goal is the nurse and staff places the patient first and provides the upmost quality care with significance on safety. There are several different types of technology that can be used to improve the medication process and will aid staff in reaching a higher level of care involving patient safety. One tool that can and should be utilized in preventing medication errors is barcode technology. The purpose of this paper is to demonstrate how implementing technology can aid patient safety during the medication administration process.