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How to analyze the problem of medication errors
Medication error risks
How to analyze the problem of medication errors
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Target High Risk Areas for Medication Errors
Medication errors are among the biggest issues in health care settings today. The effect of managed care is one of the causative factors. The need to contain costs has invariably doubled the nurses' workload making them less efficient as caregivers. Example of problem is the high incidence of medication errors. Nurses' workload has increased tremendously regardless of the fact that most of these patients are of great acuity, thereby predisposing them to a greater risk of medication errors.
Medication giving include five basic rights: Right patient, Right medication, Right route, Right dose, and Right time. Contrary to the above is medication errors. Most medication errors reported involve patient allergies, insulin administration , heparin, opiates, patient controlled analgesia and potassium concentrates. Most errors with PCA devices are with rate, misprogrammed dose, wrong concentration and device malfunction errors. However, lack of basic knowledge and poor performance have also caused these errors.
Another area of great concern with medication error is order transcription. Poor
Transcription or orders have resulted in wrong information passed on to a patient
Whether n a discharge or as an in patient. Clarification in the case of doubt is a weapon
against order transcription error. Most nurses have poor concentration due to the amount
of their work load that they could hardly call back the doctor to clarify either the order
clearly written or an illegible order, then arriving to their own assumption.
Administering medication later than specified time ordered or missed medication
is an area of issue. Some prophylactics given before or after according to specified order
are lifesavers. When a patient is scheduled for a surgery, prophylactic anticoagulant is
administered to prevent clots and perhaps continues post-op. If such a patient is not given
his/her medication as ordered he could break a clot resulting to embolism.
Incorrect patient history has resulted to medication errors. It is obvious that
nurses' workload permits them with a limited time that a complete or basic issue in
patient history is neglected resulting to a serious health crisis or ever death and lawsuits.
Poor documentation is among the biggest issue with nurses. It has been said,"if
you don't chart is you didn't do it". Documenting properly bails you from a lawsuit. Most
nurses are quite busy especially with another patient of a high acuity and have no time to
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.
It is very disturbing at the number of errors that occur in children who receive medication in the ambulatory care setting. According to Medication Dosage Error...
Over the past years, there has been a nursing shortage which has led to the need of more registered nurses in the hospital setting. This is the result of higher acuity of patient care and a decrease in their length of hospital stay. In order for the patients to get safe and quality care, the staffing, education and experience of the nursing staff needs to be made a priority. Because of the lack of nurses, patient quality of care has suffered.
Unver, V., Tastan, S., & Akbayrak, N. (2012). Medication errors: Perspectives of newly graduated and experienced nurses. International Journal Of Nursing Practice, 18(4), 317-324. doi:10.1111/j.1440-172X.2012.02052.x
...health of a patient and a follow up check at the GP’s may be required.
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.
Nurses want to give complete and quality care, but are unable to, due to the constant needs of their workload and inadequate staffing. They have to prioritize their patients needs based on the most critical treatments first. Then whatever time is left, they fill in what treatments they can. Some reasons that nursing treatments are missed include: too few staff, time required for the nursing intervention, poor use of existing staff resources and ineffective delegation.” (Kalisch, 2006) Many nurses become emotionally stressed and unsatisfied with their jobs. (Halm et al., 2005; Kalisch,
Poor staffing stresses every nurse and makes them despite what they once loved to do. Nurses are overworked and because of that they may not provide adequate patient care.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Medical errors can happen in the healthcare system such as hospitals, outpatient clinics, operating rooms, doctor’s offices, pharmacies, patients’ homes and anywhere in the healthcare system where patients are being treated. These errors consist of diagnostic, treatment, medicine, surgical, equipment calibration, and lab report error. Furthermore, communication problems between doctors and patients, miscommunication among healthcare staff and complex health care systems are playing important role in medical errors. We need to look for a solution which starts changes from physicians, nurses, pharmacists, patients, hospitals, and government agencies. In this paper I will discuss how does the problem of medical errors affect our healthcare delivery system? Also how can these medical errors be prevented and reduced?
This will help confirm that the proper information is provided to all healthcare workers and will help to make any future decisions. Patients will benefit in less time lost on test being repeated and by preventing wrong diagnoses or the prescription of wrong treatments. Healthcare organizations have a benefit when good clinical records smooth decision making for patients, this allows them to have more time with patients. Poor clinical records might have a deep effect on a patient’s health in the long run. The seventh principle of the Caldicott report, an NHS report on patient information, states “the duty to share information can be as important as the duty to protect patient confidentiality (Mathioudakis et al,
Keers (2013), conducted a systematic review which included 54 studies of English language publications and found evidence relating to the causes of medication administration errors within hospitals. Prescribing and administering drugs appeared to have the largest association with the greatest number of medication errors. Harm does not specifically have to be caused for medication errors to result. The most common type of unsafe medication error was found to be slips and lapses. Slips and lapses include misidentification of patient/medication, misreading labels, mental state, or forgetting to sign a medication order. The following were all other causes of medication administration errors found to complicate patient safety: knowledge and rule-based
It is one of a nurse’s duty in the medical field to administer medications, this means that one nurse is in charge of keeping track of multiple patient’s medication. Due to the amount of medication administered by nurses, medication errors occur more often than we would like, especially with younger patients. I chose this topic because medications are given to practically every patient that enters a hospital and ensuring that they are administered properly is important to keeping the patients safe. A study was done in a pediatric intensive care unit at a hospital in Zurich to “determine the number and type of medication prescription errors” (Glanzmann, Frey, Meier, & Vonbach, 2015, p. 1) that typically happen in this unit of the hospital. The goals of the study were to learn about the rate of medication errors, the most common drugs involved in the errors and how severely they affected the patient.
Work overload and understaffing can be significant factors that contribute to errors. In order to make improvements and maintain a high level of patient safety and quality care, it is very important that health care employees keep a record of any mistake that happens. Also, emphasis needs to be made in improving the working environment for health care professionals, and in consequence decreases the number of errors. As stated by Hughes and Beglen (2003), “Medication safety for patients is dependent upon systems, process, and human factors, which can vary significantly across health care settings” (p.415). Therefore, policies and guidelines need to be made in order to establish an acceptable number of employees available for patients per shift and to evade designating too many tasks per employee. In addition, the implementation of a system that double checks the prescriptions before giving it to the patient can help to prevent mistakes. Overall, all these changes will decrease errors and improve patient
Thank you for you post. Medication error is a serious issue which may affect patients and even cause death. In my hospital, in order to reduce the medication mistakes, except medical record and date of birth, we use the scanner scan the patient’s ID bandage and medication to match the e-MAR. The computer system will notify us any errors. This system helps us to avoid medication errors.