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2006 report “preventing medication errors” from the institute of medicine
2006 report “preventing medication errors” from the institute of medicine
Previous research statement on medication errors in hospitals
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Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of the nursing profession, taking up to forty percent of a nurse’s time in providing nursing care (Fowler). Consequently, nurses are commonly held accountable for medication errors. To improve the safety of a vital aspect of nursing care, bar code scanning was introduced to reduce errors in medication administration. Although bar code scanning has its advantageous aspects, there are also disadvantageous qualities.
Background
Bar-code-assisted medication administration (BCMA) has replaced the traditional paper-based medication administration (PBMA) systems in some health care facilities. The BCMA system’s objective is to verify the five rights of medication administration meaning that “the right patient receives the right dose of the right drug by the right route at the right time (Grissinger).” The process begins with the pharmacy ensuring that all medicines are labeled correctly and that all medicines have appropriate bar codes that identify the name, dose, and form of the medication. Patient...
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...nistration to enhance medication safety. Nursing Ecomonics, 26(3), 207-210.
Mims, E., Tucker, C., Carlson, R., Schneider, R., & Bagby, J. (2009). Quality-monitoring program for bar-code-assisted medication administration. American Journal of Health System Pharmacy, 66, 1125-1131.
Adams, M. P., & Koch, R. W. (2009). Pharmocology: connections to nursing practice. (1 ed.). Upple Saddle River, NJ: Prentice Hall. (ADD PAGE NUMBERS TO CITATION)
Grissinger, M., & Globus, N. J. (2004). How technology affects your risk of medication errors.Nursing2004, 34(1), 36-41. Retrieved from www.nursingcenter.com
Robinson, F. P., Gorman, G., Slimmer, L., & Yudkowsky, R. (2010). Perceptions of effective and ineffective nurse–physician communication in hospitals.Nursing Forum, 45(3), 206-216.
Henneman, E. A. (2010). Patient safety and technology. Critical Care Nurse,Feb(2010), 8-12.
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.
Lilley, L. L., Rainforth, S., & Snider, J. (2013). Pharmacology and the Nursing Process (7th Ed.)
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
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,
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
The intent of this paper is to analyze interviews with a staff nurse and a nurse manager. The interview questions revolve around what the nurses perceive as the main communication issues at work. More specifically, the communication issues with patient communication, communication with colleagues and communication with leadership/administration. This paper will also list three actions that would improve communication in response to the issues raised during the interviews.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread publicity has helped build awareness of e-prescribing’s role in enhancing patient safety. Although it has not been in practice for very long, e-prescribing has already made a positive impact in the field of health care.
Communication encompasses a wide range of processes such as the exchange of information, listening, posing of questions (Fleischer et al., 2009) or use of body language. In a healthcare environment where there are constant interactions among nurses, doctors, patients and other health professionals, professional and effective communication is important in ensuring high quality healthcare standards and meeting the individual needs of patients.
An error can happen at any step of the process. The Institute for Safe Medication Practices has identified ten elements with the greatest influence on medication error such as, two patient identifiers, ask the patient about any allergy, Avoid abbreviations, pay close attention to patient’s diagnosis, and note the patient current medication regimen. Using two identifiers when dispensing medication can cut the risk of medication errors. For example, along with patient’s name ask for the date of birth to make sure the prescription matches the patient. In addition, having a system in place to show patients with similar names. This can be simple as a special color coded stickers or even verify information with the family members. Secondly, ask the patient about any allergy and reaction to medications before any new medication is administered. This includes information from the patient’s chart. Thirdly avoid the use of abbreviations which can easily misinterpret when documenting medication of allergies. Fourthly, pay close attention to the patient’s diagnosis, which can affect the dose and frequency. For instance, patients with kidney, impairment, liver and diabetes fall under this category. Educate patients to ask for information from their doctor when they received a medication to include what is the name of the medicine, dosage, and what it is used for. Lastly, note the patient’s current medication regimens and update the list for each visit. These simple tips can definitely enhance patient safety and decrees any
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.
medications is more than the act of getting drugs to a patient. The delivery of medication is directly tied to the charge for the medication. Thus the responsibility for charging or crediting medication belongs to technicians. This aspect of their job is strictly governed by federal regulations. These laws hold the technician directly responsible for the accuracy of a patient’s account’s charge and credit transactions. Because every dose is related to a specific day and time, when technicians credit they must apply that change to the corresponding dose. Assignificant as accuracy is to the patient’s account, accuracy in the making of their medications is even more important.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
Despite the frequency of verbal interactions, miscommunication of patient information occurs that can lead to patient safety issues. . . . ‘Effective communication occurs when the expertise, skills, and unique perspectives of both nurses and physicians are integrated, resulting in an improvement in the quality of patient care’ (Lindeke & Sieckert, 200...
Introduction The introduction paragraph gives information on communication and the impact that it has on patient-nurse relationships. It gives the reader an understanding of what is involved in true communication and how it is a fundamental part of nursing and the skills all nurses need. It leads those interested in delivering quality nursing to read on. Showing us the significance that communication makes in the perception of the quality of care that patient perceives they received based not on the care it’s self but on the patient-nurse communication.. Purpose/Problem/Hypothesis