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
Most undergraduate nursing students are not being properly educated on proper medication administration. Clinical instructors and registered nurses need to be updated on medication administration reporting, so students do not develop bad habits when they become registered nurses. Registered nurses must also continue their education on med error prevention to prevent future errors. Another significant problem with registered nurses was that they did not have positive attitudes when reporting an error. Once these negative attitudes were changed, more errors were reported (Harding & Petrick, 2008). The three main problems that cause medication errors...
For many patients the scariest part of being in the hospital is having to rely on other people to control their life changing decisions. There are multiple causes of patient harm, one of the major contributors are medication errors made by health care professional. Medication errors are inappropriate dispensing and administration of drugs which cause harmful effects such liver damage and excessive bleeding. Most cases of medication errors in hospitals occur as a result of wrong diagnosis by the doctors leading administration of inappropriate drug, poor communication between doctors and nurses and between patients and nurses who issue the drugs. However in an article by the International Journal of Nursing practice, in Australia many occurrences
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.
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
If a patient is confused or thinking of altering their medication regimen the nurse and/or physician should be informed
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.
This assignment will discuss the professional, legal and ethical issues related to the self-use of medication by nurses. It will also explore the importance of reporting this misconduct by both professionals in the scenario and how they might do so. The self-use of medication by nurses is not allowed or justifiable according to the guidance provided to nurses by An Bord Altranais (ABA 2007). It will also be evident throughout this assignment the need for Jack to report Linda’s self-use of the medication or urge Linda to do so regardless of the consequences it may present to both him and Linda as according to Nurses and Midwifery Board of Ireland (NMBI 2013), nurses can now be held responsible for not taking action. This is because delivering the greatest level of care to a patient is an essential role of a nurse and the main focus of the nurse’s work should be on caring for that patient (ABA 2010). There is also an ethical duty upon both nurses to report the misconduct according to the four ethical principles; Beneficence, non-maleficence, justice and autonomy (Edwards 2009).
Falls are the second most common adverse event within health care institutions following medication errors, and an estimated 30% of hospital-based falls result in serious injury. The severity of this problem led the Joint Commission to make reducing the risk of patient injuries from falls a national patient safety goal for hospitals in 2009 (AHRQ, 2006). Falls are a leading cause of hospital-acquired injury and frequently prolong and complicate hospital stays and result in poor quality of life, increased costs, and unanticipated admissions to long-term care facilities.
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.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
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.
Patient safety should be the highest priority when it comes to health care, so why wouldn't the administrators reduce the ratio of nurse to patients to provide maximum patient care? Nurses that have a higher workload of patients are probably more prone to commit a medication error because they may not have the time to do the five checks of medication administration: the right drug, the right dose, the right route, the right time, and the right patient.
Multiple steps are conducted to ensure that medications received and administered to nursing facility residents are the intended ones. Nursing facility regulations specify that the facility “must develop and implement appropriate policies and procedures for accurate acquiring, receiving, and administering of all medications” (CMS, 2014). Before medications are packed for delivery, a LTCP employee checks that individual content of a package match the prescription label on the package (CMS, 2014). It is crucial for the nursing staff to be conscientious on the order submission cut-off time so the medications can be delivered as soon as possible.
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