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Medication error in clinical setting
Medication error in clinical setting
Medication error in clinical setting
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INTRODUCTION Pharmaceutical error refers to any unintended error in prescribing, dispensing or administering a medicinal product in control of health care professional. Drug use is a very complex process and there are drug related challenges at different levels, involving prescribers, pharmacists and patients. Medication errors can occur anytime, anywhere in the health care system from prescriber to dispense to administration and lastly to patient use.
There are many errors that can be prevented and pharmacists play vital role in appropriate use of drugs. Medication errors do not always lead to Adverse Drug Reactions (ADRs) but if they do, they may cause harm and are considered preventable. Most medication errors are known as latent errors,
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2. Barcode Medication Administration (BCMA)
The recent efforts in order to reduce recurrence of ADEs have focused on eliminating errors in medication dispensing and administration. Barcode Medication Administration software enables users to document electronically the administration of medications at the bedside to improve the accuracy of medication administration.
Nurse carries out barcode scanning at the patient’s bedside to identify the administered medication to assure it is the prescribed medication and dose.
This system is done by placing a barcode on a patient wrist bracelet as identification (ID) badge so that they can assure an identical match between patient and medication and capture the practitioner administering the medication.
3. Computerized Physician Order Entry (CPOE)
CPOE is an application that enables users to key in medical orders into a computer system that is located within an inpatient setting. CPOE replaces traditional methods of placing medication orders so as to reduce errors in prescribing
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Automated Medication Dispensing
Automated dispensing is unified medication management system help in removing the time-consuming tasks from the medication process. It enhances the safety and efficiency of the whole complete medication process as well as improving efficiency of nursing and pharmacy staff by cutting down a few manual steps and processes. Automated dispensing of medications will effectively reduce medication errors and the correct dosage will be committed. Package that contains the medication would be wrongly labeled and sometimes the label is unclear. This caused confusion to the health care professionals to dispense the drugs and leads to incorrect medication being dispensed to the particular patient. Dispensing the wrong medication will cause the individual patient to develop allergic reactions or in some cases it might put patients’ lives at risk if there is severe recurrence of adverse drug effects.
5. Smart Infusion Pump
In recent years, "smart" infusion pumps have become increasingly sophisticated and include close error reduction software. The smart pump's "brain" consists of customized software that contains a drug
The pros of the CPOE system included that the prescribing of wrong medications was reduced, there were fewer errors with the patient’s basic information, orders for lab work, blood work, and medications were standardized; and mistakes in the ordering...
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
Overview: E-prescribing systems enable the electronic transmissions of prescriptions to pharmacies from the provider's office. The promise of e-prescribing in regard to patient safety is reduction in the time gap between point of care and point of service, reduction in medication errors, and improved quality of care. This paper will give a brief overview concentrating on the reduction in medication errors and the challenges that remain with electronic prescriptions. Electronic prescribing or known as e-prescribing is the transmission, using electronic media, of prescriptions or prescription-related information from a prescriber (physician, nurse practitioner, etc.) to a pharmacy (Fincham, 2009). The information may flow to a number of parties
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
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.
Implementing technology in a clinical setting is not easy and cannot be successful without a well-organized system. It is important that healthcare providers understand the electronic medication administration record (eMAR) and its role in improving patient safety. One of the most significant aspects of healthcare is the safety of our patients. Medication errors account for 44,000-98,000 deaths per year, more deaths than those caused by highway accidents or breast cancer. Several health information technologies help to reduce the number of medication errors that occur. Once of these technologies is bar-code-assisted medication administration (BCMA). These systems are designed to ensure that the right drug is being administered via the right
Agyemang, REO, and A While. "Medication errors: types, causes and impact on nursing practice." British Journal of Nursing (BJN) 19.6 (2010): 380-385. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
The Medication Administration Accuracy Project is a quality improvement project, whose purpose is to improve the accuracy of nursing medication administration. The study used for this project was to find where the most common “wrong doings” happened in the medication process and how to get rid of it. After a year of this project the medication error percent went from 4.3% in 2010 to 1.2% in 2011. The Bar Code Administration System implementation had been very successful with a 95% success rate every year that it is done. The study provided important insight on reducing the medication errors in children. Some were: making sure there are no distractions as possible, double checking medications and making sure the dose in adequate range for the child, and making sure you have two ways of identification with the bar code scanning (Hardmeier, A., Tsourounis, C., Moore, M., Abbott, W., Guglielmo, J.
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
Responsibility and accountability become important when medical staff gives or doses patients with medication. The chance for making a medication error presents itself at all times. Those passing medications must follow established policies and procedures developed and laid forth by t...
Precision of a patient’s intravenous medication is essential; it must be safe from. contamination, toxicity, and side effects. Most people believe these medications are compounded or mixed by a trained and licensed individual. However, this is inaccurate because the pharmacy technician actually compounds a large percentage of a patient’s medications. Compounding involves a technician’s math skills, aseptic technique, and professional ethics.... ...
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.
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.