The Importance Of Medication Errors In Healthcare Organizations

McComas, Riingenm and Kim (2014), conducted a study that investigated the occurrence of medication errors and the efficiency of medication administration following the implementing an eMAR system. The study was conducted in an appropriate setting and all observed nurses volunteered for the study. Before implementing the eMARs mandatory class were provided and nurses were evaluated for competency. Data was collected by observation and nurses were randomly followed throughout a medication pass. Collected data consisted of medication errors, distractions during medication pass and amount of time spent administering medications.

There are many rules and precautions taken to ensure that medication errors do not happen. In nursing school students in the RNs and BSN program are both taught ways to not make medication errors. A study done by Margret Harris, Laura Pittiglio, Sarah Newton, and Gary Moore was done to see if simulation can be used to improve medication administration to reduce medical errors.

This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions

Many were reprimanded by verbal or documentation measures which was placed in their personnel files. One sixth of the hospitals had no documentation or disciplinary action in place. One fourth were either suspended or terminated as their form of disciplinary action, and legal action was never used. Many of the hospitals listed medication errors which had caused harm (42%), and death (40%) in personnel files. However, 34% of the other hospitals did not put any form of documentation of medication errors in any personnel file. There were a difference of three fourths between errors caught and not caught before the medication leaves the pharmacy and reaches the patient.

The words medication error elicit fear in every nurse. According to Stefanacci and Riddle (2016), preventable medication errors are responsible for third reason of death apart from heart disease and cancer in the United States. As a nurse, it is important to obtain skills and knowledge to prevent them as these errors could result in extended hospitalisation of patients, simultaneously a burden of health care cost. These errors could be reduced by identifying the problems which lead to medication errors and following certain protocols in a coordinated environment.

The issues addressed are Findings 1 and 3: Finding 1 is patient medication errors are up and there is a perception of shady hiring practices and playing favorites. All employees are responsible for compliance. Policies and professional standards exist for the medical profession. The challenges will be reintroducing employees to Federal and state law that govern the profession. For hiring practices and playing favorites the challenges faced are the lack of compliance reporting structure or training for understanding compliance. There is a perception that work rules are not being enforced. Finding 3 is high job turnover and low employee morale. The challenges faced will be building communication strategies, building confidence in leadership,

Older adults are at high risk for adverse effects of medication error more than their counteract younger adults. This is because they depend on more than one medication in order to treat or prevent disease, syndromes and sickness (Lindenberg, 2010). It is inevitable that the elderly face adverse effects of drugs while on medication especially when they still live independently. However, chances of errors in hospitals and care homes are more frequent when the medication process connects several departments (Belen et. al., 2009). Therefore, tactical measures are required in the provision of drug therapy in order to optimize safe medication in older adults. This paper discusses the issue by analyzing the existing structure of administering medication, reviewing the occurrence of medication errors; evaluating systems developed to advance safe medication administration. Finally, addressing the implication for professional nursing practice.

Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.

The administration of medication can be associated with a significant risk with it is recognized as a central feature of the nursing role. It should continue in order to avoid a possible medical malpractice continuous care. Nursing staff have a unique role usually given to patients to manage their medication and responsibilities, then they can report these identified medication errors. Some of the most distinguishable events can be related to errors in professional practice, prescribing, dispensing, distribution, and education or monitoring. Since medication errors can arise at any state of the administration process, it is essential for nursing staff to be attentive of the most commonly encountered errors. For the most part, the common of the perceptible aspects related with medication errors are due to minimal awareness about hospital policies, inappropriate implementation or latent conditions (Farinde, n.d).

Intravenous infusion therapy is an infusion of fluids directly into the patient’s bloodstream via a vein using an intravenous catheter. It is frequently used in hospital settings for patients that require a rapid onset of medication and for those who are unable to receive medications orally. According to Adams and Urban (2012), intravenous (IV) infusion is considered to be the most dangerous route of receiving medications because medication cannot be retrieved once it enters the bloodstream. Patients receiving IV infusion therapy require close monitoring for adverse reactions, which can happen immediately or it can take a couple of days for it to take effect. There are three types of IV administrations: large volume infusions, intermittent infusions, and IV push (p. 37). Patients receive IV therapy to for a variety of reasons including maintaining, restoring or replacing fluids and electrolytes, to administer medications, blood and blood products, nutritional feeds, chemotherapy, and pain mediations.

Medication administration errors can be made when patients are not properly identified. A consistent method for the proper identification of patients is needed to ensure patient safety. Many institutions have implemented technologies aimed at reducing error rates, for example, bar-code assisted medication (BCAM) administration, but the practice and rate of use varies, and medication errors are still a problem in the healthcare setting. The purpose of the study is to examine the effect of implementing a visual aid that will prompt nurses to scan patient’s identification bands prior to medication administration on the occurrence of medication administration errors.

“Any error in the process of prescribing, dispensing, or administration of a drug, irrespective of whether such errors lead to adverse consequences or not, are the single most preventable cause of patient Harm.

This reflection will reflect on an incident that happened during my clinical placement. According to Gulland, A. (2013, Jul) the most frequent reported error in health care settings are medication errors.

Within the first seven days of admission and readmission in a skilled nursing facility older people have an increase in medication errors. The study was put together to evaluate the process-related factors and structure that my cause and increase in medication errors as well as harm. The residents in North Caroline skilled nursing facilities during months of October 2006 to September 2007 showed medication errors from the medication error quality initiative-individual error database. When looking at the prescribing errors they were much less common than administration errors. However, they were much more likely to cause harm to patients. On the contrary looking at structure and process measures of quality, they were related to the volume

The leadership role of the nurse is pivotal for healthcare teams in a wide variety of clinical scenarios. This includes taking action following signs of clinical deterioration, the prevention or management of adverse events and the maintenance of safe and quality care standards for all patients. One of the key skills involved in nursing leadership is the ability to identify and manage patient risks; this is especially relevant in the event of medication errors. According to the World Health Organization (2016), a medication error can be described as a preventable error that may cause or lead to patient harm through inappropriate prescribing or administration of medication.