Clinical Application Paper
Medication errors are a serious public health problem and they pose a serious threat to patient safety. Medication errors are costly from an economic, human, and social viewpoint since all patients are potentially vulnerable to these errors. It is estimated that in the United States more than 250,000 deaths per year are attributed to medication errors (Dirik, Samur, Seren Intepeler, & Hewison, 2019). Nurses work in a fast-paced healthcare environment which makes administering medication to be a high-risk nursing task. Medication errors can occur at any phase of medication from prescribing, dispensing, transcribing, administering, monitoring, and reporting. When a nurse makes a medication error they are emotionally traumatized since most of them beat themselves up for making such an error and this might undermine their self-esteem and confidence. Medication errors can be caused by any member of the healthcare team, but nurses account for the majority since nurses execute the majority of medical orders and they spend over 40% of their time in the hospital administering medicines (Tong et al., 2017). This paper aims to not only offer an overview of the problem within the clinical setting but to also use evidence-based research to identify solutions that can be used to improve the situation and reduce medication errors. A plan will be developed to address the problem of medication errors and methods of evaluation identified.
The Problem
In our clinical setting, there is a computerized provider order entry system used for specifying patient prescriptions and reducing transcription errors. In the past nurses had a problem trying to transcribe what the provider had written and this was the major cause of medication errors. However, with the installation of the system, it was expected the errors would be eliminated. Sadly, this was not the case. The current problem is mainly due to administration and medication mixing. When a nurse is attending to multiple patients and he or she has to administer medication to the patients at the same time, he or she will prefer to retrieve the drugs at the same time and make only a single round. This is a time-saving strategy and it reduces the time spent moving from the medicine cabinet to the ward and back for other drugs. The problem comes when the nurse fails to label the drugs especially medicines in syringes, basins, and cups. The nurse ends up mixing the medication and administers the wrong medication to a patient. This results in adverse drug events as the patient is likely to react to the drugs and this will worsen the patient's condition. For our clinical setting, the main reason nurses prefer to use this system when administering medication is there is a shortage of nurses. When understaffed, nurses will be overworked and they tend to look for ways they can increase their efficiency and reduce the time they spend moving up and down...
References
Cho, S.-D., Heo, S.-E., & Moon, D. H. (2016). A convergence study on the hospital nurse's perception of patient safety culture and safety nursing activity. Journal of the Korea Convergence Society, 7(1), 125-136.
Dirik, H. F., Samur, M., Seren Intepeler, S., & Hewison, A. (2019). Nurses’ identification and reporting of medication errors. Journal of clinical nursing, 28(5-6), 931-938.
Kelly, K., Harrington, L., Matos, P., Turner, B., & Johnson, C. (2016). Creating a culture of safety around bar-code medication administration: An evidence-based evaluation framework. JONA: The Journal of Nursing Administration, 46(1), 30-37.
Lee, S. E., Scott, L. D., Dahinten, V. S., Vincent, C., Lopez, K. D., & Park, C. G. (2019). Safety culture, patient safety, and quality of care outcomes: A literature review. Western journal of nursing research, 41(2), 279-304.
Tong, E. Y., Roman, C. P., Mitra, B., Yip, G. S., Gibbs, H., Newnham, H. H., . . . Dooley, M. J. (2017). Reducing medication errors in hospital discharge summaries: a randomised controlled trial. Medical Journal of Australia, 206(1), 36-39.
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