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Medication errors have serious direct and indirect results, and are usually the consequence of breakdowns in a system of care…Ten to 18% of all reported hospital injuries have been attributed to medication errors" (Mayo & Duncan 2004: 209). One of the most common reasons that errors in medical administration transpire is miscommunication. On a staff level, errors may occur in terms of the paperwork associated with the patient. The hospital pharmacist may misread the strength or even the name of the pill or the frequency of the dose and release the patient with an incorrect pill or orders. Or, within the hospital a nurse may misread the patient's orders and administer treatment incorrectly. If a nurse, within the environment of the hospital, is pressed for time or overtired, risks of medication errors increase.
When a patient is discharged with orders, miscommunication can also occur if the nurse does not stress the seriousness of taking medications as the right time (some medications must be taken with food, some without food, some must be coupled with certain types of food, such as antibiotics with yogurt, to reduce digestive distress, some foods may need to be avoided). Correct dosage, such as tablespoons vs. teaspoons, or the need to split pills, must also be explained. Asking the patient to repeat directions can be a simple way to reinforce these principles. Particularly if the patient is elderly, does not have a high level of literacy, or speaks English as a second language, it is essential that the nurse tailor her responses to the individual patient. The...
Miscommunication between team members can result in incorrect dosing. Difficulties inherent to the task or an environment that is not conducive to focus and concentration can likewise result in incorrect or misread dosages. The nurse's own mental state (one of experience with the drug, culture of the patient, and level of tiredness) can affect the transmission of knowledge, as can the patient's (or caregiver's) level of literacy and understanding. One survey of nurses themselves found that nurses "cited illegible physician handwriting and being distracted or tired as the primary causes for drug errors" (Clinical rounds, 2004, Nursing).
The six 'rights' of drug administration are: 1. Right Patient 2. Right drug 3. Right Dose 4. Right Route 5. Right Time 6. Right to refuse must be upheld, regardless of the challenges of the situation (Bullock & Manias 2011). Only effective communication can ensure that they are followed at all times. Healthcare providers on the same treatment team must communicate with one another, and carefully review drug orders if something seems amiss, rather than obeying by rote. Nurses must know how to listen to patients to assess the patient's…
References
Bullock, S., & Manias, E. (2011). Fundamentals of pharmacology. Frenchs Forest, Australia:
Pearson Education (6th ed). Australia.
Clinical Rounds: How nurses perceive mistakes. (2004). Nursing. 34 (11): 34. Retrieved
September 5, 2011 at http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=531200
Warfarin. (2011). National Institute of Health (NIH). Retrieved September 5, 2011 at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682277.html
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