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Preventing Medication Errors in Healthcare: Strategies and Solutions, Lecture notes of Accounting

An in-depth analysis of medication errors in healthcare, focusing on the nine rights of medication administration and the factors contributing to these errors. It discusses various solutions to prevent medication administration errors, such as increased education for nurses, standardized dosing and packaging, and implementation of barcode medication administration programs. The document also highlights the importance of collaboration among nurses, pharmacists, and physicians in ensuring patient safety.

Typology: Lecture notes

2023/2024

Available from 06/14/2024

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NURS-FPX 4020

Enhancing Quality and Safety: Medication Errors Capella University NURS-FPX4020: Improving Quality of Care and Patient Safety Enhancing Quality and Safety: Medication Errors Medication administration is a critical process impacting patient care daily. There are many factors affecting medication administration which in turn, leads to administration errors. When a medication administration error occurs, there are effects on patient care, so preventing medication administration errors is imperative. Hospitals and facilities must implement procedures and policies that make the medication administration process safer and more efficient. Medication Errors Elements of the Issue The nine rights of medication administration seek to decrease the occurrence of medication administration errors. These rights include: the right patient, the right drug, the right route, the right dose, the tight time, the right form, the right documentation, the right action, and the right response. These nine rights are the framework that nurses follow when administering medications. As humans, we rely on our thought processes to perform actions. “The thought process can be broken down into 2 steps: planning and execution” [ CITATION Pop16 \l 1033 ]. Errors can occur throughout either of these two steps, unfortunately making medication errors even more difficult to avoid. Violation of the Nine Rights Medication errors occur throughout the many phases of medication administration. Beginning at prescription, through packaging and administration, there are many chances for an error to occur by violating any of the nine rights of medication administration. Nurses must find

it crucial to examine the medications being prescribed. Understanding fully why the medication is being administered, if the dosage is correct, and if it’s being given in the right format. Nurses, alongside physicians and pharmacists tackle this step together. We must then investigate the patient. This includes ensuring the patient can tolerate the medication: by using the correct route, ensuing vital signs are within parameters, and patient is alert enough for medication administration. After administration, the correct outcome and documentation are required. Many factors, including team communication, complexity of care and hospital policies or procedures can impact medication administration errors [ CITATION Fot14 \l 1033 ]. There are also factors dependent upon nursing knowledge and information available to staff. The environment in which medication is prepared and administered also impacts medication administration [ CITATION Fot14 \l 1033 ]. There are patient-specific factors, such as polypharmacy and geriatrics [ CITATION Asa18 \l 1033 ]. With an increase in prescribed medications, an increased chance for medication administration errors occurs. In the hospital setting, geriatric patients are at an increased risk of medication errors due to the possibility of medications metabolizing differently as they age. In the community setting, geriatric patients are at an even more increased chance for medication errors due to many factors involving their memory and cognitive status while self-administering their medications. Considering Solutions When seeking to prevent medication administration errors, there are solutions which must be considered. These solutions involve: increased education for nurses, standardized packaging and dosing, and implementation of a barcode medication administration program. These solutions would lead to increased patient safety and satisfaction by decreasing medication administration errors. Preventing Medications Administration Errors from the Start

Student nurses must spend more time focused on the medication administration process, not only in the clinical setting but even in lectures [ CITATION Fot14 \l 1033 ]. By having a more thorough understanding of the medication administration process, nurses will be better equipped to face the medication administration process without falling victim to the many distractions or potential for errors. Student nurses should also work to develop stronger math skills, by developing their math ability they will have a stronger foundation in which to develop their medication administration skills. Student nurses must be presented with stringent, informative educational experiences. In order to foster a safer nurse, less inclined to make medication errors, these skills must be honed from the start of their education. Standardized Dosing and Packaging By standardizing dosing and packaging, medication errors will decrease. In 2018, Brass, Reynolds, Burnham and Green evaluated the impact that packaging and dosing standardization had on medication administration errors. These researchers found that these changes lead to a decrease in medication administration errors among all age groups investigated. Impressively, those under the age of two saw a 24% decrease in medication administration errors, thanks to these standardizations [ CITATION Bra18 \l 1033 ]. Medication errors decreasing directly correlates to the implementation of standardized packaging and dosing [ CITATION Bra18 \l 1033 ]. Barcoded Medication Administration Program Barcoded medication administration programs involve linking the medication administration record (MAR) to the medications prescribed to each patient. These programs require a patient identifier to be scanned, along with the medication to be administered. These programs serve as a second check, ensuring no human error has occurred thus far in the medication administration process. By correctly scanning the patient and the medications, a relative reduction in medication errors of 85% was observed [ CITATION Mac18 \l 1033 ]. This tremendous decrease leads to improved patient safety and outcomes, but also streamline the

medication administration process – leaving nurses more time for direct patient care. Nurses can focus their time on direct interaction with patients, which in turn leads to increased patient satisfaction. Collaboration of Care Implementation Implementation of the aforementioned tools may appear to be a daunting task, and even costly, but the benefits greatly outweigh these drawbacks. Applying these tools will involve education for nurses, pharmacists, and physicians, alike. By ensuring that properly educated nurses, pharmacists and physicians, are working together, patient outcomes will increase – leading to invaluable savings throughout the future. Hospital administration should work to ensure the medication administration process is streamlined and distraction free, ensuring upmost patient safety. Conclusion Medication errors present an enormous challenge for health care organizations. These errors have a tremendous cost for hospitals, and patients. They cause poor patient outcomes, decreased patient safety, and even lead to death in some cases. Nurses face many challenges when administering medications, but by ensuring a proper educational foundation, rolling out standardized dosing and packaging and implementing barcoded medication programs, medication errors will decrease. References Asaad Assiri, G., Atef Shebl, N., Adam Mahmoud, M., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8 , 1-30. doi:doi:10.1136/bmjopen-2017-

Brass, E., Reynolds, K., Burnham, R., & Green, J. (2018). Medication errors with pediatric liquid acetaminophen after standarization of concentration and packaging improvements. Academic Pediatrics, 18 , 563-568. doi: 10.1016/j.acap.2018.03. Fothergill Bourbonnais, F., & Caswell, W. (2014). Teaching successful medication administration today: More than just knowing your ‘rights’. Nurse Education in Practice, 14 , 391-395. doi:10.1016/j.nepr.2014.03. Macias, M., Bernabeu-Andreu, F., Arribas, I., Nevarro, F., & Baldominos, G. (2018). Impact of a barcode medication administration system on patient safety. Oncology Nursing Forum, 45 (1), E1-E13. doi:10.1188/18.ONF.E1-E Pop, M., & Finocchi, M. (2016). Drug update. Medication errors: a case-based review. AACN Advanced Critical Care, 27 (1), 5-11. doi:10.4037/aacnacc