Medication Safety In Nursing

Reporting medication errors is beneficial to improve the learning process for nurses. The factors of workload, ineffective communication, and distraction all contribute to medication errors (Sears et al., 2013). Nurses often excuse the behavior of colleagues when a medication error occurs, or nurses will pass the buck to a senior nurse to report the medication error (Haw, Stubbs and Dickens, 2014). Implementing a no blame policy for reporting medication errors, and providing nurses with the knowledge and training to report medication errors will result in an increase of medication errors reported.

The idea remains that the dispersal of stable patients to MNAs in regards to medication administration allocates more time for RNs/LPNs to prioritize care for critical patients. A stable patient is defined by the New Hampshire Board of Nursing as one “whose overall health status, as assessed by a licensed nurse, is at the expected baseline”. Research conducted by Randolph and Scott-Cawiezell revealed trends in medication errors prior to and following the integration of MNAs. “Before the introduction of medication aides, error rates were as follows: RN (11.55%) and LPN (10.12%) with a mean error rate of 10.4%. Six months after the introduction of medication aides, error rates were as follows: RN (2.75%), LPN (7.25%) and medication aides (6.06%) with a mean error rate of 6.6%” Randolph & Scott-Calwiezell (2010) as cited in Budden (2011). While errors remain, the objective of reducing inaccuracies among primary nursing staff was achieved by

In care settings the currently legislations, guidelines policies and protocols relevant to the administration of medication would be:

Medication errors are defined as faults in drug prescribing, transcribing, dispensing, monitoring, ordering, and/or administration. These errors have significant potential for injuring or even killing a patient. Discussed below is an article that highlights the dangers of inaccurate drug administration.

To create an environment where these errors are a rare occurrence, all healthcare professionals must dedicate themselves to implementing QSEN's six core competencies each and every day. These professionals must also speak up when they see room for improvement in their workplace. Regardless of the healthcare setting or demographic of patients, safe outcomes are the purpose of providing patient-centered care. Since nurses are the largest subgroup of healthcare professionals, their ability to make strides towards improved medication administration is undeniable. As the nursing code of ethics states, nurses have the duty to protect the health and safety of those in their care (Winland-Brown, Lachman, O'Connor Swanson, 2015). By taking extra caution to administer medications correctly, this honorable obligation will always be within

The first way would be to check the 5 rights more than once and very carefully. The right patient determination is essential, and typically two-forms of identification are required. This can include checking the patients identification bracelet, asking the patient to state their name and date of birth, or scanning the barcode on the ID bracelet. The nurse must also confirm any allergies. The nurse must have the knowledge to determine if the drug prescribed is the correct drug, correct dose, correct route, and the correct time. To properly read the medication order the nurse must know all of the components and appropriately question anything that is unclear to them (Kee, 2012). To avoid drug error the drug order should be read three times. The fist check is when you review the MD order. The second check is to review the MD order with the eMar or Mar and the last check is to review the eMar or Mar with the medication. Another way the nurse can avoid medication error is to wear a safety vest that alters others they are not to be disturbed when administering

An ineffective communication can lead to errors in patient’s misdiagnosis and even medication on admission, during hospital stay, and after discharge, and whether these errors were potentially harmful. Medication use is potentially dangerous. Polypharmacy is increasing, and makes it harder to keep track of side effects and interactions and of potentially inappropriate drug combinations. “The risk of serious consequences, hospitalization, and death due to medication errors increases with patients’ age and number of medications (Scand J Prim Health Care, 2012)”. For example, the GP is supposed to monitor the patient's regular medication, but does not always do so. Lack of monitoring and keeping track of patients’ medication use is a main cause when a patient is given inappropriate drugs. When the nurse fails to communicate successfully with patients, it costs. It costs in unnecessary pain, in avoidable deaths, in poor health outcomes and in the prolongation of

This discussion is an excellent example and perception of the nursing scope of practice. Often, nurses understand what is within their scope of practice, and never think of what they are not allowed to do within their scope of practice pertaining to the setting they work in. While administering medications to patients is within our scope of practice, having the knowledge of why we are administering it and if it is appropriate to administer is also our responsibility.

Healthcare systems have traditionally been constructed around hierarchical perspectives used to train healthcare professionals (Porter-O’Grady and Malloch, 2007). In such hierarchies, senior physicians are often put at the top with certain power distances between other professionals. This can lead to difficulties in patient management when the patients safety is in question, but the healthcare professional involved may be hesitant to question the physician’s treatment plan or are too intimidated to voice out their opinions. In a study of over 2000 healthcare professionals including nurses and pharmacists, nearly half of the respondents felt pressured into administering a medication for which they had concerns, despite previously questioning the prescriber regarding the safety of the order (Institute for Safe Medication Practices, 2004). This was due to feelings of intimidation by the prescriber and an inability to effectively communicate their concerns. This resulted in 7% of the respondents reporting involvement in a medication error during that past year. Good interpersonal skills and effective communication ensures that concerns regarding patient safety can be brought up without seemingly challenging the knowledge of the other healthcare

Recognizing, acknowledging, and understanding medication safety is important when administering medications. Understanding which medications are high-risk ones, being familiar with the medications being given, remembering the five most important rights when administering medications, communicating clearly, developing checking habits, and reporting the medication errors will lead to safe outcomes for the residents. However, errors do occur from a lack of experience, rushing, distractions, fatigue, doing too many things at once, not double checking, poor communication, and lack of team work. It is not only the staff that commit errors, but also the work environment that contributes to the medication error. Two examples are poor reporting systems

Moreover, several studies have been conducted to examine the effects of low nurse staffing on patients hospitalization experiences, as well as its effect on nurse careers in the long run. A recent study by Frith, Anderson, Tseng, and Fong (2012) to explore the relationship between nurse staffing and medication errors, demonstrated that medication errors were higher in a cardiac care unit and non-cardiac care unit when staffing levels were lower. In addition, Frith et al. (2012) pointed out that medication errors increase by 18% for every 20% decrease in nurse staffing below the average due to failure to follow medication administration protocol As mentioned earlier, nurses perform the last and the most important step of medication administration. Thus, having adequate time to assess each patient efficiently and following the medication rights is critical to provide safe patient care and prevent errors.

When I read this guideline I realize my hospital don’t even have a Standing Operating Procedure (SOP) on administration of medication. I strongly believe this is one major contributing factor why the medication error took place in my practice area. A key point that I notice in this guideline is that, the nurse who is administrating medication should have knowledge especial the risk involved in this group of drugs and must have had read the guidelines on Medications

Yvonne, your post was extremely intriguing to me as a community health department is not an environment I have had the privilege of experiencing. Interestingly, the utilization of computerized order entry does not prevent the prescriber from ordering an incorrect medication dose or the wrong drug (Lapane, Waring, Dube’, & Schneider, 2011). Do the facility employ process to assure nurses are checking the medication in order to avoid the administration of an incorrect drug or dosage?

Student nurses and nurses spend majority of their time dedicating themselves to patient safety and quality of care. They do patient education, administer medications, perform head to toe assessments, but most importantly, they possess effective communication skills by listening to their patients. This is important because it allows the nurse to understand the concerns of their patients and advocate for their rights. According to the American Nurses Association (ANA), advocacy is when one uses his or her position to protect, support, or speak out for the rights and interests of another.” (Sanford, 2012). The nurse serves as a patient advocate in many situations. Some of these situations include but are not limited to patient rights,

Medication errors are preventable adverse events and costly to patients, insurance companies and health care organizations (Institute of Medicine, 2006). It is estimated that for every adverse drug event that occurs in a hospital, adds over 8,000 to the hospital stay (Institute of Medicine, 2006). One of the essential components in reducing medication error is a collaborative partnership with the patient and healthcare providers to facilitate communication. Patient education regarding risks, side effects, drug interactions and contraindications must be thoroughly reviewed with the patient (Institute of Medicine, 2006).