The prevention of medication errors is a process that should involve all staff in the emergency department. Yes, it is the registered nurse (RN) that administers the medication. However, patient safety is a concern in which all staff can assist. According to Kim and Bates (2013) medication errors represent one of the major concerns in patient safety. The process of medication administration first starts when the RN receives the order. From there the nurse must use the Pxysis dispensing system to obtain the medication. The problems noted in the emergency department (ED) at Florida Hospital Memorial Medical Center (FHMMC) has been distractions while the nurse is obtaining and preparing the medications. The issue is the Pxysis systems in the ED are not in closed rooms, they are located in the open at the nursing stations. This issue allows distractions while the nurse is obtaining the medications from the Pxysis.
This article define medication errors and when occur these medication administration errors (MAEs) such as one or more of the seven rights of medication administration (right patient, right drug, right dose, right time, right route, right reason and right documentation) are violated. Moreover, the writers suggest study more about nurses’ knowledges with and perceptions on preventing MAEs through this journal. Wulff, K., Cummings, G. G., Marck, P., & Yurtseven, O. (2011). Medication administration technologies and patient safety: a mixed-method systematic review. Journal of Advanced Nursing, 67(10), 2080-2095.
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
There is an opportunity at the Alvin C. York VA Medical Center to improve the safety of patients and staff during the administration of medications on the acute psychiatric units. Currently, all inpatient units at the Alvin C. York VA Medical Center utilize a Pyxis medication station to store patient medications. The current physical location of the medication room and Pyxis stations are not ideal. The Pyxis machine that stores the medications is placed against the back wall close to the nursing station. The location of the Pyxis is next to the medication room where the nursing medication administration cart and scanning system is located.
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. For instance, on my unit we are only allowed to administer enalapril intravenous push and metoprolol intravenous solutions for lowering a patients' blood pressure.
Lesson 7 Small-Group Discussion. Patient Safety Step 1 In a report by the Institute of Medicine (2006), Titled, Preventing Medication Errors, “The committee concludes that there are at least 1.5 million preventable adverse drug events (ADE’s) that occur in the United States each year.” These numbers are astonishing given the number of adults that are taking prescription medications daily. Most of the errors occur during the prescribing and administering steps and during an average hospital stay, a patient can expect to have one medication error occur every day (Institute of Medicine, 2006).
It is important to follow any guidelines and leaflets in medication, as this helps the safe administration of all medicines. It is also important to find out if a person has already taken medication prior to the care support worker giving them any. This is to ensure that you do not overdose the individual. A service user usually has a MARS sheet where the medication that is administered in signed off by the care worker that last administered it to them, so that the care support worker can clearly see that last time the medication was administered to service user, and when they are next due to have the medicine.
In care settings the currently legislations, guidelines policies and protocols relevant to the administration of medication would be: - The misuse of drugs act 1971 - The Medicines Act 1968 - Care Standards Act 2000 - The Health and Social Care Act 2001 The Control of Substances Hazardous to Health Regulations 1999 - The RPS Handling Medicines in Social Care Guidelines The recording, storage, administration and disposal of medication must be adhered by employees in accordance with the current policies and procedures. The policies are in place to protect everyone - training must be undertaken or up-to-date before support workers can administrate any medication.
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
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).
Fisher Week Three Response to McConnelly 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? Distractions have been linked to medication errors, consequently, and the ability to care for a solitary patient at one time clearly minimizes the distractions and interruptions that a nurse may experience during medication
By creating this comprehensive list of the medication plan given to the patient, the hospital pharmacist can then send this information to the community pharmacist and make sure that the information is held up to date. This would allow for a smoother transition for the patient and it would allow the patient to be more informed of their medications. The pharmacist is “poised to play an important role in improving medication management during transitions of care and reducing readmission rates” so the pharmacist should play a more active role to help ensure the best therapy for the patient (7). The pharmacist should ultimately design an ideal system for Medication Reconciliation to help reduce medication errors and better inform patients on ADEs to prevent any unnecessary medical
All prescription and OTC drugs must be kept out of their reach. Adult patients sometimes don’t understand the instructions on how or when to take their medications safely. Others simply aren’t able to take drugs without assistance. Part of in-home care includes monitoring and administering medications in the correct dosages according to schedule.
The primary prevention is the best way to eliminate the potential for exposure. Since hand washing is the most effective mean of spread of infection, it would be my primary goal to increase the compliance of hand hygiene among healthcare workers, but also an extensive education of patients and family members on hand washing before and after touching the patient as well as afar any contact with any potentially contaminated materials (surface, body fluids or respiratory secretions). Mandatory education of patients, visitors and healthcare workers, across the system as well as cross department compliance practices are single best mean of preventing the spread of infection. For example, every patient and family member can be educated about hand hygiene, use of PPE-personal protective equipment (face mask, gowns and gloves). Although, the practices are already being utilized, I believe the compliance is poorly monitored.