...Nurses are the fine line between medication administration errors and medication administration error prevention. Nurses should be required to go above and beyond to avoid medication errors for the safety of the patient. This paper includes studies on the nurses knowledge, adherence and opinions on two-nurse double-check method for medication administration. The research concludes the evidence proved to be insignificant. Keywords: time management, medication errors, patient safety, double-check medication administration THE LINK BETWEEN INDEPENDENT DOUBLE CHECK AND PATIENT SAFETY Introduction The risk of medication errors will always exist, despite the many methods of preventing medication administration errors. The steps of the medication administration process are vital for patient safety. Unfortunately due to the lack of nurses in hospitals, nurses tend to skip steps of safe medication administration because of patient load and the time required to perform the steps. Are double checks essential in preventing medication errors? A diabetic patient on the medical-surgical floor needs the...
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...Prevention of Medication Errors in Nursing Practice Breton Sloop NU 332 Foundations of Nursing November 11, 2015 Teresa Faust Mary is a critical care nurse at a busy urban hospital, who is trying to catch up on her morning medication administrations. Her patient had required several procedures that morning, due to an alteration in his condition, and now Mary is behind schedule. The patient is intubated, so she decides to crush the pills, and administer them through his nasogastric tube. The patient’s medication is already late, but in her dash to give the medication as quickly as possible, she fails to notice the “Do Not Crush” warning on the electronic medication administration record (MAR). She then crushes an extended-release calcium...
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.... There are many factors that contribute to medication errors resulting in consequences to both patient and nurse. Factors that can contribute to errors include illegible handwritten drug orders, confusing drug names, and the use of nonstandard or unclear abbreviations (Neal, 2006). For the patient, the effect of drug errors can range from no side effects to death. For the nurse who commits a medication error the consequences can range from additional training and supervision to lawsuits and revocation of licensure. Medication errors can occur at any stage in the process of delivering medications to patients, from the originating prescriber to the pharmacy, but the majority of medication errors occur during administration. Adherence to established safety procedures by all healthcare professionals can help to reduce medication errors. Errors occurring during the administration process are likely due to one of the steps of the five rights of medication administration being omitted: the right patient, medication, dose, route, and time, with the most frequent errors resulting from omission, wrong dose, and wrong medication (Davidhizar & Lonzer, 2003). Factors that can exacerbate errors include problems with the drug distribution system, inadequate staffing levels, environmental factors (e.g., distraction), nurses working in unfamiliar units, and not following standard policy and procedure. According to Davidhizar and Lonzer (2003), the following strategies are useful in addressing...
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...Medication errors are flaws in the healthcare system that can result in injury, disease, and even death. There are ways to prevent these mistakes and to make a facility more safe by enforcing certain rules and regulations. In order for these rules to be effective, the entire healthcare team including doctors, nurses, pharmacy, etc., need to cooperate and work together. It's very common for someone to make a clumsy move which is why triple checking is becoming more and more effective today. First scenario: A patient was prescribed two completely different medications to her but with similar names. The first drug was hydroxyzine 100 mg PO QID as needed and the second was hydrochlorothiazide 25 mg PO daily. When the nurse was supposed to be giving the 100 mg dose of hydroxyzine they instead pulled four 25 mg hydrochlorothiazide pills from the automated dispensing cabinet. The nurse proceeded to administer the medication before using the barcode scanning system. Not using the barcode was her first mistake. The nurse scanned the barcode after the patient had already consumed the pills. A pop up error came up saying "medication not found" because the daily dose of hydrochlorothiazide had already been given that day. Thankfully, the patient survived this incorrect administration of medication with no side effects to report. The nurse in this scenario administered the wrong medication that ended up being four times the prescribed dose of something that had already been given...
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...Wrong-time Medication Administration Errors NUR 45200 Quality and Safety for Professional Nursing Practice May 1st, 2016. Patient Safety/Quality Improvement Statement and Chosen Cause that will Drive Improvement Wrong-time medication administration error has been identified as one of the major components of medication errors committed my health care professionals especially nurses. Several factors or causes are responsible for this error, but nursing factor will be discussed in this essay focusing majorly on medications pass time insufficiency and med pass rule of 30 minute. Nurses are directly involved in medication administration and they can play a huge role in preventing or reducing wrong-time medication administration error. Current Knowledge of the Patient Safety Concern/Quality Improvement Issue Wrong-time medication administration error is the most common type of medication errors committed by nurses. It can simply be defined as failure to administer medications 30min before or after the due due/scheduled time. The last element of the 5 Rights -- right time -- has often been governed by the "30-minute medication rule." For as long as many nurses can remember, every hospital, unit, and nurse has passed medications by this rule, which says that a medication is "on time" if it is administered 30 minutes before or 30 minutes after the scheduled administration time (although some hospitals have policies that allow a 60-minute, rather than a 30-minute, window). Such...
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...patient’s safety. The role of nursing in improving medication safety has been largely underestimated. Much of the research undertaken to date in relation to adverse medication events has neglected the impact that nurses have or could have in improving patient safety. In examining literature regarding adverse medication events one can see the urgent need for significant improvement in medication practices and processes. In addition that this health care issue will only improve with the participation of all disciplines working towards a common goal of improving the safety of those in our care. Introduction Medications play a key role in healthcare but can also be a significant key cause of medical error and of adverse patient outcomes. Nurses by the nature of their roles in medication administration can be the last line of defense in eliminating or reducing adverse medication events. The administration of medication is a common and almost routine activity in a nurse’s daily work, yet it is fraught with complexity and risk for both the patient and nurse. As a student nurse working in partnership with a registered nurse I have observed a variety of practices in medication administration that have varied from what I have been taught in class. On reflecting on these practices and questioning nurses why such practice has been adopted has illustrated to me both the flawed processes and environment that nurses provide care in. Nurses will need to develop an understanding of how the...
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...Drug Errors Introduction Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit commission 2002). Drug administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (O'Shea 1999). The patient is expected to receive the correct medication at each drug round but several studies have shown that this is not always the case (Raju et al 1988, Ferner 1995). Medication errors do occur and are a persistent problem associated with nursing practice (O'Shea 1999). The aim of this paper is to answer the question: Why are nurses still continuing to make drug errors? In order to answer this question this paper shall examine the guidelines that nurses must adhere to when administering drugs, shall provide a definition of a drug errors, look at reasons why drug errors occur and approaches that are aimed at reducing drug errors on the ward. There are a number of pieces of legislation that relate to prescribing, supply, storage and administration...
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...Medication Errors Stephanie Stephens January 9, 2016 NU1426 ITT TECH Nurses must always follow the six rights of medication administration thoroughly to ensure patient safety. These rights include right medication, right route, right time, right client, right dosage, and right documentation. When one of these rights is not followed a medication error has occurred and must be reported immediately. Medication error prevention is vital in the role of the nurse. There were many contributing factors leading to this medication error and there are many ways to avoid medications errors. Looking at the reasons why medications occur helps the nurse understand what areas to be most vigilant. The main areas of medication errors are distractions/ interruptions, medication education, interpretation of an order and poor calculations. Patients during their time in the hospital will receive medications. Distractions will occur throughout a nurses shift, losing concentration at the task at hand can lead to serious and harmful mistakes. It is important for the nurse to let her surrounding nurses know when she/he is pulling medications so that there isn't any distractions. Also, a quiet environment when taking telephone orders so that the order can be heard clearly and dictation from the provider is understood. Another medication administration error prevention for the nurse is to allow for delegation and to not take on to much. When a nurse is in the process of administering medication...
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...Medication Bar Code Scanning Bar Code Medication Administration (BCMA) system is a bar code system that was designed to prevent errors in medication administration, save time, give timely feedback, and improve patient safety in the health care field. Not only are these goals of the bar code medication scanning system, but it also improves accuracy and produces online records of the patient’s medication administration in their file (Weston & Roberts, 2013). The bar code scanning system has greatly impacted the medical field in many ways, especially nursing. In this paper, I will specifically be talking about how the bar code medication administration (BCMA) scanning system has impacted nursing, nursing care, and patient outcomes. I will...
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...Medication Administration Errors A medication error is commonly defined as a deviation from the physician’s medication order in the patient record or an error occurring in the medication-use process. (Choo, Hutchinson, & Bucknall, 2010, p. 854) The review of literature in the article “Nurses’ Role in Medication Safety” attempts to identify the challenges of medication safe delivery in the clinical practice by reviewing multiple studies. The article authors define two different approaches to viewing human errors in medication errors. The “person” approach focuses on the individual nurse making the error and focuses on the unsafe behavior related to inattention, forgetfulness, carelessness, negligence or recklessness. With this approach, errors are reduced by modifying human behavior. The system approach focuses on the working conditions and looks at errors as results of systems problems within the clinical setting, such as staff shortage, increased workload, interruptions etc. (Choo, Hutchinson, & Bucknall, 2010, p. 855) The system approach is more conducive to changing processes which contribute to errors instead of blaming the individual. Work environments are reported as being a major influence in medication errors. The authors cite a study by Sanghera et al. (2007) which states lighting, nurse interruptions, and poor communication amongst team members contribute to medication errors. Another study is cited as reporting increased workload for nurses as another cause of medication...
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...Medication errors are a serious threat to the provision of care in health institutions. There are concerns that healthcare agencies have not made much progress in ensuring that the consumers of health services receive the appropriate medication from the hospital personnel (Rash-Foanio et al., 2017). Among the methods of enhancing accurate medication procedures are increased training of health care providers engaged in administering medications and the expansion of oversight from government agencies. Additionally, many health institutions have transitioned to computer-based applications; Electronic Health Records (EHRs) – that store patient data to ensure accurate physician orders. Medication errors can result from the lack of patient/staff education and the overwhelming workload of nurses, and ultimately could lower hospital income due to an increase in the expenditures used to correct these errors. Health institutions and their respective EHR systems need to create more algorithms that flags possible errors in medication prescription/administration to track and lower the incidences at which the healthcare employees are likely to make mistakes. Causes of Medication Errors Patient safety has been a...
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...Running head: PRACTICE PROBLEM: MEDICATION ERRORS Practice Problem: Medication Errors Amy Courcier Grand Canyon University NRS-433 V Christine Thompson-Sanxter September 22, 2012 Career progression: preventing drug errors. Ashurst, A. (2008). Career progression: preventing drug errors. Nursing & Residential Care, 10(10), 498-501. Abstract: Making errors in drug administration can have serious consequences for the patient and the nurse involved. In the second of two articles Adrian Ashurst discusses the ways that risk can be minimized and drug errors prevented. Nurses' experiences of drug administration errors Schelbred, A., & Nord, R. (2007). Nurses' experiences of drug administration errors. Journal Of Advanced Nursing, 60(3), 317-324. doi:10.1111/j.1365-2648.2007.04437.x Abstract: This paper is a report of a study to describe the experiences of nurses who had committed serious medication errors, the meaning these experiences carry, and what kind of help and support they received after committing their error. Background. Medication administration is an important nursing task. Work overload, combined with increased numbers and dosages of medication prescribed, puts nurses at risk of making serious errors. A drug error has the potential for disastrous consequences for patients. What is sometimes disregarded is the effect on the nurse involved. The majority of research on nurses and medication errors is framed within biomedicine, law and management. Methods...
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...Medication Safety Medication plays a key role in healthcare but can also be an important key cause of medical error. Patients are entitled to receive safe care including receiving the correct medications. The administration of medication is a daily routine for nurses therefore, it is vital to remember the “Five Rights” of medication safety. The other issue that we are facing on the medical surgical floor is stress. The last issue is that staffs are being interrupted in medication room. Many different things can go wrong when it comes to the administering medication, for example communication between the patient and the nurse could go wrong, or the labeling of the medication, even the dosage can cause improper usage of the drug. The question is what role do nurses play when it comes to medication safety? Nurses play many different roles in the world of medicine; however the most important role is to assure that patients are receiving their medication safely. One of the recommendations to reduce medication errors and harm is to use the “Five rights: the right patient, the right drug, the right dose, the right route, and the right time” (Choo, Hutchinson & Bucknall, 2010). Verifying the patient’s identity ensures that the correct patient is receiving the medication, confirming that the medication written on the order is the same medication being prepared, ensures the right drug, dose and route is given. Some medications must be given at specific time, so it imperative to provide...
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...“Nursing’s Role in Promoting Quality and Patient Safety Assignment” Nurses inherently are concerned with patient safety. They are best positioned to prevent medical errors at the bedside. There is a moral and legal imperative to implement safe practices at all times. Nurses and the profession are negatively impacted when medical errors occur. Until recently the Centers for Medicare & Medicaid Services (CMS) mandated that all patient medications be administered 30 minutes before or after a scheduled time (Department of Health & Human Services [DHHS] & Centers for Medicare & Medicaid Services [CMS], 2011, December 22). Given the expanding role of nurses, the CMS mandate is now unrealistic and counter-productive. The Institute for Safe Medication Practices (ISMP) addressed this issue by creating an Acute Care Guideline for the timely administration of schedule medications. Institute for Safe Medical Practice The ISMP is dedicated to preventing medical errors by promoting safe medication administration procedures (ISMP, 2013a). The ISMP reviews all facets of safe medication administration. Medication errors frequently result in debilitating injuries or death. The ISMP posits that the most frequent medical error is medication administration. Medication error affects over 1.5 million people annually (ISMP, 2007b, p. 1). The ISMP has committed staff and resources to reduce medication errors. It has developed training and educational programs for health care staff and consumers...
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...researching and implementing proven evidence in providing better patient care and is crucial as the role of the nurse is ever expanding (Banning, 2005). This essay will demonstrate that as a student nurse, the author has gained the necessary skills to conduct an evidence-based literature search and review and implement that knowledge into practice. Starting with a brief discussion on EBN it will go on to identify a suitable research question. During a placement on a medical ward the author noticed that nurses experienced many interruptions whilst conducting medication rounds and this review will consider ways to minimise interruptions and thus improve patient safety. Using the PICO acronym a suitable research question was formulated, ‘do interruptions during medication rounds increase the drugs administration errors made by nurses?’ A short description of the literature search is given and a summary of findings is presented in tabular form. Five original articles were selected and one chosen to critically appraise (see appendix 2). The rest of the essay will focus on reviewing the five articles. It will furthermore demonstrate the link between interruptions during drug rounds and patient and nurse safety, consider the implications of the studies for nursing practice and include the nurse’s perspective of these interruptions. Dale (2005) defines EBP as ‘the nurse making conscious judgements...
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