...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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...Plan For Compliance 3 Provider and staff education 4 Care team communication 4 Patient Discharge Education 4 Justification 5 Works Cited 6 Executive Summary The purpose of this report is to summarize, analyze and evaluate the compliance status of Nightingale Hospital to Joint Commission requirements. This report will focus on medication management, specifically anticoagulation therapy and the patient and staff education associated with it. In an effort to maintain the highest quality of care for our patients, we must continue to work towards a reduction in adverse anticoagulation related events. This will involve proper pre-discharge instructions and education with the patient and improved communication between the nurses, physicians and pharmacists to ensure the best possible outcomes. Compliance Status Source: (Nightingale Community Hospital, 2014) As the preceding graph shows, the adverse events related to anticoagulation therapy is trending downward. However, this leaves ample room for improvement of current processes to continue the downward movement to zero incidents. Continued progress in the area of medication management is required to maintain TJC standards compliance and is listed as a National Patient Safety Goal for the current term (The Joint Commission, 2015). During TJC audit two years ago, it was found that the hospital lacked documentation of appropriate patient evaluation/education (PC.02.03.01), was not effectively managing its policies regarding...
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...Improving The Safety Of Using Medications In Hospital Settings Background Improving the safety of using medications was the third Joint Commission safety goal for 2014 (Hospital National Patient Safety Goals, n.d.). Every year medication errors are a significant cause of morbidity and mortality in hospitals. Simply put, medication errors come from incorrect dosing by physicians on prescriptions, administration of the wrong dose of the prescribed medication to the patient, failure of the healthcare provider to administer prescribed medication, or failure of the patient to ingest said prescribed medication (Choo, J., Hutchinson, A., & Bucknall, T., 2010). Role of the Nurse According to the Journal of Nursing Management, nurses should practice the five rights of administration that they are taught while in school. Those rights are: right medication, right dose, right route, right time, and right patient (Choo, J., Hutchinson, A., & Bucknall, T., 2010). While checking the five rights is useful in the final stages of the administration process, the rights do not reflect the other complex steps to medication administration, such as preparation, labeling, determining interaction, etc. Normally medication errors are never the result of an isolated human error. They may come from workplace stress, distractions, interruptions, insufficient training, and misinformation (Choo, J., Hutchinson, A., & Bucknall, T., 2010). The individual nurse should make sure that...
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...skills standards regarding the design and review of services promote independence, which in turn is captured within organisational policies and procedures. Second, learners will investigate factors that can affect participation, independence and choice, including systems for assessing and minimising risk. Finally, learners will investigate the administration of medicine and the effectiveness of policies and procedures for administering medication in achieving the best possible outcomes for users of services. Learners will study legislation and factors that affect the care that is received. Learners will also examine strategies to promote the best possible outcomes for individual users of services. INTENDED LEARNING OUTCOMES On successful completion of this unit a learner will: 1 Understand how the design and review of services promotes and maximises the rights of users of health and social care services 2 Understand how to promote the participation and independence of users of health and social care services 3 Understand the responsibility of managing and monitoring risks in health and social care settings. 4 Understand how good practice in the administration of medicine is essential for users of health and social care...
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...Medication Administration March 12, 2014 Medication Administration Without a doubt, the single biggest aspect of healthcare that needs to improve with regards to safety is medication administration. We, as healthcare providers, are human and therefore human errors will happen, but we still must strive to limit these errors to the best of our abilities. The QSEN Competency definition of safety reads, “minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (QSEN.org 2014). I understand this as we are obligated to minimize the risk to all patients and fellow healthcare professionals through our own practice, but also by perpetuating an environment that does the same. It is not only our job to be safe in our own practice, it is also our obligation to promote safety in other’s practice. In turn a system becomes effective with regards to safety. Over the course of the last week I’ve realized how difficult it can be to provide safety in medication administration. I’ll tell you how being my own patient and how deciphering the world of medications opened my eyes to how difficult medication administration is for the patient and the healthcare provider. My first observation as I started this exercise of being patient and nurse was that I must be very sick because I’m taking a lot of medications. This is actually quite typical of many patients that we might care for though. Some issues that can arise from this fact is that...
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...Abstract Healthcare unlike many high-risk industries has made slow progress in improving 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...
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...1. What are the risk factors for low back injury? The risk factors for low back injury are: occupations that require heavy lifting, elderly, sports, poor posture, osteoporosis, arthritis, disk disease, obesity and poor physical strength. 2. Describe differences between acute pain management and chronic pain management. The differences between acute pain management and chronic pain management are: acute pain can be treated right away and the patient’s pain might be relieved. The patient with chronic pain will have to be treated long term. 3. Identify common concerns related to long-term use of opiod medications. The common concerns with opioid medications are: the risk of drug tolerance, drug abuse, respiratory depression, and accidents related to the use of opioids. 4. What are the top three nursing diagnosis priorities for a patient with an acute exacerbation of chronic pain? The top three nursing diagnosis priorities for a patient with an acute exacerbation of chronic pain are: 1. Acute or chronic lower back pain. 2. Risk for injury due to lower back pain. 3. Risk for social isolation. 5. Identify and explain at least two adjuncts, other than medications, that are used for chronic pain management. Two other treatments that can be used to treat chronic pain are the rotation of hot and cold packs to reduce inflammation, and sooth the pain. The second adjunct treatment is relaxation by giving the muscles a break. 6. Describe the possible impact...
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...are the risk factors for low back injury? 2. Describe differences between acute pain management and chronic pain management. 3. Identify common concerns related to long-term use of opiod medications. 4. What are the top three nursing diagnosis priorities for a patient with an acute exacerbation of chronic pain? 5. Identify and explain at least two adjuncts, other than medications, that are used for chronic pain management. 6. Describe the possible impact of chronic pain on the psychosocial, spiritual, cultural, and developmental levels of a patient. Asthma 1. What are the risk factors for asthma? 2. Describe routine nursing care that would be appropriate for a homecare patient. 3. Describe education a patient requires to self-administer nebulizer treatments. 4. What are the top three nursing diagnosis priorities for the patient having an asthma attack in the home. 5. Identify three common complications for untreated asthma. Explain the nursing care designed to prevent each of these complications from occurring. 6. Describe the effects of common asthma medications. 7. Prepare for teaching a patient with limited English proficiency how to manage asthma at home. Tuberculosis 1. What are the risk factors for tuberculosis? 2. Describe three different types of tuberculosis and the common treatment recommendations for each. 3. Identify common concerns related to long-term administration of tuberculosis medications. 4....
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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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...Chronic Pain What are the risk factors for low back injury? Physical and family risk factors • Being middle-aged or older • Being male • Having a family history of back pain • Having had a back injury before • Being pregnant. A woman's back is significantly stressed by carrying a baby. • Having had compression fractures of the spine • Having had back surgery before • Having spine problems since birth Risk factors you can change with lifestyle changes • Not getting regular exercise • Doing a job or other activity that requires long periods of sitting, heavy lifting, bending or twisting, repetitive motions, or constant vibration, such as using a jackhammer or driving certain types of heavy equipment • Smoking. People who smoke are more likely than people who don't smoke to have low back pain. • Being overweight. Excess body weight, especially around the waist, may put strain on your back, although this has not been proved. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These can lead to low back pain. • Having poor posture. Slumping or slouching on its own may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse. "Good posture" generally means your ears, shoulders, and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back. • Being under stress. Stress and other...
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...CHECKLIST FOR NABH ASSESSMENTS Issue No. 1 Issue Date: 03/ 11 Page 1 of 53 NABH Assessment Checklist Introduction This checklist will facilitate cross functional audits throughout the hospital as NABH standards are applicable Vertically as well as Horizontally across the hospital and its various functions. The checklist has 2 components namely: i. Primary: Essentially pertaining to area specific point ii. Secondary: Common requirements for the area This checklist can be used for practical guidance. The assessor should not limit the assessment only to this checklist and can add more points based on their experience and observations. This will help out in updating this checklist and making it more comprehensive in the 2nd version Version 1 Issue Date: 17/05/11 Page 2 of 53 NABH Assessment Checklist CONTENTS Clinical Areas S. No Department/Area Page Number 1. Emergency and Ambulance 5 2. Out Patient Department 6 3. Wards 7 4. Specialized wards 11 5. Palliative Care 12 6. Dialysis Unit 13 7. Intensive Care, Neonatal/ Paediatric ICU and High Dependency Units 14 8. Operation Theatre 17 9. Recovery Room 19 10. Endoscopy 20 11. Rehabilitation 22 12. Imaging: X Ray/ USG/ CT Scan/ MRI 22 13. Nuclear Medicine 24 14. Cardiac Catheterization lab 25 15. Laboratory: Haematology/ Microbiology 16. ...
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...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. An explorative...
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...care. Evidence-Based Nursing (EBN) involves the process of 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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...Standards for medicines management a We are the nursing and midwifery regulator for England, Wales, Scotland, Northern Ireland and the Islands. • We exist to safeguard the health and wellbeing of the public. • We set the standards of education, training and conduct that nurses and midwives need to deliver high quality healthcare consistently throughout their careers. • We ensure that nurses and midwives keep their skills and knowledge up to date and uphold the standards of their professional code. • We ensure that midwives are safe to practise by setting rules for their practice and supervision. • We have fair processes to investigate allegations made against nurses and midwives who may not have followed the code. b Standards for medicines management Introduction The Nursing and Midwifery Council (NMC) is the UK regulator for two professions: nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK and by setting standards for their education, training and conduct. One of the most important ways of serving the public interest is through providing advice and guidance to registrants on professional issues. The purpose of this booklet is to set standards for safe practice in the management and administration of medicines by registered nurses, midwives and specialist community public health...
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...Abstract An electronic bar code medication administration was a system developed and successfully implemented in a 118-bed Veterans Administration hospital in February 2000. Known as Barcode Medication Administration (BCMA), this software proved useful in generating fast and accurate medication administration as well as online patient medication records preservation. The application created by the Eastern Kansas Health Care System in association with Colmery-O’Neil VA Medical Center has been modified a number of times to meet the general requirements in all U.S. Veterans Health Administration medical centers. The implementation of Barcode Medication Administration software has enabled electronic bedside administration of medication of medications. Online Barcode technology is revolutionizing medication administration more aspects than originally thought, and is such a blessing to the business industry in terms of cost cutting. To be honest, the force driving the momentum in the adoption of the new systems has been majorly based on financial, rather than safety concerns. The fee for- service compensation systems has done exceedingly well in increasing revenue to hospitals resulting from additional technology-related charges levied on patients for each dose dispensed (Cohen, 2002). From the evidences adduced in this research, bar code technology seems to hold great promise for general improvements in medication safety and efficiency. Nevertheless, evidence so far is limited...
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