...“One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase… (Smeulers, Verweij, Maaskant, Boer, Krediet, Nieveen van Dijkum & Vermeulen, 2015). Even though medication administration safety measures have been applied as healthcare continues to grow, there are still errors made. Safety measures have been implemented over the years in attempt to be thoroughly safe as one can be. However, administration of medications is still a target point for health care errors, as the nurse still must critically think before administering a medication to a patient. Using the Donabedian Model, structure is the first level to be examined to seek improvement in medication administration safety. Some examples of the structure level are facility, equipment, and staff and their qualifications (Shi & Singh, 2015). When discussing medication...
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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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...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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...importance in their role of medication administration. Pharmacology knowledge allows the nurse to carry out safe medication administration, monitor medication actions, educate patients, and act legally and ethically within the pharmacological parameters. This knowledge is also vital for the nurse practititioner in their role of nurse prescribing. Pharmacology plays a huge part in these roles for the nurse. This essay below will elaborate on the importance of pharmacology for the five reasons of safe medication administration, monitoring of medication actions, patient education, legal and ethical aspects of pharmacology and the nurse practitioner. Firstly, safe medication administration. To administer drugs safely it is the nurse’s responsibility to have knowledge of the prescribed medications as well as their therapeutic and non therapeutic effects. Knowledge of the medications include, knowing its approved drug name and classification, correct dose and route of administration. A medication may have as many as three different names- a chemical name, a generic (proprietary) name and a trade name (Crisp & Taylor, 2011). A chemical name refers to the chemical makeup of a drug, a generic name is the drug name listed in official publications such as the MIMS annual, and the trade name is the name manufacturers have registered the medication as. In a clinical setting medication is normally dispensed using the generic name to avoid confusion, but because medications may come under a number...
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...To provide safe drug administration, the nurse should practice the “rights” of drug administration. They are: 1. The right client 2. The right drug 3. The right dose 4. The right time 5. The right route Experience indicates that five additional rights are essential to professional nursing practice; 1. The right assessment 2. The right documentation 3. The client’s right to education 4. The right evaluation 5. The client’s right to refuse The right client needs to be ensured by checking the wrist band, and by checking a second piece of identification. This could be a picture on the chart, or a case number that is both on his chart and wristband. This must be done before any medication is administrated. The right drug means that the client receives the drug that was prescribed by a physician (MD), dentist (DDS), podiatrist (DPM), or an advanced practice nurse with the license to write prescriptions (APRN). The use of computerized systems to record medications has helped to decrease medication errors, because nurses are not trying to read written forms of the prescriptions. Dr.’s can electronically add a new medication order to a pt. chart from any location. If there is a phone order or verbal order it must be cosigned by the prescribing physician within 24 hours. The components of a drug order are as follows: · Date and time the order is written · ...
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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 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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... Final Project N311 Dr.Peggy Shipley Shannon McKnight 6/14/2014 2. Introduction According to the Institute of Medicine there are more than a million injuries and almost 100,000 deaths associated with medication administration errors every year in the healthcare profession. Administration of medication is a large part of every day nursing care. As the patient’s primary advocates, it is the nurse’s responsibility to make certain these medication errors do not occur and to uphold the patient’s safety. Hebda & Czar (2013) state, “The desire to reduce or eliminate medication errors focuses attention on computerized physician order entry (CPOE), Bar Code Medication Administration (BCMA), and e-prescribing”. With the growing amount of medication errors, many institutions are introducing the Bar Code Medication Administration System. This is a system that will aid in assuring the right patient is getting the right medication and reduce the risk for medication errors. Although BCMA will not be a remedy for medication errors, it can provide a safeguard that is not possible with manual method. The implementation of the Bar Code Medication Administration system has been highly proven reduce the number of medication errors, improve patient safety, and increase the nurse’s job satisfaction. 3. Barrier to the Implementation Understanding the barriers to change is one of the...
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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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...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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...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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...include expulsion from Indiana Wesleyan University. Thesis The health care industry each years spends millions in medication errors that could be prevented. By implementing a data entry system that would allow access by medical professionals and pharmacies to collaborate and reduce the chance of medication errors dramatically. The data systems are pricy but when compared to the cost of medication errors and loss of lives it saves most medical establishments money. Annotated Bibliography The need for data entry systems to reduce medical errors Rinda, J. (2012). integration helps clinicians reduce medication errors. Health Management Technology , 33 (10), 12-13. With the risks of medication errors endangering lives, the technology has been gearing towards linking smart infusion pumps with health information platforms. Electronic health records have already been developed and are currently being used in some areas. This can lead to reductions in health care costs and increase in workflow. The medication errors could result in 400,000 preventable injuries each year. 1.5 million errors occur in the U.S. each year, resulting in $77 billion in cost annually. The iv integration system which is a form of the medication entry system, resulted in no iv related medication errors within the first 90 days used at Lancaster General Hospital. With the right implementation any healthcare would be able...
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...subject of safe administration of medicines. The assignment will outline both legal and professional standards that have been set out by government and professional bodies for nurses and other health care professionals to follow whilst administering medicines. It will then go onto analyse actual and potential problems that may occur when a professional is trying to achieve these standards. This assignment will be supported by literature findings. The conclusion will reflect what is written. The administration of drugs could be defined as the way in which drugs are selected, obtained, delivered, prescribed, administered and reviewed to make sure that the medicine is having the desired affect (Dougherty et al 2004). Drug administration is an integral part of a nurse’s role and as such responsibility for correct administration of drugs rests with the nurse (O’Shea 1999). It is stated that nurses spend up to 40% of their time administrating medicine (Armitage et al 2003) In order to perform this intervention safely a nurse needs to know about the drug its immediate effect and any side effects it may cause. This role involves safe handling and administration of medicines, the role also includes the nurse being responsible for the patients knowing what medicines they are taking and why. Legal, professional and cultural boundaries are changing in health care settings, which mean that a nurse’s role is now medicines management. (Dougherty et al 2004). Medication errors can place...
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...Risk Management with Medication Administration Victoria Ferguson National University HTM 680 Robert Kaye June 29, 2013 Risk Management with Medication Administration Medication administration is an act that can go very wrong very fast. Sometimes it can be corrected and sometimes the patient dies. The benefit of learning from our mistakes is that we learn what not to do in the future. Mistakes with such high risks involved should always be investigated thoroughly and checkpoints should be put in place. This is where risk management comes in to play. First thing to do is identify the risk. In the Children’s Hospital case it was the miscalculation of dosage which ended in a severe overdose to a child. Next step is to assess the situation. Figure out what exactly went wrong every step of the way (creating a flow chart is a good tool for this as it helps to visualize the steps). Finding blame and arguing is non-productive and should be held to a minimum. Children’s Hospital approached this subject quite well. They gathered together a group and were not told the name of the patient or the staff that were involved in the incident. Emotions can really get in the way of progress and when dealing with the safety of lives, you need a solid focus. The next step is to manage the information that has been produced along with a new plan of action for the future executions of medicine administration. Everyone should be trained well on the new procedure. There is a basic...
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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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