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Medication errors affect patient safety
Medication error in clinical setting
Medication errors affect patient safety
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The topic of this article is medication error related to chemotherapy drugs. Forty percent of medication errors have been related to chemotherapy drugs. It is imperative that the nurses are properly trained on these medications and fully understand what is being administered before giving it to the patient as well as know what the proper dose is before administering anything to the patient. More importantly the nurse must pay close attention to their patient’s response to the chemotherapy given to the patient or it could lead to a serious injury or death. Chemotherapy drugs are more dangerous than other drugs because of their narrow therapeutic index. What is therapeutic index you ask? It is the ratio between a toxic dose and a therapeutic dose of a drug so any medication error with chemotherapy drugs could be a fatal one. Chemotherapy drugs can be very toxic even at the prescribed therapeutic level recommended by the physician. The findings in this article shows that the patient themselves are the first line of defense in spotting errors in medications they receive because they obs...
The article quotes this as the “worst type of preanalytical error”. The reason behind this is the result of this error means that a patient is treated for a disease or illness that they are not suffering from. This could be by medication or treatments even as extreme as chemotherapy. Problems that then grow from this is the effects of the treatment can be life threatening as they are managing a condition that isn’t there. An example of this is if a patient is incorrectly prescribed warfarin, an anticoagulant to treat blood clotting but has no issues with blood clotting the blood will thin and increase blood pressure leading to serious health defects.
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
The purpose of this paper is to show most of medication errors occur on the night shifts and the weekend shifts in pediatric care, Bar Code Medication Administration System’s success on extremely low medication errors in pediatric care, and tenfold medication errors in pediatric care.
The authors of Computerized Physician Order Entry and Medication Errors in a Pediatric Critical Care Unit explored the effectiveness of computerized physician order entry (CPOE) systems on medication errors. The study’s stated purpose was “to see the impact of CPOE on the frequency of medication errors at the degree of physician ordering in a pediatric critical care unit (PCCU)” (Potts, A.L., Barr, F. E., Gregory, D. F., Wright, L., & Patel, N. R., 2004). The work was set in the PCCU of an academic foundation and included medication errors from the two month period before the implementation of CPOE – October 4, 2001 to December 4 2001 – and a two month period after CPOE – January 4, 2002 to March 4, 2002 – with a one month period in between when no information was garnered in order to acclimate hospital staff (Potts et al., 2004). Each error was categorized into one of three groups: potential adverse drug effects (ADEs), medication ordering errors (MPEs), and rule violations (RVs). The results
Medication errors in children alone are alarming, but throw an ambulatory care setting into the mix and it spells disaster. When it comes to children and medication in the ambulatory care setting, the dosage range is drastically out of range compared to those that are treated in the hospital setting (Hoyle, J., Davis, A., Putman, K., Trytko, J., Fales, W. , 2011). Children are at a greater risk for dosage errors because each medication has to be calculated individually, and this can lead to more human error. The errors that are occurring are due to lack of training, dosage calculation errors, and lack of safety systems. Medication errors in children who are receiving ambulatory care can avoided by ensuring correct dosage calculation, more in-depth training of personal and safety systems in place.
Physicians ultimately decide what dose and drug will benefit the patient and restore them back to health. Held by the standards set by The College of Physicians and Surgeons, Physicians must abide by the Health Professions Act. Physicians are responsible to prescribe the right medication and right dosage. It is thought that physicians and other prescribers are ultimately to blame for medication errors. Although malpractices do occur among physicians, nurses are responsible to have a thorough understanding of the medications one administers to their patients. A nurse does not just simply do what they are told and administer drugs without having a thorough understanding and background knowledge. Nurses are to know the purpose of each drug they administer, the therapeutic effects, side effects which can be harmless or injurious, and adverse effects which is a severe negative response to the drug (2009). In reference to the previously mentioned scenario, the physician’s handwriting was careless and illegible. Although the Physician demonstrated lack of clarity, the nurse noticed the hastily written sentence signed by the physician and continued to administer the drug as she had routinely done the past couple days. Nurse’s should have a strong pharmaceutical knowledge background and be aware of the potential harm a medication could cause. In the process of medication administration, registered nurses are responsible to “determine that each medication order is clear, accurate, current and complete. Medications should be withheld when a medication order is incomplete, illegible, ambiguous or inappropriate; with concerns being clarified with the prescriber (CNO, 2015)”. The critical care nurse demonstrated ineffective communication, which was shown by failing to ask the physician for clarification. Another instance of miscommunication is during medication
Adverse drug events or medication errors that result from polypharmacy can often be difficult to predict and prevent. According to an article posted in the American Journal of Health-System Pharmacy (2012), drug –drug interactions may lead to increased toxicity levels when taken together. An example is the interactio...
Medication errors made by medical staff bring about consequences of epidemic proportions. Medical staff includes everyone from providers (medical doctors, nurse practitioners and physician assistants) to pharmacists to nurses (registered and practical). Medication errors account for almost 98,000 deaths in the United States yearly (Tzeng, Yin, & Schneider, 2013). This number only reflects the United States, a small percentage in actuality when looking at the whole world. Medical personnel must take responsibility for their actions and with this responsibility comes accountability in their duties of medication administration. Nurses play a major role in medication error prevention and education and this role distinguishes them as reporters of errors.
is considered cost efficient compared to the financial loss the hospital could have incurred if a medication error did occur. (Julie Ann Sakowski & and Alana Ketchel, 2013). E-prescribing is the provider’s ability to request patient prescription electronically directly to their choice pharmacy. E-prescribing is meant to enhance patient safety and aid in reducing medication error. E-prescribing and Bar Code technology work together to provide the ‘right” medication to the patient. When the drug’s bar code is scanned, it alerts the pharmacy staff if there is an error in the medication being dispensed. E-prescribing is supposed to help avoid the errors that occur when providers manually prescribe medications and also help to lower cost by offering less expensive medication.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
When we hear the words, cancer treatment, our minds naturally shoot straight to chemotherapy. Chemotherapy is one of the most commonly used ways to treat cancer. Chemotherapy did not have original plans to treat cancer patients, but it did have other plausible problems to aid. After WWII, lymphoma, a form of chemotherapy, was used to help soldiers who were harmed by mustard gas (Chemo Brain, 2012). This medical advancement continued to progress into what we now know as chemotherapy. However, no action takes precedence without effects, good or bad. Although chemotherapy is given to cancer patients in hopes of a positive outcome, chemo can have negative effects. Common effects that are seen in cancer patients who have received a form of chemotherapy treatment may experience: “chemo brain”, anemia, and nausea along with vomiting (Chemo Brain, 2012). Like any drug/treatment, chemotherapy can have a negative impact on a cancer patient.
Nurses are expected to provide a competent level of care that is indicative of their education, experience, skill, and ability to act on agency policies or procedures. In a study of 1,116 hospitals Bond, Raehl, and Franke (2001) found, “Medication errors occurred in 5.07% of the patients admitted each year to these hospitals. Each hospital experienced a medication error every 22.7 hours (every 19.73 admissions). Medication errors that adversely affected patient care outcomes occurred in 0.25% of all patients admitted to these hospitals/year”(p. 4). This means at least one medication error occurs every 24 hours in those facilities studied, and these are preventable errors. The main responsibilities of nurses when administering medications are to prevent or catch error, and report such error. Even if the physician or prescribing health care professional has made a mistake in the order, it is the nurse’s job to question the
While chemotherapy is beneficial at curing or helping a disease such as cancer, it can has a negative effect on a person’s body too.
For most, the primary fears associated with cancer are connected to the effects of treatments. If the patient is diagnosed when the cancer is still in the early stages, more than likely surgery is the appropriate treatment. However if the cancer has developed into an advanced stage, a more drastic treatment is necessary.
I was also responsible for monitoring medication orders and reviewing patient profiles to ensure that the proper drugs and dosages were prescribed and that the pharmacy technician had prepared them properly. In many instances there were mistakes made in the preparation phase and sometimes even before, with incorrect dosages or drugs being prescribed and prepared, which could result in serious adverse effects for the patient. A clinical pharmacist’s role, however, is to make sure that these mistakes never reach the