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Communication aspects in pharmacy
Preventing medication errors institute of medicine 2007
Preventing medication errors institute of medicine 2007
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Medication errors are and continue to be a substantial problem in the health care setting. The definition of a medication error is “any preventable event that may cause or lead to inappropriate medication use or patient harm” (Brady, 2009). These errors are one of the major causes of harm to a patient while they are in the hospital. Medication errors is not a foreign concept to nursing, and the profession has come a long way in bettering the safety of the medication administration process. However, there is still a staggering number of medication errors that are happening daily. “About 15% of adverse events occurring in hospitals are related to medications” and an estimated 98,000 people in the U.S. die each year from medical errors with a …show more content…
Now, this specific study is referring to adverse events all over the hospitals such as the operating room, intensive care unit, and emergency room. This is important because nurses are not just on a medical surgical floor, nurses are throughout the hospital administering an assortment of medications to several different patients in several different age groups. When looking at the patient outcomes from this study, 19.1% experienced temporary disability, 7.0% were permanently disabled, and 7.4% died from an adverse event (Tzeng, 2013). Over 7% of patients died from a medication error that we as nurses strive to prevent, but unfortunately to err is human. We as humans are not perfect and make mistakes, but patients’ lives are at stake. Nurses must have compassion and love for caring for those around them, and when it comes to our patients we need to have the utmost care and heart for them. In 2007 the Joint Commission came to the conclusion that communication and procedural compliance were the two most frequently noted causes of medication administration errors (Tzeng, 2013). Communication errors can happen between anyone including the patients and physicians which it is why telephone read back is important when receiving a prescription order from a physician over the phone to reduce the number of transcription
For my research paper, I will be discussing the impact of medication errors on vulnerable populations, specifically the elderly. Technology offers ways to reduce medication errors using electronic bar-coding medication administration (BCMA) systems. However, skilled nursing facilities (SNFs) are not using these systems. Medication is still administered with a paper or electronic medication administration record (eMAR), without barcode scanning. In contrast, every hospital I have been in: as a patient, nursing student, and nurse uses BCMA systems. The healthcare system is neglecting the elderly. Nursing homes should use BCMAs to reduce the incidents of medication errors.
Nurses were the professional group who most often reported medication errors and older patients were those most often affected in the medication errors reports analyzed for this study (Friend, 2011). Medication error type’s revealed omitted medicine or dose, wrong dose, strength or frequency and wrong documentation were the most common problems at Site A where the traditional pen and paper methods of prescription were used; and wrong documentation and omission were the most common problems associated with medication errors at Site B where the electronic MMS was introduced (Friend, 2011). Reports of problems such as wrong drug, wrong dose, strength or frequency, quantity, wrong route, wrong drug and omitted dose were less frequent at Site B (Friend, 2011). The reduced incidence of omission errors at Site B supports suggestions that an advantage of the MMS is easy identification of patient requirements at each drug round time slot. Despite the finding of less omission errors at site B where the MMS had been introduced, there was a relatively high frequency in the incident reports of medication errors related to both omission and wrong dose, strength and frequency at both sites (Friend, 2011).
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).
Unver, V., Tastan, S., & Akbayrak, N. (2012). Medication errors: Perspectives of newly graduated and experienced nurses. International Journal Of Nursing Practice, 18(4), 317-324. doi:10.1111/j.1440-172X.2012.02052.x
Baccalaureate nurses are responsible for providing and ensure our patients safety. The knowledge from others mistakes can help informs nurses of extra precautions that we can take to ensure our patient’s safety. Risk Analysis and Implication for practice course helped me understand the steps I as a nurse can take as well as the facilities I work for to help reduce the number of medication errors that occur. Interviewing the pharmacist help me get a better insight to what facilities already have in place to help prevent medication errors. However like most things you have to have educated and compassionate caring staff to enforce and follow the guidelines set in place.
Some method such as audits, chart reviews, computer monitoring, incident report, bar codes and direct patient observation can improve and decrease medication errors. Regular audits can help patient’s care and reeducate nurses in the work field to new practices. Also reporting of medication errors can help with data comparison and is a learning experience for everyone. Other avenues that has been implemented are computerized physician order entry systems or electronic prescribing (a process of electronic entry of a doctor’s instructions for the treatment of patients under his/her care which communicates these orders over a computer network to other staff or departments) responsible for fulfilling the order, and ward pharmacists can be more diligence on the prescription stage of the medication pathway. A random survey was done in hospital pharmacies on medication error documentation and actions taken against pharmacists involved. A total of 500 hospital were selected in the United States. Data collected on the number of medication error reported, what types of errors were documented and the hospital demographics. The response rate was a total of 28%. Practically, all of the hospitals had policies and procedures in place for reporting medication errors.
Furthermore, short staffing affects the quality direct care each patient receives. The National Coordinating Council for Medication Error Reporting and Prevention (2012) states an estimated 98,000 individuals die every year from medical errors in the United States. One out of many significant tasks nurses do within their scope of practice is medication administration. Research shows a relationship between short staffing on medication errors: the longer the hours nurses work, the higher the chances of medication errors (Garnett, 2008). (include definition of medication error) Administering medications requires knowledge of patient rights, pharmacological information on the drug, adverse effects, proper dosage calculations, and hospital protocols. When nurses are assigned more patients, they are pressured to give due medications on time. Sometimes due to hunger or fatigue, nurses give the wrong medication to the wrong patient (Frith, Anderson, Tseng, & Fong, 2012).
Agyemang, REO, and A While. "Medication errors: types, causes and impact on nursing practice." British Journal of Nursing (BJN) 19.6 (2010): 380-385. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
A medication error is any preventable event that may cause or lead to inappropriate medication use or harm to a patient (NCCMERP 2014). The death rate for medication errors averages around 7,000 deaths per year. Lawsuits for medication errors were mainly made against registered nurses because nurses are the last people to check a medication before it is administered. 426 medication error related lawsuits were made against registered nurses. (RightDiagnosis 2014).
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
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.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
What classifies as a Medication errors? An error can occur any time during the medication administration process. A medication error can be explained as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer” (National Coordinating Council for Medication Error Reporting and Prevention, 2014, para 1). Rather it is at prescribing, transcribing, dispensing or at the time of administration all these areas are equally substantial in producing possible errors that could potentially harm the patient (Flynn, Liang...
Provider related factors contributing to medication errors include clinical practices associated with prescribing, transcription, dispensing, and administration and monitoring (8). In the aspect of medication safety, medication administration, storage and management of medications, and managing adverse events are regarded as crucial domains .When nurses perform mal-behavior on medication administration, it is said to be non-compliance, in turn, neglect of conduct, resulting in medication administration errors (MAE )probably. Therefore, studying nurse’s behaviour of medication administration is very important
This article discusses the importance of reducing interruptions during medication administration and ways to educate the heathcare staff in the hazards of interruptions. According to Lewis et al. (2012) “each interruption is associated with a 12.7% increase in medication errors.” The impact of interruptions in the clinical environment can result in serious or deadly mistakes. In the healthcare environment interruption include overhead pages, alarms, rounding by healthcare providers, and questions from other nurses or family members.