Introduction The purpose of this paper is to distinguish, outline, and evaluate the affects that workarounds have on patient safety and quality. According to Alexander, Frith, and Hoy (2015), a workaround is defined as when a problems arise within the workflow and a worker uses an unauthorized way around the health information technology system. This being said, workarounds are present in the hustle and bustle of the stressful hospital workflow, and in return can potentially lead to negative consequences. Therefore, it is essential for health care professionals to recognize the workaround, analyze their workflow, and then develop possible solutions.
The Workaround As nurses we juggle many things throughout our eight to twelve to sixteen
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The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the …show more content…
Furthermore, this implies that workarounds are present not only in the nursing profession but in other professions as well. Having known this information, nurses can utilize certain strategies to prevent workarounds from occurring in their future practice. Those are: being able to identify certain work practices, improving one’s overall work performance, and interactions at a multidisciplinary team approach (Soares et al., 2012). In return, these implications and recommendations for practice will help to ensure the upmost of patient quality and
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.
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
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.
Henry, although you displayed the fact that nurses are overwhelmed for taking more time than ever to document, checking new orders, and updating patient treatment, I think these are nurses’ responsibilities according to the Nursing Scope and Standards of Practice. However, the technologies have helped nurses to work efficiently to remind them when they need review the quality of care. Electronic medication administration record (EMAR) has a great feature to remind nurses when the two-hour window to administer medications is over. Although it may take some time to get used to new systems and review the competition of EMAR, it decreases the risk of incompletion of EMAR as well as the risk of administering medications outside of the two-hour window.
In nursing school, nurses are taught to apply the nursing process to administer care safely and effectively. However, that value doesn’t always coincide with the employer. Instead it is about the e...
After completing the phone conference with Barbara Black, Janel and John Maldonado (Kinship Caregivers), and CMS Gloria Gooding, we concluded that baby Maria will remain in her current placement. This baby no longer needs to be placed in the Pediatric Specialty Room. However, this family expressed that they would feel more confident once they've obtained their medical certification.
To attain this goal, nurses must work in collaboration with other members of the health care team. To improve efficiency, the health care environment must foster the development of collaborative relations among health care professionals. Trust, open communication, commitment, and shared goals must be present to support collaborative relations and effective teamwork. Health care organizations continue to place a greater demand on health care professionals while often working with limited resources. In a recent study focused on determining if there was a current or impending shortage of nurses in care settings throughout the United States, 81% of the 178 hospitals sampled indicated they have or are an... ...
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.
Drug administration forms a major part of the clinical nurse’s 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). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. 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 (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
Analyzing Workflow for a Health IT Implementation by Lydia Washington, is a short shifted scenario published January 1, 2008 The inability to integrate electronic health records (EHRs) into clinician workflow is a well-documented barrier to implementing EHR systems. To address this problem, organizations must analyze their workflow processes before implementing an EHR system. Optimal workflow requires having the right information at the right time so that the individual performing a step or task can advance the process toward completion. To achieve optimal workflow, organizations must take a step back and analyze the flow of work.
ANA describes “The Scope of Nursing Practice (as) the “who,” “what,” “where,” “when,” “why,” and “how’ (8).’ In other words, it is the responsibility of the nurse to know who their patient is, what the patient’s diagnosis and treatment are, where it is they will be delivering treatment, the rationale behind their actions, and how they will deliver the care. By following the scope of practice, nurses reduce avoidable errors and are aware of the liability their actions entail. The ANA also puts forth a nursing process to guide nurses in treatment. The constantly evolving process is currently assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation (ANA 9). Though this method has dramatically improved nursing care, it may be necessary to repeat steps to adapt to a patient’s changing needs and pathologies. By following guidelines set by the ANA, nurses are able to better connect with their patients and instill the image of professionalism to the public while also optimizing safety
Administration of medication is a vital part of the clinical nursing practice however in turn has great potential in producing medication errors (Athanasakis 2012). It has been reported that over 7,000 deaths have occur per year related to medications errors within the US (Flynn, Liang, Dickson, Xie, & Suh, 2012). A patient in the hospital may be exposed to at least one error a day that could have been prevented (Flynn, Liang, Dickson, Xie, & Suh, 2012). Working in a professional nursing practice setting, the primary goal is the nurse and staff places the patient first and provides the upmost quality care with significance on safety. There are several different types of technology that can be used to improve the medication process and will aid staff in reaching a higher level of care involving patient safety. One tool that can and should be utilized in preventing medication errors is barcode technology. The purpose of this paper is to demonstrate how implementing technology can aid patient safety during the medication administration process.
Best practice with positive patient outcomes through complex problem-solving requires leadership and management, and this is possible by practicing theory. Nursing practice today analyze complex health care delivery process. In view of this bedside nursing has improved tremendously (James, 2010). The General Systems Theory has established as the protocols for roadmap for the nursing profession. As a nurse, at times we can be very protective even defensive, we have the tendency to believe that our nursing license is a testimony of our competence. We at times ignored the one great characteristic of the general system theory, the need to build and nurture a structural relationship among one another. “The Various parts of a system have functional as well as structural relationships between each other” (Current Nursing Sept, 2013) Our selfishness sometimes overtake our intellects abilities; our egoist has at times overshadowed our ability to be opened, ready to accept constructive criticism. This is a behavior that has prevented us from applying the concept of self-correcting that Bertalanffy has taught us. We often times closed our ears as well as our mind to the general theory of open feedback. We must remember our mission as a nurse, services. When we apply the general system theory, everyone wins, including our patient. We improve the care through self-correcting. We evaluate our delivery of care, re-evaluate our performance and skills, make the improvement and improve the image of the nursing
Moreover, there is a risk of data getting lost due to cyber attacks or system failures, which can cripple the operations of a particular healthcare facility (Keller, 2016). In some instances, employees who lack adequate skills can input wrong or non-factual data and patient details in a system, and this is likely to create a lot of confusion (Li & Slee, 2014). The issues associated with electronic medical records can be addressed in various ways to ensure hospitals and other organizations are influenced by patient-centered strategies in their performance. Health administrators must invest in high quality technological infrastructure to prevent different risks that can make a system not to function as expected (Pourasghar, Malekafzali, Koch & Fors, 2008).