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Preventing medication errors institute of medicine 2007
Medication error in clinical setting
Preventing medication errors institute of medicine 2007
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Implementing technology in a clinical setting is not easy and cannot be successful without a well-organized system. It is important that healthcare providers understand the electronic medication administration record (eMAR) and its role in improving patient safety. One of the most significant aspects of healthcare is the safety of our patients. Medication errors account for 44,000-98,000 deaths per year, more deaths than those caused by highway accidents or breast cancer. Several health information technologies help to reduce the number of medication errors that occur. Once of these technologies is bar-code-assisted medication administration (BCMA). These systems are designed to ensure that the right drug is being administered via the right …show more content…
The paper MAR had many issues related to patient safety and lead to adverse drug events. In addition, paper records had no backup system and paper records were easily damaged or destroyed. Legibility was also a problem with the paper MAR. It was often very difficult to read handwriting of others. Script versions of certain terms have led to serious and sometimes fatal medication errors. The MAR was used primarily by the nurse when administering medications. The eMAR is used by multiple disciplines. Physicians use them to order medications, pharmacies use them to review and verify the orders and dispense medications, and nurses use them to organize their care for their patients and to document medication administration (Sewell and Theade, …show more content…
Properly implemented and medication-use technology has the potential to moderate these costs. Bar-code-assisted medication administration (BCMA) has been shown to reduce medication administration errors by as much as 54-86%. BCMA, along with computerized electronic prescriber order entry and an electronic medication administration record, closes a technological loop that extends from the transmission of the order to the administration of the medication at bedside (Strykowski, Hadsall, Sawchyn, VanSickle, Niznick,
During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left room for error due to misreading bad handwriting, confusing medications with similar names, etc.
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.
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
I am truly amazed by the positive impact of bar-code medication administration (BCMA). Since we have a fully integrated electronic health record, it is a true closed loop-system, with medication order entry, pharmacy validation of medications, and clinical decision support. Implementing technology such as BCMA is an efficient way to improve positive identification of both the patient and medication prior to administration. It is estimated that the bar-code medication charting can reduce medication errors by 58% (Jones & Treiber, 2010). Even though we have good adoption of BCMA, nurses still make drug administration errors. In many of the cases, errors are caused by nurses, because they do not validate and verify. The integration of technology
This technology assist the nurse in confirming patients identify by confirming the patients’ dose, time and form of medication (Helmons, Wargel, & Daniels, 2009). Having an EHR also comes with a program that allows the medical staff to scan medications so medication errors can be prevented. According to Helmons, Wargel, and Daniels (2009) they conducted an observational study in two medical –surgical units one in the medical intensive care (ICU) and one in the surgical ICU. The researchers watched 386 nurses within the two hospitals use bar code scanning before they administrated patients’ medications. The results of the research found a 58 % decrease in medication errors between the two hospitals because of the EHR containing a bar code assisted medication administration
According to Accuracy at Every Step: The Challenge of Medication Reconciliation (n.d.), the most challenge is called medication reconciliation, which is a formal steps of gathering information related to the patient’s medication with accurate current medication list and compared to the doctor’s admission, transfer and discharge orders. Its aim is to prevent medication errors. There are three steps process- Verification (gather medication history), Clarification (confirm the medication with doses, properly) and Reconciliation (documenting with medication information). This challenge is important to obtain accurate information on all patients entering the hospital. Information technology may play an important role in improving
medications is more than the act of getting drugs to a patient. The delivery of medication is directly tied to the charge for the medication. Thus the responsibility for charging or crediting medication belongs to technicians. This aspect of their job is strictly governed by federal regulations. These laws hold the technician directly responsible for the accuracy of a patient’s account’s charge and credit transactions. Because every dose is related to a specific day and time, when technicians credit they must apply that change to the corresponding dose. Assignificant as accuracy is to the patient’s account, accuracy in the making of their medications is even more important.
The Medication Administration Accuracy Project is a quality improvement project, whose purpose is to improve the accuracy of nursing medication administration. The study used for this project was to find where the most common “wrong doings” happened in the medication process and how to get rid of it. After a year of this project the medication error percent went from 4.3% in 2010 to 1.2% in 2011. The Bar Code Administration System implementation had been very successful with a 95% success rate every year that it is done. The study provided important insight on reducing the medication errors in children. Some were: making sure there are no distractions as possible, double checking medications and making sure the dose in adequate range for the child, and making sure you have two ways of identification with the bar code scanning (Hardmeier, A., Tsourounis, C., Moore, M., Abbott, W., Guglielmo, J.
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
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.
while transferring patients between units. [After reviewing these events], “The Joint Commission identified “Improve the Safety of Using Medications” as one of the 2009 National Patient Safety Goals (Cleveland Clinic, 2009, p.1). In relation to this safety goal, hospitals created a medication reconciliation form that resides in the patient’s ch...
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread publicity has helped build awareness of e-prescribing’s role in enhancing patient safety. Although it has not been in practice for very long, e-prescribing has already made a positive impact in the field of health care.
In today's world, where technology is constantly and rapidly growing, the use of electronic prescribing systems is increasing. An electronic prescribing system, also known as e-prescribing, allows the health care provider to authorize an electronic transmission of one or more prescriptions to a pharmacy. There are, however, challenges presented with e-prescribing such as incorrect medication doses and the adoption of the system in a few health care fields. This two-way transmission of electronic prescribing can increase the quality of patient care, advance patient safety and decrease medication errors. Introduction
Mistakes can occur when a client is moved or admitted, therefore it is advantageous for the nurse to confirm what is ordered for the client to what the client takes. A more recently enacted intervention is the use of electronic medication administration record(eMAR). The eMAR allows the nurse, and any other health professional in charge of caring for the client, access to all of the medications the client is on, the time for administration, and when the medication was last administered. Along with the eMAR, computer provider order entry was created to enable the prescribing provider to document orders directly onto the client’s record from any location with internet access. Telephone and written order errors are
• As more hospital pharmacies move in the direction of computer access, the profession must identify more clinical applications for computer programming. The use of computers has demonstrated the potential to decrease adverse events, preserve financial and medical resources, and improve patient management.