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Ethical dilemmas within health care
Impact of medication errors on health care
Impact of medication errors on health care
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Ethical dilemmas are the issues that nurses have to encounter everyday regardless of where their workplaces are. These problems significantly impact both health care providers and patients. Patient safety is the most priority in nursing and it can be jeopardized by a slight mistake. Medication errors and reporting medication errors have been major problems in health care. Errors with medications have been found to be the most common cause of adverse drug effects (Brady, Malone, Fleming, 2009). Northwestern Memorial Hospital in Chicago conducted a research in 2012 that approximately forty percent of the hospitalized clients have encountered a medication error (Lahue et al., 2012). A nurse’s role is to identify and report these medication errors immediately in order to stop or minimize any possible harm to the patients. Ethical moral dilemmas arise when reporting the mistakes that have been made by one’s own colleagues, acquaintances, peers, or physicians. Ethical dilemma situation A traveling nurse is taking care of four patients on med surg floor at the hospital during a Monday morning shift. She is a new nurse who just started working in this facility a few months ago. This one patient is having continuous IV medication from a piggy-bag medication and the nurse is supposed to change the bag regarding the physician’s order. When the nurse comes into the room, she finds out that the previous medication bag is still full and the medication has not been administered into the patient. After assessing the patient’s condition and double-checking the medication, she hangs the new piggy-bag on the IV pole. There is no incident report filled and no-one is informed about this incident. The nurse claims that the patient’s condition is stab... ... middle of paper ... ...nform the previous shift nurse who has made a mistake and conducted the medication error. Along with informing the co-worker, a right decision would be following the chain of command and report to the next person in authority at the hospital. Conclusion Ethical dilemmas in nursing happen daily therefore nurses must treat all patients with respect and integrity for the patients’ best interest and health. Nurses must be the advocators for their clients, in this case being an advocate for the patient helped in the resolution because the nurse made sure to speak for the patient with mediation error and no affect on the patient’s health. The decisions nurses make can affect the patient’s health and quality of life, hence making the right choice is critical in nursing. The decision making can be based on the nurses’ values, experiences, ethical principles and theories.
Planning included reaching out to other health organizations, objectives, and goals of health fair were established. The implementation includes getting volunteers, set up for the health fair. The evaluation of the process occurred throughout the implementation and changes were made as needed. The evaluation will be completed by gathering information from health booth to determine the number of participants. Review vendor and participant evaluations about the health fair including how they heard about the health fair, ratings of booths and suggestions for improvements. Record everything to determine changes. Reflection on past experiences and what worked and did not work.
Most undergraduate nursing students are not being properly educated on proper medication administration. Clinical instructors and registered nurses need to be updated on medication administration reporting, so students do not develop bad habits when they become registered nurses. Registered nurses must also continue their education on med error prevention to prevent future errors. Another significant problem with registered nurses was that they did not have positive attitudes when reporting an error. Once these negative attitudes were changed, more errors were reported (Harding & Petrick, 2008). The three main problems that cause medication errors...
Define a critical thinking task that your staff does frequently (Examples: treat high blood sugar, address low blood pressure, pain management, treating fever etc.). Create a concept map or flow chart of the critical thinking process nurses should take to determining the correct intervention. Include how much autonomy a nurse should have to apply personal wisdom to the process. If the critical thinking process was automated list two instances where a nurse may use “wisdom” to override the automated outcome suggested. Note the risks and benefits of using clinical decision making systems.
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.
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
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.
Healthcare provider’s perception and judgment in the patient’s well being as well as taking into account the right of the patient in every action is one of the key elements in nursing practice. International Council of Nurses (ICN), (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3). Furthermore, nursing action guided by theory and principles of moral and legal rights complements excellent nursing care. Nurse’s awareness in moral and legal codes helps them control the complicated scenario encountered and direct the nurses in the best possible action answerable by law (Lachman, 2006).
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Preparing and administering medications accurately is a vital part of a nurse’s job. Medication errors can happen anywhere along the medication administration process. They can occur in prescribing, documenting, transcribing, dispensing and administering. Nurses must always be alert and double check themselves, healthcare providers, pharmacists, and others in the chain of medication administration to ensure medication is properly administered. The execution of the six rights of medication administration is critical in ensuring accurate medication administration. The six rights of medication administration include – right patient, right medication, right dosage, right route, right time and right
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
Abuse is any action that intentionally harm or injures any person. Anyone can be abused such as child, adult and elder. Abuse can be done in many ways which is also known as types of abuse and they are physical, emotional, financial, sexual and neglect. Two years ago ,when I was working in the hospital ,I noticed the girl of age 12 who was admitted in ward with fever and after three days of admission there was no fever but she seems excessively withdrawn, fearful and anxious ,shows extremes in behavior (suddenly she become aggressive and suddenly passive) and also doesn't seem close to her parents and siblings. I decided to talk to her but she refused. I was encouraging her to share the things and at last she was convinced and share that her mother and elder brother abuse her emotionally. They always ignore and reject her and tell her that she is worthless ,no good ,bad etc and making negative comparison with others and she also told that she don't want to live because nobody was there to care her and request me not to tell anything to her parents. But as the nurse, we are in unique position to observe and interact with
In terms of health, the patient must have a condition that requires medication, to be a potential victim of a medication error. The patient plays a big role in the manifestation of a medication error. Some factors include, non-adherence, health literacy, financial barriers, comorbid conditions, cognitive status, and anxiety. If a nurse does not practice safe medication reconciliation, does not validate that education provided was successful, is rushing, or has a lack of knowledge then the likelihood a medication error will occur increases. Antecedents related to the environment include miscommunication due to multiple communication methods, conflicting provider schedules, and lack of understanding of the electronic medical record.
Nurses support the quality of life through improving factors and caring for the sick and dying. The primary focus of a nurse is to their patients. With sound ethical moral standards and core values they serve their patients with a faithful heart. Not only compelling to the institution but also the public. In the nursing profession, core values and standards of ethics commensurate together to deal with issues within health care. They are to treat patients with respect and commit themselves as advocates for the well-being of their patients. Furthermore, nurses consistency to uplift and build a moral environment contribute to the institution overall