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Strengths and weaknesses of mediation
Literature review on mediation
Literature review on mediation
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Summary of Content and Context
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. Family members and healthcare providers may not consider the impact of their interruption on others; this is why it is critical to educate them about the hazards of interruptions.
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Before readying this article I didn’t consider the potential impact of interruptions on others. I agree with the author that it is important to educate healthcare providers, families and nursing students about the hazards of interruptions. I think that the rubric the author provides could help decrease unnecessary interruptions and decrease medication administration errors.
In the future, I am going to carefully analyze each situation to avoid any unnecessary distractions or interruptions. I think that at the beginning of my nursing practice I am going to use the guidelines for healthcare staff to lessen interruptions. This is a very helpful tool to help you determined whether or not to interrupt a nurse. Another strategy that I would like to use in my future nursing practice is the “No Interruption Zone”. During the “No Interruption Zone” a nurse wore a bright yellow vest or sash that meant do not interrupt this nurse. The nurse would wear the sash during medication preparation and administration. According to Lewis et al. (2012) this strategy” reduced errors by 47% in a 5 to 6 month period.” I think the benefits of this strategy are significant and I would like to use this strategy when I start working or help implement
Nurses have a considerable amount of responsibility in any facility. They are responsible for administering medicines and treatments to there patient’s. While caring for there patients, nurses will make observations on patient’s health and then record there findings. As well as consulting with doctors and other healthcare professionals to plan proper individual patient care. They teach their patients how to manage their illnesses and explain to both the patient and the patients family how to continue treatment when returning home (Bureau of Labor Statistics, 2014-15). They also record p...
...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.
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.
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.
Many years from now, I will take this experience with me to better myself as a nurse. I know for the future that it is in my patient’s best interest, if I collaborate with other health care professionals. In order to maintain patient safety, I must always remember to work together with my fellow collogues to obtain a positive working environment. In order to be a good nurse, I need to always understand that I am part of a team to help those in need. I want to incorporate providing efficient care to each and every patient the best way I possibly
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.
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).
Prioritization and Time Management in Nursing Nursing can be particularly difficult and demanding and during the busy times and shifts some nurses might rarely have sufficient time to sit down or eat. A lot of nurses have a lot of things that they have to accomplish and have to be aware of ways to ask quick questions when it comes to the well-being and care of their patients. It is because nursing is increasingly high-paced and demanding that it becomes significantly critical for nursing professionals to learn ways to manage their times at work efficiently in order to decrease their levels of stress and ensure that the care they deliver is of high quality (Patterson, Ebright & Saleem, 2011). Improving the capacity of nurses to manage their times is significant, especially because it makes them become more efficient nurses, nurses who will be able to address the needs of a large number of patients within a short period. This does not usually translate to sacrificing the quality of patient care and the bedside manners of nurses; only that they have to complete the fundamental care they need within a short period.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Safe nurse-patient ratio is a complex issue debated on for many years. Due to inadequate staffing registered Nurses are faced with high patient ratios, and nurse burn out everyday. According to the American Nurses Association, “Massive Reductions in nursing budgets combined with, the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside”. (2012) Through the nursing process, the essential role of the Registered Nurse is to assess, diagnose, and plan based on outcomes, implement and evaluate the effectiveness of nursing care. However, it is not realistic to thoroughly implement these core guidelines in a safe and effective way, when you are
Everybody makes mistakes, but it is always good to learn from them. In professions like nursing which combines pressure and tight schedules, it is important for nurses to stay sharp at all times. However, focus is easy to maintain if we adopt a problem-solving mentality and a positive attitude (Tucker, 2000). Only then can we go far.
The major concern for registered nurses regard’s the nurse’s health and well being. Safe staffing levels are continuing to become more of a problem. The U.S is expected to experience a shortage of nurses as the “Baby Boomers” age and the need for health care grows (Rossester, 2014). This shortage is causing some health organizations to work with minimal amounts of nurses. This is affecting the nurse’s ability to provide safe care due to fatigue and injury. This shortage is also resulting in a dramatic increase in the amount of mandatory overtime, which often means that nurses stray from face-to-face patient care and can produce an increase in the amount of medical errors (American Nurses Association,
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
Timing is key; nurses and other members of the interdisciplinary team have to be aware of the best times to communicate with a patient (O’Hagan et. al., 2014). This is best complimented when nurses have established great rapport with the patients and their families. Patients are much more accepting of timing when they are interrupted and issues that arose when they trust the nurse (O’Hagan et .al., 2014). An example is if a patient just died and the family has to go through certain rituals, however, nursing care has to be completed as well. If the nurse has rapport with the family, they are more accepting of these hospital policies especially when they have been communicated at an appropriate