Nurses are liable for giving clients the correct medications ordered by the health care provider. However, when the nurse administers the wrong medication it is considered a medication administration error. These errors can occur and depending on several factors the error can range from no harm to death of the client. According to Adams and Urban (2016), 95% of medication administration errors do not cause harm to the client, while 4% are considered severe enough to call for treatment. Medication administration errors can ultimately be prevented with numerous interventions that have been proven to minimize such error. Therefore, the nurse must know what a medication error is and the causes that lead up to them in order to learn interventions …show more content…
Theses causes include, but are not limited to: errors in client assessment, inaccurate prescribing, errors in administration, inadequate medication reconciliation, and person-centered factors. An inadequate medication history or incomplete physical assessment are examples of errors in client assessment (Adams & Urban, 2016). Inaccurate prescribing refers to having the incorrect medication or dosage (Adams & Urban, 2016). This cause not only applies to the nurse, but also equally applies to the prescribing provider. For example, the written order may be illegible or the telephone order may be written incorrectly. Errors in administration include omission, improper time, or incorrect route of administration (Adams & Urban, 2016). According to Jones (2009), the nurse is regarded as the issue in the medication process and specifically the nurses’ poor calculation competency, inability to adhere to protocols, lack of knowledge of medications, and complacency as person-centered factors. Mathematical deficiencies cross from student nurses to experienced nurses and have a correlation with the confidence level of the nurse (Jones, 2009). Inability to adhere to protocols can refer to the non-adherence of the ‘5 rights’ of medication administration (Jones, 2009). These are only a few of the many causes that can lead to medication errors, nevertheless if preventative …show more content…
The 5 rights of medication administration are one intervention has been used for several years and is still used today to effectively prevent medication errors. These rights consist of ensuring the nurse has the appropriate client, drug, dosage, route, and time (Adams & Urban, 2016). If all of these rights are maintained it would be difficult for the nurse to make a medication error, which is why it is considered to be the “cardinal ‘5 rights of medication’” (Adams & Urban, 2016). Medication reconciliation is another intervention and involves comparing what the client is currently taking to what is ordered (Adams & Urban, 2016). 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
The two of the six rights of medication administration that were violated where the right medication, the right dosage, and the right client. The nurse failed to read the medication order three times before administering the medication, failed to scan for the right count of the medication, and as well failed to match the patient ID with the scanned
...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.
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).
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...
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.
I learned a lot from this experience. As I mentioned earlier first time when I saw pharmacist doing medication reconciliation I felt it is difficult task to do and hence I started getting more information about medication reconciliation from my friends and pharmacist whenever I got a chance. I prepared myself before I expose myself in this area, which helped me to gain more confidence when I was performing medication reconciliation with standardized patient. I learnt how important is Pharmacist role in finding and solving medication related discrepancies. From this activity, I learnt that it is very important to communicate effectively with patients and other health care providers. If I am unable to communicate properly I will not be able to
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).
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.
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.
Accurate medication documentation is a critical step in safe care transitions. When a patient is admitted to the hospital, a member or members of the healthcare team must identify the patient’s current home medication regimen. This process is called medication reconciliation and should be done at every transition of care (Peinado, Silveira, Vargas, & Vicedo, 2016). Incomplete or inaccurate medication documentation can be harmful if a physician orders the wrong type of medication or if a chronic medication is omitted from the orders. These are examples of medication discrepancies.
Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of the nursing profession, taking up to forty percent of a nurse’s time in providing nursing care (Fowler). Consequently, nurses are commonly held accountable for medication errors. To improve the safety of a vital aspect of nursing care, bar code scanning was introduced to reduce errors in medication administration. Although bar code scanning has its advantageous aspects, there are also disadvantageous qualities.