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Preventing medication errors institute of medicine 2007
Medication error risks
Preventing medication errors institute of medicine 2007
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Introduction The pharmacologic treatment of psychiatric disorders has improved in recent years. Specifically, many new psycho-pharmacologic agents have been developed; some of which have proved to be highly effective. As a result, many acute and chronic psychiatric illnesses can now be treated much more effectively than a decade ago. However, while these new agents have better side-effect profiles than many of the older drugs, the potential for medication errors (MEs) and adverse drug events (ADEs) continues to be an important problem (1) Medication Error (ME) is defined as any preventable error that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of health care professional, patient …show more content…
Although nurses have the central role in this process, it involves a multidisciplinary team that also consists of the physician, pharmacist, and patient. In the acute care setting of a hospital the medication process is complex and time-consuming, occupying up to one-third of the nurses time …show more content…
Provider related factors contributing to medication errors include clinical practices associated with prescribing, transcription, dispensing, and administration and monitoring (8). In the aspect of medication safety, medication administration, storage and management of medications, and managing adverse events are regarded as crucial domains .When nurses perform mal-behavior on medication administration, it is said to be non-compliance, in turn, neglect of conduct, resulting in medication administration errors (MAE )probably. Therefore, studying nurse’s behaviour of medication administration is very important
Medication administration within SNFs is arguably the most difficult part of the job. On average, it takes two hours for each scheduled medication pass; AM, Noon, and PM. The nurse-to-patient ratio is approximately one nurse for every twenty-five patients within the SNF. Much higher than the average one-on-one to one-to-six ratio within a hospital setting. The enhanced risks of medication error during the medication pass include very limited amount of time to perform the American Nurses Association (2015) standard of five...
...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).
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...
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.
Currently, through observations and clinical experience on Med/Surg at Cary Medical Center, medication is administered by the nurse. Nurses are responsible and accountable for administrating medications to patients. Patient me...
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.
This assignment will discuss the professional, legal and ethical issues related to the self-use of medication by nurses. It will also explore the importance of reporting this misconduct by both professionals in the scenario and how they might do so. The self-use of medication by nurses is not allowed or justifiable according to the guidance provided to nurses by An Bord Altranais (ABA 2007). It will also be evident throughout this assignment the need for Jack to report Linda’s self-use of the medication or urge Linda to do so regardless of the consequences it may present to both him and Linda as according to Nurses and Midwifery Board of Ireland (NMBI 2013), nurses can now be held responsible for not taking action. This is because delivering the greatest level of care to a patient is an essential role of a nurse and the main focus of the nurse’s work should be on caring for that patient (ABA 2010). There is also an ethical duty upon both nurses to report the misconduct according to the four ethical principles; Beneficence, non-maleficence, justice and autonomy (Edwards 2009).
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
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.
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
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.
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.
Care planning is one of these tasks, as expressed by, RNCentral (2017) in “What Is a Nursing Care Plan and Why is it Needed?” it says, “Care plans provide direction for individualized care of the client.” A care plan is for an individual patient and unique for the patient’s diagnosis. It is a nurse’s responsibility to safely administer a patient’s medication prescribed by the doctor. Colleran Michelle Cook (2017) in “Nurses’ Six Rights for Safe Medication Administration,” she says, “The right patient, the right drug, the right dose, the right route and the right time form the foundation from which nurses practice safely when administrating medications to our patients in all health care settings.” Nurses must be safe when dealing with medications, and making sure they have the right patient. Nurses document the care that is given to their patient, as said by, Medcom Trainex (2017) in “Medical Errors in Nursing: Preventing Documentation Errors,” it states, “Nurses are on the front lines of patient care. Their written accounts are critical for planning and evaluation of medical interventions and ongoing patient care.” Nurses must provide an exact, complete, and honest accounts of everything that happens with a patient. Doing this allows for the proper evaluation, and medical interventions for the patient. The typical tasks a nurse involves care planning, administration of treatments and medication, and documenting the care given to a