Medication Errors In Nursing

“Medication errors were once the eighth leading cause of death in the United States” (Keane, 2014). With 44,000 to 98,000 annual deaths it is apparent that medication errors are still prevalent in healthcare settings. In a review done by Agyemang and While, a medication error is defined as a “failure to the drug treatment process that leads to or has the potential to lead to harm to the patient” (Agyemang & While, 2010). Medication errors are common, however, with proper education and training they can be prevented. A variety of factors can lead to medication errors including: interruptions while administering medications, misidentification of resident, poor communication between medical professionals, and general hospital chaos (Nazarko,

2015). Avoiding medication errors can increase patient safety as well as patient satisfaction. There are many non-preventable medical events, but medication errors are categorized as preventable. Ideally, there would be zero medication errors in the healthcare setting; knowing that this is nearly impossible, taking all measures to avoid these errors is what medical professionals strive towards. In order to decrease instances of medication errors, healthcare settings should implement methods to reduce these preventable errors. These methods include enforcing education and prevention, using a barcode system, and using an electronic medication administration record.
Education is important because it allows mistakes to be brought forward, recognized, and encourages prevention of these mistakes.

If medical professionals do not know what mistakes they are making, or how to fix them, the mistakes will continue. Nurses need to be aware of harmful medications and adverse effects that some medications have so that patients do not suffer from easily preventable side effects. There are many medications that look alike and sound alike so being conscious and knowing which medications cause confusion can reduce the chances of giving a patient the wrong medication. It is important to make sure the right patient is getting the right dose of the right medication, through the right route at the right time. If the above precautions are not followed precisely the patient could suffer from adverse effects and possible death. Not only is it important for healthcare providers to be educated on the safety of administering medications; patients too need to know the proper ways to administer medications once they are discharged from the hospital. It is important to note that education extends far beyond the classroom. Education can be as simple as informing another nurse of a common mistake they are unknowingly

making.
Another method used in most healthcare settings to avoid preventable medication errors is a bar coding system. A barcoding system is linked to a database that lists the dose and time of each medication that a patient is receiving. When the nurse is preparing to administer medications to a patient they first scan the patient’s wristband. The list of that patient’s medications is brought up on the computer screen and the nurse should then start scanning the medications she intends to give to the patient. If the nurse happened to pull a medication intended for another patient it would flag her to not administer the medicine. The system will also flag the nurse if they are giving the wrong medication or the wrong dose of a medication. If a medication is scanned that has restrictions on whether or not it should be administered, the computer prompts the nurse to questions regarding the implications of the medication. For example, if a patient is scheduled to receive an antihypertensive medication the system will ask for the patient’s blood pressure before it allows the nurse to administer the medication. Using bar codes for medication administration helps prevent human error by having a computerized check system. The barcoding system improves productivity and accuracy while administering medications (Cohen, 2007). Barcoding technology has “led to a 74% reduction in the administration of wrong medications, a 57% reduction in errors caused by the administration of incorrect doses, a 91% reduction in wrong patient errors, and a 92% reduction in wrong time errors” (Keane, 2014). If all healthcare settings implemented a barcoding system the statistics of incidences and deaths caused my medication errors would decrease greatly.
The use of an electronic MAR is another method that can help contribute to the decrease of medication errors. Approximately “8.4% of medications administered were observed to be an error” (Wright, 2014). Implementing an electronic medication administration record (eMAR) would help decrease this statistic and increase patient safety. An eMAR is an electronic chart that lists a patient’s medication and instructs the nurse on what dose and time the patient is scheduled to receive that medication. Having an eMAR in place can help increase patient safety because it allows nurses to double check that they are giving the right patient the correct medication. The barcoding system relates to the eMAR because after scanning the patient’s wristband the nurse can scan the medication and if the wrong medication is scanned it flags the nurse to double check that the patient is scheduled to be getting it. Implementing an eMAR system improves the quality of care by having another system in place to ensure that patients are given the right medication.
Medication errors have caused many preventable deaths. There are many systems that have been put into effect to help reduce these occurrences. Educating medical professionals on why medication errors happen can help reduce errors, as well as making staff aware of common factors that lead to errors. Implementing a barcoding system and an electronic MAR system can decrease the amount of errors by ensuring that the right patient is receiving the right medication. Educating staff is the initial step that can help reduce medication errors, barcoding and MAR systems are the final checkpoint before the administration of the medication. If all of the above systems are in place, human error can be reduced.
Literature Review
Patient safety can be defined in a variety of different ways. One definition is “freedom from accidental or preventable injuries produced by medical care” (Mitchell, 2008). Nurses serve a crucial role in the administration of medication. Nurses are the last person to come into contact with the medication before it is administered therefore putting the greatest pressure on the nurses to ensure proper administration.
Each of the reviewed articles discussed the many types of medication errors as well as possible ways to prevent a reoccurrence of the errors.

The articles all went in depth about ensuring that nurses are following the five rights: right patient, right medication, right time, right dose, and right route. If the nurse is aware of the five rights many errors with the distribution of medications can be prevented. Nazarko (2015) suggests that having a picture of the resident in their eMAR will decrease the instances of the wrong patient getting the wrong medication. She also discusses the importance of knowing if patients have any swallowing problems that would interfere with the patient getting the correct dose of a medication. Agyemang and While (2010) focus mainly on the causes of medication errors, emphasizing on personal factors and organizational factors. They discuss that errors do not depend solely on the nurse but instead majority of medication errors are a result of an illegible prescription. Wright (2014) spends most of her article discussing how staff is not following proper policies and procedures leading to errors in administration of medications. She also goes in depth about checking a patient’s medication list every few years to ensure that they still require the

medications.