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Maintaining a safe environment reflects a level of compassion and vigilance for patient welfare that is as important as any other aspect of competent ...
Reflection on medication error
Reflection on medication error
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Medication Errors Related to Children in Ambulatory Care
Error which was found
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.
Causes of Pediatric Dosing Errors via Emergent Care
It is very disturbing at the number of errors that occur in children who receive medication in the ambulatory care setting. According to Medication Dosage Error...
For my research paper, I will be discussing the impact of medication errors on vulnerable populations, specifically the elderly. Technology offers ways to reduce medication errors using electronic bar-coding medication administration (BCMA) systems. However, skilled nursing facilities (SNFs) are not using these systems. Medication is still administered with a paper or electronic medication administration record (eMAR), without barcode scanning. In contrast, every hospital I have been in: as a patient, nursing student, and nurse uses BCMA systems. The healthcare system is neglecting the elderly. Nursing homes should use BCMAs to reduce the incidents of medication errors.
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...
The most common kind of medication error is administering the wrong medication or giving wrong doses. A medication error is any error that happens to patients whether they suffer any harmful results or not. Inappropriate nurses-to-patients ratio should be taken into consideration because it can cause medication errors. A new study shows that every year about 210,000-400,000 people who were admitted to the hospital die due to medication error; it also shows that is is “the third leading cause of death behind heart disease and cancer”(MacDonald). For instance, an interview was done with Nurse Carol, a retired nurse; she said that she made a medication error while administering medication to one of her patients. She said that she was rushing and accidentally gave Cozaar to one of her patients instead of Colace. Cozaar is often used for high blood pressure and Colace is for constipation. She said her patient’s pressure dropped very low after taking the medication; she realized then that she gave the patient the wrong medication. Nurse Carol also said that if she did no...
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.
Medicating our children for problems such as; Attention Deficit Hyperactive Disorder, bipolar disorder, or autism seems to be a new trend. Unfortunately, these medications have very dangerous side-effects especially in sensitive children like those in foster care. Healthy alternatives are often overlooked for a quick fix pill. Do parents even know what these medications do? Do they know what these medications were originally for?
Agyemang, REO, and A While. "Medication errors: types, causes and impact on nursing practice." British Journal of Nursing (BJN) 19.6 (2010): 380-385. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
What classifies as a Medication errors? An error can occur any time during the medication administration process. A medication error can be explained as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer” (National Coordinating Council for Medication Error Reporting and Prevention, 2014, para 1). Rather it is at prescribing, transcribing, dispensing or at the time of administration all these areas are equally substantial in producing possible errors that could potentially harm the patient (Flynn, Liang...
Attention Deficit Hyperactivity Disorder (ADHD) is a psychiatric disorder that causes children to have problems with paying attention, trouble with following instructions, have impulsive behaviors and become easily distracted. Medications, such as Adderall and Ritalin, are used to treat the symptoms of this disorder by helping the patient to focus and pay attention while also curbing their impulsive behavior and hyperactivity. Side effects of these medications are, but not limited to, anxiety, addiction and in some cases psychosis. Proponents of giving ADHD medication to children argue that ADHD is a real disorder in children and the medication does improve the symptoms of the disorder by a large margin as well as being cost effective. Also, not only are the parents happy with the outcome of their children taking the prescribed medication but so are the children themselves. Proponents also argue that by not letting parents of the children, young adults and adults choose to take these prescriptions when diagnosed with ADHD that the medical and psychiatric communities would be in violation of the principle of autonomy. Justice as well would be violated since most of the burden of dealing with all the symptoms caused by this disorder would fall onto those with ADHD and partly on their families. Opponents of giving ADHD medication to children point out that it is not only going to children with ADHD but also being prescribed to those not diagnosed with the disorder as well as the pills being given or sold to other children and young adults. They also claim that the full side effects of ADHD medication are still not known and could have harmful long- lasting side effects on the children taking the medications. In this case, the princip...
The documentary “The Medicated Child” gave me a lot of insight into the lives of children diagnosed with bipolar disorder. When we hear and learn about bipolar disorder, we do not normally think of children. However, there are many children diagnosed with bipolar disorder ranging from all ages. As we saw in the documentary, bipolar disorder can be very hard on both the child and the family, so finding a cure that is effective and safe is important. The video also highlighted how little research there has been on the effectiveness of antidepressants on children.
Historically, pediatric drugs have been used without the adequate research done for pediatric formulation and dosage information for children usage. There have been difficulties and lack of pediatric trials done on drugs and children received unapproved therapeutic uses based on adult formulation, which have caused harmful results in children. There is a profound need for pharmaceutical tests to be approved for safety and effective for use by children. Only few drugs have adequate labeling information and approved indication for dosage, frequency, and route of administration. However, over the recent years, implementation of pediatric regulations and legislations have been initiated and review committees have been established to renew this issue.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
The findings of various studies suggest that to reduce prescribing errors hospitals should train junior doctors regarding the principles of drug dosing before they start prescribing, and enforce