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Communication in nursing practice
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Steps to Reduce Medication Errors To successfully provide care to a patient the nurse must administer many different types of medications. Medication errors are one of the leading causes of avoidable harm to patients. There are many medications that have serious consequences if an incorrect dose is delivered. Administering some medications simultaneously can also cause serious reactions. Facilities attempt different initiatives to decrease these errors. Ultimately, it is up to the nurse to be educated on the medications they will be administering and ensure that the medication is administered correctly and accurately. One study I read compared medication error rates when nurses used a separate medication preparation room to prepare medications. …show more content…
My first nursing job was in a long term care facility that did not use this type of technology. The dosage ordered was hand written on cards. It was often confusing how much medication the patient was supposed to receive. I often felt nervous and stressed about the complicated med pass while working at the facility. The conclusion of a study done by comparing two nursing homes, one using electronic medical records, and one using a more traditional paper charting system showed, “the eMAR reduced the perceived risk of omitting a dose, medication errors occurring as a result of communication problems, and medication errors occurring as a result of inaccurate medication administration records” (Alenius, and Graf, 2016). Therefore, using technological advances and electronic medical records the patient and the nurse are safer during med administration. Barriers that continue to exist to ensure safe medication delivery may be a lack of education, time constraints of staff, and technology malfunctions. Some nurses have been working in the field for a very long time and they may be uncomfortable with learning a new process involving medication administration. The nurse may feel the process adds too much time to their daily duties and may resist learning and using the system. Also, if the computer system is down and there is no paper version of what has been ordered the patient my miss a dosage
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.
...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.
I am truly amazed by the positive impact of bar-code medication administration (BCMA). Since we have a fully integrated electronic health record, it is a true closed loop-system, with medication order entry, pharmacy validation of medications, and clinical decision support. Implementing technology such as BCMA is an efficient way to improve positive identification of both the patient and medication prior to administration. It is estimated that the bar-code medication charting can reduce medication errors by 58% (Jones & Treiber, 2010). Even though we have good adoption of BCMA, nurses still make drug administration errors. In many of the cases, errors are caused by nurses, because they do not validate and verify. The integration of technology
This technology assist the nurse in confirming patients identify by confirming the patients’ dose, time and form of medication (Helmons, Wargel, & Daniels, 2009). Having an EHR also comes with a program that allows the medical staff to scan medications so medication errors can be prevented. According to Helmons, Wargel, and Daniels (2009) they conducted an observational study in two medical –surgical units one in the medical intensive care (ICU) and one in the surgical ICU. The researchers watched 386 nurses within the two hospitals use bar code scanning before they administrated patients’ medications. The results of the research found a 58 % decrease in medication errors between the two hospitals because of the EHR containing a bar code assisted medication administration
Implementing technology in a clinical setting is not easy and cannot be successful without a well-organized system. It is important that healthcare providers understand the electronic medication administration record (eMAR) and its role in improving patient safety. One of the most significant aspects of healthcare is the safety of our patients. Medication errors account for 44,000-98,000 deaths per year, more deaths than those caused by highway accidents or breast cancer. Several health information technologies help to reduce the number of medication errors that occur. Once of these technologies is bar-code-assisted medication administration (BCMA). These systems are designed to ensure that the right drug is being administered via the right
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.
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
Patient safety should be the highest priority when it comes to health care, so why wouldn't the administrators reduce the ratio of nurse to patients to provide maximum patient care? Nurses that have a higher workload of patients are probably more prone to commit a medication error because they may not have the time to do the five checks of medication administration: the right drug, the right dose, the right route, the right time, and the right patient.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Henry, although you displayed the fact that nurses are overwhelmed for taking more time than ever to document, checking new orders, and updating patient treatment, I think these are nurses’ responsibilities according to the Nursing Scope and Standards of Practice. However, the technologies have helped nurses to work efficiently to remind them when they need review the quality of care. Electronic medication administration record (EMAR) has a great feature to remind nurses when the two-hour window to administer medications is over. Although it may take some time to get used to new systems and review the competition of EMAR, it decreases the risk of incompletion of EMAR as well as the risk of administering medications outside of the two-hour window.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
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.
Technology is stated as the scientific method and material used to achieve a commercial or industrial objective. To go one step further, nursing technology is using a tool to advance nursing practice. “The Institute of medicine identified that technology as a viable method of enhancing patient care delivery and improving staff productivity” Sensmeier, Horowitz (2003 page). Because inadequate nursing staff causes shortcuts to be taken, there are mistakes made that could have possibly been prevented. Errors by nursing staff were variously reported as being responsible for between 44,000 and 98,000 hospital deaths per year. Sensmeier, Horowitz (2003). Technology can have a large impact on nursing. In the past 5 to 10 years, computerized patient records have increased less than 10%. This number shows us that we are still not embracing technology to its full potential. Today in most hospital systems computerized electronic charting is being used. Many hospitals have many different systems for...
The functionality, layout, extent of accessibility of information, and ease of use all affect an EMR’s efficacy and are determining factors in whether patient care outcomes are successful or fall short of achieving goals for care. To illustrate this point, when I worked in a trauma 1 center in North Orange County, the hospital used something of a fusion of paper and electronic medical records. Orders, medication prescriptions, and even progress notes were frequently found in paper form in the charts of patients. This made “competing for charts” something of a given, with doctors, specialty consultants, nurses, and nursing students all vying for patients’ charts. It likewise increased the risk of errors being made due to illegible penmanship and the challenge of deciphering orders.
Medication administration is one of the major responsibilities that a nurse has. This change will have a great impact on the staff because adaptation can be challenging, without mention the impact on the time management, workflow of the nurses, and the readiness for change. The concepts that are involved are the competence, attitude, method, and system. Since not everybody assimilates technology the same way, the competence of some employees will be compromised with the new system. In this case, there will be a disequilibrium among the staff because some of them will be excited for a change, while others will feel as they aren’t ready to implement new tools into their work duties. These changes could create hostility between the staff members,