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STAFFING effects on nursing care
STAFFING effects on nursing care
STAFFING effects on nursing care
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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). QA/QI …show more content…
There is a strong association between short staffing and medication errors since out of all the health care professionals in acute hospital settings, nurses spend longer hours providing direct care to their patients.
They usually are the ones who administer medications. Incidents of medication errors are caused by many factors; however, it is commonly due to nurses who fail to follow proper protocols and lack knowledge for each medication. A study by Frith et al. (2012) demonstrates how an increase in registered nurses (RN) decreases medication errors and an increase in licensed practical nurses (LPN) increases medication errors. Hospitals hire more RNs than LPNs which is why LPNs are most commonly seen working in clinics. Research implies LPNs often ask RNs questions during medication administration hours, and since LPNs are not allowed to make phone calls to the physician, they have to ask an RN to do it (Frith et al.,
2012).
...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.
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...
Although nurses are trained to take care of patients, some treat them based on orders from physicians. The two assess patients and determine their illnesses carefully. Equally, these nurses determine whether the remedies ordered by doctors are necessary for treating different patients in the hospital. They also prescribe effective drugs to their patients. According to Taylor, Lillis, & LeMone (2011), some of these nurses have specialized duties like understanding and interpreting electronic displays.
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 medication education is conducted by the nurse. Medication education includes informing the patient the reason for the medication, when and how long to take the medication, drug interactions, and importance of checking with primary care provider prior to taking any over-the-counter or herbal products. If the nurse is unfamiliar with a certain medication, a drug book is available for the nurse to utilize and gain knowledge regarding the drug use, action, adverse reaction, and contraindications.
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
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.
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.
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.
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
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.
Largely, licensed practical nurses does not work by themselves, rather they are always supervised by a registered nurse. Yet, it was observed that the lines between registered nurse and licensed practical nurse scopes of practice in long-term care facilities had become blurred when a licensed practical nurse was seen administering medication intravenously to a patient independently. According to stated standards, regardless of the degree of delegation, registered nurses are responsible for the administration and clinical management of intravenous
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
First, here is some important background information about Pharmacists. A Pharmacist is someone who is trained and licensed to distribute medicinal drugs and to advise on their use. According to the Occupational Outlook Handbook Pharmacists do all of the following: "Fill prescriptions, verify proper amounts of medication to give to patients, check whether the prescription will interact negatively with other drugs that a patient is taking or conditions the patient has, instruct patients on how to and when to take a prescribed medicine, Advise patients on potential side effects they may experience from taking the medicine, Advise patients about general health topics, such as diet, exercise, managing stress, and on other issues, such as what equipment or supplies would be best for a health problem, Keep records and do other administrative tasks, Complete insurance forms and work with insurance companies to be sure that patients get the medicine they need, Teach other healthcare practitioners about proper medication therapies for patients, and lastly oversee the work of pharmacy technicians and pharmacists training."() Some pharmacists participate in compounding, where they create medications by mixing ingredients themselves. Pharmacists tha...
This article discusses the importance of reducing interruptions during medication administration and ways to educate the heathcare staff in the hazards of interruptions. According to Lewis et al. (2012) “each interruption is associated with a 12.7% increase in medication errors.” The impact of interruptions in the clinical environment can result in serious or deadly mistakes. In the healthcare environment interruption include overhead pages, alarms, rounding by healthcare providers, and questions from other nurses or family members.