The article “A Controlled Trial of Smart Infusion Pumps to Improve Medication Safety in Critically Ill Patients” by Jeffrey Rothschild et al. (2005) details a study that was conducted in response to a report on patient safety. Medication administration was linked to adverse events, causing patient injury. Powerful and titratable intravenous medications are often used in the critical care setting and require an infusion pump for safe and accurate dosing. Human error can cause injury to critically ill patients with complex medical issues if infusion pump data is entered incorrectly. Smart pumps were designed to mitigate this error and to increase safe medication administration. The technology built in to smart infusion pumps consists of …show more content…
Two weeks prior to collecting data, the new Medley pump was implemented. Training to staff was given hands on and by computer instruction. Pump internal log data was collected every eight weeks from February 2002 to December 2002. Medley pumps were modified to provide intervention feedback for two weeks between each eight-week session. Modifications to pumps included overridable alerts and selecting generic infusions that were not included in the drug library. This allowed nursing staff to bypass predetermined drug doses, rates and limits which the authors identified as a potential harm to patients. Administering medication that did not have a verbal order was also linked to adverse drug events. Drug bolus administration was deemed acceptable if the event requiring the bolus was life-threatening (Rothschild, 2005).
Nurse researchers collected data from chart reviews, staff reports, incident reports and an adverse drug event log. They then reported their findings to the reviewers, two physicians who specialized in evaluating adverse events. In addition, the authors used scales that ranged from not harmful to harmful and grouped as ordering, filling, administration, monitoring or wrong dose (Rothschild,
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It can also be very challenging to improve reliability in a study like this because critical care units are a very dynamic workplace. While standardizing use of smart pumps is of the utmost importance, it can be difficult to minimize distractions when using them with regards to this patient population. Flexibility in this setting is required. Performing this study in a less critical environment, such as an orthopedic unit, may be better due to continuity of pump use, nurse skill level and similar patient
The research purpose is derived from the research problem. The purpose of this study which was clearly outlined in the introduction section of the paper, sought to determine if automatic blood pressure devices could measure orthostatic hypotension accurately in emergency settings. This purpose was accompanied by research objectives and a hypothesis that focused the study. The objectives in the study sought to find the sensitivity, specificity, positive predictive value and negative predictive value of the automatic devices, clinical and statistical significance in postural drops, and if magnitude influenced blood pressures readings (Dind et al., 2011, p. 527).The authors also predicted in their hypothesis that the automatic devices would be less accurate if the systolic blood pressures were not between 120-180 mmHg which is their...
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...
Unver, V., Tastan, S., & Akbayrak, N. (2012). Medication errors: Perspectives of newly graduated and experienced nurses. International Journal Of Nursing Practice, 18(4), 317-324. doi:10.1111/j.1440-172X.2012.02052.x
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...
Technology is advancing greatly every day and whether we like it or not, it is here to stay, so we need to use it to our advantage. Technology is especially helpful in health care as healthcare is very fast pace and stressful. IV smart pumps were introduced years ago and have been very successful in many facilities across the country. Although there are many “brands” of IV smart pumps, they are all generally the same and have at least one thing in common; they decrease the workload of healthcare providers. With anything there are benefits, as well as cons of using these pumps which we will discuss.
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.
JB McKenzie, et al. "STRATEGIES USED BY CRITICAL CARE NURSES TO IDENTIFY, INTERRUPT, AND CORRECT MEDICAL ERRORS." American Journal of Critical Care 19.6 (2010): 500-509. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
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.
Administration of medication is a vital part of the clinical nursing practice however in turn has great potential in producing medication errors (Athanasakis 2012). It has been reported that over 7,000 deaths have occur per year related to medications errors within the US (Flynn, Liang, Dickson, Xie, & Suh, 2012). A patient in the hospital may be exposed to at least one error a day that could have been prevented (Flynn, Liang, Dickson, Xie, & Suh, 2012). Working in a professional nursing practice setting, the primary goal is the nurse and staff places the patient first and provides the upmost quality care with significance on safety. There are several different types of technology that can be used to improve the medication process and will aid staff in reaching a higher level of care involving patient safety. One tool that can and should be utilized in preventing medication errors is barcode technology. The purpose of this paper is to demonstrate how implementing technology can aid patient safety during the medication administration process.
Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care 2001; 29: 494-500.
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
According to the National Association of EMS Physicians, older resuscitation outcomes used to call for aggressive fluid resuscitation, typically, 2L IV wide open. More recent studies have found that excessive fluid administration in the prehospital setting can lead to poorer patient outcomes (National Association of EMS Physicians). A prospective trial conducted by Bickell et al. (1994), comparing delayed and immediate fluid resuscitation in 598 patients with penetrating torso injuries and prehospital systolic blood pressures less than 90 mm HG, found that delay of aggressive fluid resuscitation until surgical interventions were available improved patient outcome.
Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.
With the introduction of the age of computers, the nursing profession has seen a transition from the manual to automated methods of record keeping and even patient management. With the introduction of new technology even in monitor systems within the hospitals, nurses are compelled to increase their scope of learning in order to cope with the changes. Intensive care unit equipment are highly sophisticated which only increases the pressure on the nurse as a learner (Urquhart, Currell, Grant & Hardiker). This explicitly shows that nursing is a