HSPM 7338 : Medication Error

Introduction:

Medication error is a term that can be can be explained as the condition, which results from inappropriate use, administration and knowledge of medication. This has the potential of harming the health of the patient exposing him or her to poor quality life, suffering and preventable deaths. (Singh & Sittig 2016, pp: 232). Such types of medication error might be related to improper procedures, knowledge as well as practices of the healthcare professionals. This may be also due to negligence and carelessness of the professionals (Hayes et al., 2015, pp: 3063). This leads to longer stays of the patients in the hospitals with more outflow of funds from the consumer as well as outflow of resources from the healthcare centers on an equal level. It also leads to increase in the readmission-rates of patients along with greater level of suffering among the patients and the caregivers. These make them depressed and anxious. Moreover, the professionals also suffer from sense of guilty and loss of confidence and even get engaged in legal obligations (Sahay, Hutchinson & East 2015, pp: 25). This report will highlight three important situations that is seen to be contributing to the medication errors.

Workload, nursing shortage and busy shifts:

One of the causes of medication errors are seen to occur when there is huge number of clients that professionals need to handle in busy shifts and with nursing shortage. When nursing professionals have to handle too many clients within a shorter period, they tend to hurry and in such situations, they tend to make medication errors in the chaotic environments. Researchers are of the opinion that working overtime with inadequate resources as well as with poor support and low job security might lead to medication errors that would not have taken place if the nurses were not burned out. Lack of concentration, restlessness, physical and mental fatigue and poor job satisfaction might result in medication errors. Nurses tend to make calculation errors or might take the wrong route or the wrong dose or the wrong medication during patient handling (Keerset al., 2015, pp: 29). Longer duty hours, overtime, distractions caused during busy and chaotic shifts, low workforces create more pressure on nurses that might lead to medication errors(Sorensen et al. 2016, pp: 456). One of the studies have reported a number of factors that can be allotted under this cause of medication errors like too many number of telephone calls, work overload or unusually busy days, large number of patients, lack of concentration, staff shortage, lack of professionals to double check and many others.

Communication issues and lack of clarity:

Improper communication both written and verbal or non-verbal has the potential to lead to medication errors. Communication failure among the healthcare providers can occur mainly due to to ineffective close-loop communication as well as information which might get lost in the transition of care and for failure for establishment of clear lines of responsibility(Hayes et al. 2015, pp: 3063). Apart from these, improper verbal communication can also occur due to power struggle, poor team working and bonding, bullying and low morale and many others among the healthcare professionals. The other nursing professionals may misinterpret poor illegible handwriting of one nurse. Drugs with similar names, misplaced or missing of zeroes and decimal points as well as confusion between the apothecary and metric systems that help in measurement can result in errors. Utilization of non-standard abbreviations and incomplete or even ambiguous orders might also lead to medication errors among service providers (Phatak et al. 2016, pp: 40). This results in patient dissatisfaction as well as exposes the person to threatening situations and preventable deaths. These have negative effects on the patients making them suffer from drug-drug interaction and leading to high amount of suffering.

Lack of experiences, skills and knowledge:

Many of the studies are of the idea that effective relationship between the level of experiences of nurses as well as the error frequency is equivocal. Lack of awareness and route of administration also causes occurrence of medication errors. Moreover, lack of in-service training as well as inadequate knowledge of the nursing graduates regarding pharmacological interventions has been reported in the studies (Sorensen et al. 2016, pp: 456). Lack of knowledge in handling the electronic health records as well as lack of knowledge in proper calculations of the dosage was also found to be the contributing factors (Vallerand 2018: pp: 256). Often nurses are seen to lack complete knowledge about how the drug works, various generic and brand names of the drug, its contradictions, its side effects, adverse-drug-drug interaction and many others may lead to medication error that often leads to threatening issues (Eliott et al. 2018, pp: 56). When medications are provided to students in wring dose, wrong routes and many others, it results in adverse events making the patient more ill. Extra resources then need to be allocated for patient that requires more spending and hence poor quality lives.

Conclusion:

From the above discussion, it becomes clear that three important contributors of medication errors are present. First, one is busy shifts, nursing shortage and work overload while the other two are inadequate knowledge and skills and poor communication (Alsweed et al. 2014, pp: 289). This information helped me in finding evidence-based articles where I found effective solutions to these barriers. The nursing leaders and the team of nurses working under them should ensure an organizational culture that would have smooth communication and effective bonding among them ensuring no power struggle (Levett-Jones 2018, pp 240). Maintenance of proper procedures of delegation with no information miss should be ensured during communication, both in verbal and written manner (Bogner 2018, pp: 456). The second strategy would be to ensure effective training of the nurses in the pharmacological unit so that they know how to calculate dosages along with the positive and negative outcomes of medication, doses and their routes of administrations, proper skills in filling electronic health records, assessment forms, writing medication names, proper placing of zeroes and decimal points. The nurses should promote in-service training along with continuous professional development (Phatak et al. 2016, pp: 40). The third strategy would be that the nurses should advocate for their work overload and burning out situations to the higher authority describing how it can affect health of patients (Medication Safety Self Assessment 2015). This would make the authorities take in more nurses to ease out the situations along with other initiatives to reduce workload and management of busy shifts.

References:

Bogner, M. S. 2018. “Human error in medicine”. CRC Press pp: 456-458

Clinical Excellence Commission., 2015 Medication Safety Self Assessment. Retrieved from: https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0011/326909/MSSA_complete_workbook_2015.pdf

Hayes, C., Jackson, D., Davidson, P.M. & Power, T., 2015. “Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration”. Journal of clinical nursing, 24(21-22), pp.3063-3076.

Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. 2015. “Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study”. BMJ open, 5(3), e005948 pp: 25-56.

Levett-Jones, T. M. 2018, ‘Medication administration’, in A. Berman, S. Snyder, T. Levett-Jones, P. Burton & N. Harvey (eds), Skills in Clinical Nursing, Pearson Australia, Melbourne, VIC, pp. 240-48.

Phatak, A., Prusi, R., Ward, B., Hansen, L.O., Williams, M.V., Vetter, E., Chapman, N. & Postelnick, M., 2016.” Impact of pharmacist involvement in the transitional care of high?risk patients through medication reconciliation, medication education, and postdischarge call?backs (IPITCH Study)”. Journal of hospital medicine, 11(1), pp.39-44.

Sahay, A., Hutchinson, M. & East, L., 2015.” Exploring the influence of workplace supports and relationships on safe medication practice: A pilot study of Australian graduate nurses.” Nurse education today, 35(5), pp.e21-e26.

Singh, H. & Sittig, D.F., 2016. “Measuring and improving patient safety through health information technology: The Health IT Safety Framework”. BMJ Qual Saf, 25(4), pp.226-232.

Sorenson, C., Bolick, B., Wright, K. & Hamilton, R., 2016. “Understanding compassion fatigue in healthcare providers: A review of current literature”. Journal of Nursing Scholarship, 48(5), pp.456-465.

Vallerand, A. H. 2018. “Davis's drug guide for nurse”s. FA Davis.pp:256-289