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The Importance of Medication Safety

Discuss about the Medication Safety and Its Affects.

Medication safety is the freedom from any preventable form of harm with medication use. Medication is an aspect which entails adverse drug events which result from usage of medication., (Rajasekaran et al, 2017 pp. 183) The consumed drugs leads to adverse reactions and include observations of side effects, overmedication and medication errors. Adverse drugs events are termed as serious public health issue globally. Medication safety has led to improved revision of standards which emphasizes on systems which prevents occurrences of drug adverse effects. Health care practitioners’ and professionals thus are obligated to ensure safe use of medications and minimisation of errors, (Carayon, et al, 2014 pp.14-17).

Medication safety has been attributed to adverse drug events which result to injuries from medication use. Adverse drug events can be caused by preventable errors. Adverse drug events that are not prevented result in adverse drug reactions referred to as drug response is noxious and not intended and occurs at doses designed for prophylaxis, diagnosis or disease therapy medication, (Sørensen et al,2016. Potential cases of adverse drug evens are referred top medical errors which don’t cause any harm to the patients as they are managed before they harm the patient. Medication safety has been shown to have an impact on health outcomes of patients such as hospital length of stay, rates of readmission and overall health care costs, (Hall et al 2016).

Medication safety affects nurses negatively. The trauma effects on the nurse can be at times overwhelming to bear. Nurses most of the times worry on patients. Nurses often feel upset, guilty and often terrified on medication safety. At times they often feel loss of confidence, guilty and terrified, which end up feeling angry on the system and for themselves, (Lavin, Harper & Barr, 2015).  Most of the medical safety concerns are committed by nurses. This is largely attributed to nurses being the largest medical team who offers drugs to patients and spends an estimate of 40% of their time hospitals set ups giving medication, (DoH, Australia, 2004).

Medical safety concerns such as medical errors often lead to various medical problems such as poor treatment of patients, legal problems and rehospitalisation cases, damaged medical profession and further decline on nurses reputation.

Medical safety is a professional nursing issue  as the main goal of an health care system is to ensure that there is preservation and promotion of health, (Croke, 2003). Preserving the safety of the patient is key determinant in providing care. a paramount stage in medical care is patient safety which is guaranteed with medical safety aspects. Since the awareness of medical errors in the beginning of new millennium, many huge efforts have been made to ensure that patients access safe medical experiences and safety process. Medical errors have been attributed as common form of errors which have threatened safety of the patients in hospitals, (Australian Government, 2008).

Medication Safety and Nursing Practice

Medical administration in this sense is an important nursing task. The work over load coupled with increased dosage intake of medication prescription in the professional practice puts the&nbsp nursing practiceat a delicate balance of ensuring safety. Occurrences of medical errors often have disastrous effects on patients and affect the overall nursing practices, as medical negligence sets in, (Tobiano et al, 2015 pp 2745-2455).

Medical safety often occurs at high incidence level on a day. Medical errors as a form of medical safety indicators can include practices such as administration errors, dispensing errors, wrongful information on writing of orders and errors committed during ordering. A nurse on a single day can administer more than 50 medications in any single shift, (Durham et al, 2016 pp 76).

These medical errors have tremendous effects on the nurses. It affects them negatively. They undergo psychological trauma as the medical errors can be so much overwhelming to the nurse. Nurses worries a lot about the patient, often this worries are accompanied by feelings of upset and feelings of guilt. At times missing basic medical safety practices can lead them to loss of confidence in their enjoyment on clinical practices, (Zimmerman & House, 2016 pp 49).

Medical safety wrong doings have shown to have negative effects on patient confidence and overall burden on health care system. Further it has been shown to increase health care costs. Safety has been advanced by ethical and code of ethics of no harm for patient safety. In order to ensure principle of do not harm is practised, health care facility fosters an environment which allows patient safety and eliminates the burden associated with patient confidence and recovery, (Tobiano et al, 2016).

An important aspect in ensuring medication safety is through identifying medical errors and their root causes. Medication errors have been the most contributing factor of medication safety, which threatened patient safety and has been used as an index of determination on patient safety in various hospital settings. Studies done have shown that medication errors increases hospitalization stay by 2 days which lead to an increase of between $2000-$2500 per patient, (Kim et al, 2017). Further most of the medication errors are committed by nurses. Further causes of committing these medication errors have been attributed to personal factors such as stress, fatigue drug administration errors, lower levels of attention, predisposing causes such as shortage of skilled work force, long duration at work place, (Flynn et al, 2016).

Impacts on Nursing Practice

Patient safety entails the avoidance or unexpected harm caused to people while receiving medication attention. Patient safety put more emphasis on safety in health care practice through analysis medical errors which is associated to adverse effects. NMBA 2015 nursing practice principles advocate patient centred care and stresses on the role nurses play in offering patient centred care which is safe and of good quality.

Studies conducted in England have shown that medication errors account for 15% and of these 56% were committed by nurses, (Rose et al, 2000). Study done by Simpson et al, (Simpson et al, 2004), found out that medication safety pertaining medical errors accounted for 71% which related to imperfect prescriptions of drugs while an estimate of 29% were caused by wrong dosage calculations.  While a study conducted by Penjvini in India found out that medical errors accounted for 16.7% and most prevalent were omission of drugs and wrong dosage of drugs, (Penjvini, 2006).

The impact of medication safety on patients can cause severe injury to patients and at times can cause deaths. Further it has been linked to severe psychological, emotional and financial stress on health care organization. On a personal level the impact on patients is that it can cause temporal or permanent damage to patients. Loss of loved ones due to unsafe medical care often is devastating to the family and relatives of the loved ones, (Pham et al, 2011 pp 482).


Ethical aspects ought to be practiced when making care process for the patients so as to ensure medication safety, (Atkins et al, 2017). Good ethical process ought to be followed and usage of standard operating frameworks which inform care need to be followed, (Brown University, 2018). According to Australia Government Health department, the responsibilities of health care workers are geared towards the reduction of harm level to patients. Nurses as health workers have the responsibility of duty of care, (Austalian Gov, Online 2018), to provide professional service which promotes the safety and recovery of the patients, (Department of health, 2004). Legislation have been put in place by New South Wales state which outlines that health care professionals have the duty of care to provide safe and preventing harm during medication process, failure to this has been attributed to acts of medical negligence by patients. Practising nurses have the role of taking necessary precautions in order to enhance patient safety, (NSW, Act 2002 No 22).

Impacts on Patient Safety

Nurses as an important aspect in health care professionals need to incorporate nursing ethics which provide acts of beneficence and non mal eficent, (Johnstone, 2016). Nurses have a role of doing good for the patients and reducing harm to patients.  There is need for following codes and guidelines for nursing practice, (Staunton & Chiarella, 2017 pp 20-50).  In this way embracing professional accountability is of concern; hence nurses need to practice safely and take accountability for their actions so as to enhance, promote patient safety and improve overall score of medical safety.

The need for strategies for improving medication safety is of great interest in acute care setting for patient safety is key. These strategies include;

  1. Nurses training and continuous education
  • Facilitating education approaches which improves medication safety and minimises medication errors need to be implemented. Randomised controlled study on the interactive use of CD-ROM education tool to improve on safe usage of medication and decrease on the rate of medical associated errors has been found effective, (Schneider et al, 2006). Use of web based educational forms to improve drug safety among nurses has been effective, (Frankline et l, 2006 pp 335). Education training for nurses and use of simulation process of medication administration in cotrolled settings has been successful in improving medication safety.
  1. System change
  • One of the factors which have hampered medical safety is low levels of reporting and identification of system lapses. Strategies targeting system change include error reporting, process of medication administration which is aimed at reducing the errors, (Force et al, 2006 pp 35). Further involving patients in care process is an aspect of system change. Patients who are hospitalized have the chance to administer their own medicines under nursing staff supervision. This enhances overall patient safety on nursing practice and overall care process of the patients which involve their families, (Wright et al, 2006 pp140).

Thus medication safety nature of the problem s extensive and nursing practice finds itself on the path of medication process. Nurses are majorly involved in medication administration phases and play crucial role in prevention and detection of errors. The impact medication safety has on patients is tremendous, thus there is need for professional practice so as to reduce unsafe medical processes.

References

Atkins, K., De Lacey, S., Britton, B. & Ripperger, R. 2017, Ethics and law for Australian nurses, Cambridge University Press.

Australian Government 2008, Law of Negligence and Limitation of Liability Act 2008 (NI), Federal Register of Legislation, Viewed 27/02/2018, <https://www.legislation.gov.au/Details/C2016O00058>.

Australian Government 2018, Guide to Social Security Law, Viewed 27/02/2018, <https://guides.dss.gov.au/uide-social-security-law/1/3/4/10>.

Brown University 2018, A Framework For Making Ethical Decisions, viewed 4/3/2018, <https://www.brown.edu/academics/science-and-technology-studies/framework-making-ethical-decesions>.

Carayon, P., Wetterneck, T.B., Rivera-Rodriguez, A.J., Hundt, A.S., Hoonakker, P., Holden, R. and Gurses, A.P., 2014. Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), pp.14-25.

Croke, E.M. 2003, ‘Nurses, Negligence, and Malpractice: An analysis based on more than 250 cases against nurses’, AJN The American Journal of Nursing, vol. 103, no. 9, p.p. 54-63.

Department of Health 2004, Duty of Care Issues, Australian Government, viewed 27/02/2018, <https://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front11-wk-secb-6-1>.

Durham, M.L., Suhayda, R., Normand, P., Jankiewicz, A. and Fogg, L., 2016. Reducing medication administration errors in acute and critical care: multifaceted pilot program targeting RN awareness and behaviors. Journal of Nursing Administration, 46(2), pp.75-81.

Flynn, F., Evanish, J.Q., Fernald, J.M., Hutchinson, D.E. and Lefaiver, C., 2016. Progressive care nurses improving patient safety by limiting interruptions during medication administration. Critical care nurse, 36(4), pp.19-35.

Force, M.V., Deering, L., Hubbe, J., Andersen, M., Hagemann, B., Cooper-Hahn, M. and Peters, W., 2006. Effective strategies to increase reporting of medication errors in hospitals. Journal of nursing administration, 36(1), pp.34-41.

Ethical Practices for Medication Safety

Franklin, B.D., O’grady, K., Parr, J. and Walton, I., 2006. Using the internet to deliver education on drug safety. BMJ Quality & Safety, 15(5), pp.329-333.

Hall, L.H., Johnson, J., Watt, I., Tsipa, A. and O’Connor, D.B., 2016. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One, 11(7), p.e0159015.

Johnstone, M., (2016). Bioethics : a nursing perspective. Chatswood, NSW.

Kim, J.M., Suarez-Cuervo, C., Berger, Z., Lee, J., Gayleard, J., Rosenberg, C., Nagy, N., Weeks, K. and Dy, S., 2017. Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety. The Patient-Patient-Centered Outcomes Research, pp.1-14.

Lavin, M.A., Harper, E. and Barr, N., 2015. Health information technology, patient safety, and professional nursing care documentation in acute care settings. Online J Issues Nurs, 20(6).

New South Wales Government 2002, Civil Liability Act 2002 No 22, viewed 27/02/2018, <https://www.legislation.nsw.gov.au/#/view/act/2002/22>.

Nusing-and-Midwifery-Board---Code---Code-of-conduct-for-nurses--1-March-2018.docx , https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Penjvini, S., 2006. Investigation of the rate and type of medication errors of nurses in Sanandaj Hospitals.

Pham, J.C., Story, J.L., Hicks, R.W., Shore, A.D., Morlock, L.L., Cheung, D.S., Kelen, G.D. and Pronovost, P.J., 2011. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. Journal of Emergency Medicine, 40(5), pp.485-492.

Rajasekaran, S.K., Schnipper, J., Kripalani, S., Ramanan, R., Maxwell, S., Karpa, K., Durning, S., Nierenberg, D., Kenison, T. and Englander, R., 2017. Medication Safety Curricula in US Medical Schools—A Call for Action. Medical Science Educator, 27(2), pp.183-187.

Ross, L.M., Wallace, J. and Paton, J.Y., 2000. Medication errors in a paediatric teaching hospital in the UK: five years operational experience. Archives of disease in childhood, 83(6), pp.492-497.

Schneider, P.J., Pedersen, C.A., Montanya, K.R., Curran, C.R., Harpe, S.E., Bohenek, W., Perratto, B., Swaim, T.J. and Wellman, K.E., 2006. Improving the safety of medication administration using an interactive CD-ROM program. American Journal of Health-System Pharmacy, 63(1), pp.59-64.

Simpson, J.H., Lynch, R., Grant, J. and Alroomi, L., 2004. Reducing medication errors in the neonatal intensive care unit. Archives of Disease in Childhood-Fetal and Neonatal Edition, 89(6), pp.F480-F482.

Sørensen, A.L., Poulsen, B.K., Nielsen, L.P., Lisby, M. and Mainz, J., 2016. Psychiatric nurses perceptions of the nurse-physician relationship in relation to medication safety. In 4th Nordic conference on research in patient safety and quality in healthcare.

Staunton, P. & Chiarella, M. 2016, Law for nurses and midwives, 8th edn, Elsevier, Sydney.

Tobiano, G., Bucknall, T., Marshall, A., Guinane, J. and Chaboyer, W., 2016. Patients’ perceptions of participation in nursing care on medical wards. Scandinavian journal of caring sciences, 30(2), pp.260-270.

Tobiano, G., Bucknall, T., Marshall, A., Guinane, J. and Chaboyer, W., 2015. Nurses' views of patient participation in nursing care. Journal of advanced nursing, 71(12), pp.2741-2752.

Wright, J., Emerson, A., Stephens, M. and Lennan, E., 2006. Hospital inpatient self-administration of medicine programmes: a critical literature review. Pharmacy World and Science, 28(3), p.140.

Zimmerman, D.M. and House, P., 2016. Medication safety: Simulation education for new RNs promises an excellent return on investment. Nursing economics, 34(1), p.49.

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