Improving Nursing Practice

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

The standards, during this case, are referred to as the rights of medication administration and over the years there are 5, then six and currently in several places eight rights. All medication errors may be connected, in a way, to AN inconsistency in adhering to those rights of medication administration. The rights are educated in nursing education and coaching, as well as they are enforced by the nursing board and the employer.

The nursing practise has continually evolved and can be described as autonomous due to the significant involvement of nurses in patient care. This then necessitates critical reflection as a way to continually develop and improve the nursing practise. The Gibbs' model, one of the reflection models, assists nurses in complying to the codes and guidelines of nursing practice. For example, developing action plans, evaluating patient outcomes, and thinking critically. This essay will describe an event involving nurses and explain the feelings it evoked. It will also provide an evaluation of the positives and negatives, analysis and enhancement of learning, and an action plan.

As it is mentioned earlier, medication administration includes various steps and an interdisciplinary team. Undoubtedly, nurses play a vital role in the medication administration process. Since patient safety is the priority to all health care professionals, it is important for the nurses to effectively communicate and collaborate with an interdisciplinary team if he or she is unsure about any medication prescription to prevent any adverse events. In addition, patient education is another component of safe administration. A patient must be educated on medications they are taking, the reason for taking them, the dosage, a route, potential side effects, and interactions. Nurses should perform “six rights” of the medication each time. Before administering

In the healthcare facility there are many things that can benefit from change. Bedside rounding with the inclusion of the entire care team would be a beneficial change to any healthcare facility. By doing bedside rounding it promotes patient and family involvement in the exchange of information and planning of their care. This also allows for the interdisciplinary team to be completely involved rather than picking up bits and pieces of information throughout the day from multiple different people. This is also a great opportunity for the patient and their family to ask questions with the entire care team available for answers.

This article will look at two articles and focus on aspects of safety medication administration in nursing practice by the staff nurses. This is interesting area because the previous report on the medication administration error in the UK shows that approximately 5.6% of doses administered to adult hospital patients and it has been estimated that 0.6-1.2% of medication administration errors may lead to severe harm even death (Mcleod et al, 2013). Leape et al (1995) indicated that nurses were responsible for 86% of all medication error interception, regardless of the original errors. The nurses play the important role in identifying the causes of medication errors and preventing medication administration errors in nursing practice in order to provide safe care toward the service users (Henneman et al, 2010). The Medicines and Healthcare Products Regulatory Agency (MHRA 2004) documented that the health professionals need to effectively and safely use medicines to ensure patients get the maximum benefit from the medicine; meanwhile minimizing the potential harm. This article will be critiqued on the different types of evidence which explored safety medication administration in the nursing practice toward service user. Using evidence is important in nursing practice because it can help nurses in addressing questions related to best possible care and improve patients’ outcome. It is embedded within the code the nurses are expected to use best possible evidence in the nursing

Nurses were required to confirm the right patient, medication, dosage, time, and route. The five rights aided in the process but errors were still made. Nurses working long hours, mandatory overtime, budget cuts, increased patient nurse ratio, and high patient acuities are also noted to contribute to the increase of errors. For many of these issues there is not a quick remedy. Geiger shared the elimination of retribution for medications errors would help decrease the effects associated with medication administration.

As a leader in the workplace, medication errors mostly occur when the workplace is understaffed with a patient load of full nursing cares that require more attention and care than patients who are independent. Due to being understaffed with a patient load of 13 to 2 nurses, medication errors occur more often as nurses are being rushed to finish all cares within their work timeframe. To decrease medication errors it is important to implement more staff during medication rounds, thus giving nurses additional time to concentrate and assure that the correct medication and dose is being given to the right patient ( ). The 6 medication rights are important to implement into every workplace as it decreases the chances of administrating medication to the wrong patients ( ). The medication right include; ______________________________________________________________ ( ). Medication errors have important implications for patient safety and in improving clinical practice errors to prevent any adverse events (

Mary, a 79 year old patient has gotten up from bed without assistance to use the restroom. She falls on the way and hits her head leaving her with a huge laceration and possible subdural damage. This is the third fall this month on the unit; changes must be made in order to address the policies to prevent falls. Policy changes are one of the many issues that a quality improvement nurse will address in her field.

The new healthcare system is based on the quality service rendered that will eventually decrease the costs (James, 2012, p. 1). This system will give a reward or a bonus to the health care providers whenever they meet or exceed quality standard that are being set (James, 2012, p. 1). In contrary, the system can also penalize those providers that are unsuccessful in providing the indicated goals or cost savings (James, 2012, p. 1-2). With the healthcare systems demand on quality care, institutions participate in various quality improvement activities (Draper, Felland, Liebhaber, & Melichar, 2008, p. 1). Because nurses are the frontline in patient care, they can affect the outcome of the treatment given. And therefore, their involvement in quality improvement are essential (Draper et al., 2008, p. 1).

To determine the level of competency of nurses during medication administration facilities should provide competency exams to nurses that focus on medications administration procedures. Competency and education of medication administration in nurses should be assessed during orientation and on a yearly basis. Medication administration is one of the most common duties nurses have in hospitals. According to the New Zealand Medical Journal, most of the injuries and adverse reactions that result from the wrong medications or doses given could have been prevented through safer medication practices and education (p 63). The Institute for

From this experience, I learned that practicing skills can help you in the field to make less medication error, also, helps to build the confidence. As a nurse, it is our responsibility to provide proper care to the client and making sure that we are not risking the client’s health by not improving the required knowledge (Antipuesto, 2011). However, if we look from a client’s perspective, they are putting faith in us by taking the medications that we provide them based on their care plan. It also helps to maintain a commitment that we make to the clients and nursing profession by following CNO practice standard of ethics.

Furthermore, I also understood that simply by providing handouts and telling her what the medication is not enough. I needed to ensure that patient has a full understanding of when, how and why to take medications. From my experience, I knew that in order for me to provide the education, the patient has to be ready to receive it. I also included patient’s spouse , gave them opportunities to ask questions, and I used the teach back method to ensure that the patient has a full understanding of her disease and medication regimen. This situation is an example of teaching-coaching function domain of nursing

contemplates his/ her views, beliefs, values ideologies and opinions as well as those of others in healthcare.

Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error