Medication administration was one situation I observed during my clinical experience that was not congruent with best practice guidelines. When several nurses were giving medications, they did not ask for resident identifiers such as birth date or name. I understand the nurses see several of these patients on a regular basis; however, best practice guidelines indicate use of six medication administration rights for all residents (reference article). The nurse could get busy and forget what resident they were supposed to be giving medication to and administer the wrong medication. If medication was gave to the wrong person without the nurses knowledge this could cause harm to the resident that received the wrong medication, and cause harm …show more content…
They gave the pills to the resident with water and walked away. They did not check if the medication should be separated. I understand that many medications could be combined and given in the same cup; however, certain medications should not be given together.
I believe that this is all done due to time. With the nurse having so many patients, to get each resident their medication the nurses need to work fast. This can lead to ineffective working and mistakes that the nurse might not know are being made. This can cause harm to the resident and even cause death to the patient. It is important for each nurse to understand that they should not give any medication that they are not familiar with without calling the pharmacist to answer any questions.
2. What do evidence and regulating agencies recommend for best practice in this situation? Please be detailed in your responses and include rationale. (3pt)
When giving resident medication the nurse should do the “six rights” of drug administration. The six rights are right patient, right medication, right route, right dose, right time, right to know about medication, right to refuse and right documentation. For the right resident the nurse needs to verify the resident by asking for his or her name or room number and check this information with the patient’s MAR. For the right drug, the nurse should check the drug label three times. The first drug check is at the first contact with the medication bottle the second is
It should be made mandatory for the nurses to read back the documented prescription to the doctor. It should be signed by the doctor for confirmation after been reviewed by the druggist.
Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are
Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.
According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year. An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.
rights, health, and safety of the patient.” This provision, identifying patients, medication safety are related because it is a nurse’s responsibility to protect the patient from harm and promote safety. Nurses are taught to use multiple checks before administering a drug and use two identifiers. These checks include checking the medication against the order when obtaining it, checking again when preparing the medication and the last check is done at the patient’s bedside prior to giving the medication. Also it is imperative to question any medication order that does not seem fit. The order should include a date, time, name of the medication, dosage strength, the route for
Non care setting - Medications are often stored and administered in a variety of non-health care settings. These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following: Acquisition of medications (e.g., from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients
1. In the workplace there is a generic Medication Management Policy and Procedures for Adult Services (Issue 10, 2012) document. This is kept to hand in a locked cupboard, readily available to read. It requires that all Healthcare Staff are given mandatory training and refreshers are provided. Legislation which surrounds the administration of medication includes The Medicines Act 1968, The Misuse of Drugs Act 1971, The Data Protection Act 1998, The Care Standards Act 2000 and The Health and Social Care Act 2001
Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic
The nurse must verify the physician’s medication order, including the dose and time, and then the pharmacy is responsible for their own checks and balances via the BCMA system in order to complete the dispensing phase of the medication (Gooder, 2011). The nurse enters the BCMA system with a login and password and is able then to see a list of the virtual due list for a specific patient. The computer on wheels is then taken to that patient’s room and the five rights of medication administration begin. As nurses, we are taught to use the five rights of drug administration are (1) right patient (2) right medication (3) right dose (4) right route and (5) right time. By scanning the barcode on the patient’s hospital identification band, the nurse then asks for the patient to verbally state their name and date of birth, which can be verified by the nurse on the virtual due list and then choses the medication that are due for administration at that time. The medication is dispensed and the nurse is able to scan the barcode on the medication, the scanning triggers the automatic documentation of the medication given (Kelly, 2012).
Be careful when administering medications where there is more than one patient on the unit with the same name.
When I say this, however, most people would picture the nurse giving the wrong medication due to lack of focus on the tasks at hand. While this could happen, I have noticed during my time at hospitals that the doctor orders are still hand written for the most part. Consequently, they can be very hard to be read legibly much less correctly translated into proper medication dosages. The first suggestion I would give to an organization would be that they required all orders to be submitted securely, by the doctors, to the pharmacy be electronic means.
Basically, it is safe to delegate: routine medication administration and procedures to chronic and stable patients to licensed nurses (Yoder-Wise, 2015).
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 (
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the
In today’s current fast-paced and demanding field of heath care, medication administration has become complex and time-consuming task. Approximately one-third of the nurses’ time is used in medication administration. There is much potential for error because of the complexity of the medication administration process. Since nurses are the last ones to actually administer the medication to the patient therefore they become responsible for medication administration errors (MAE). Reasons for MAE may include individual factors, organizational factors or system factors. This paper will discuss the root causes analysis of MAE and strategies to prevent them.