McComas, Riingenm and Kim (2014), conducted a study that investigated the occurrence of medication errors and the efficiency of medication administration following the implementing an eMAR system. The study was conducted in an appropriate setting and all observed nurses volunteered for the study. Before implementing the eMARs mandatory class were provided and nurses were evaluated for competency. Data was collected by observation and nurses were randomly followed throughout a medication pass. Collected data consisted of medication errors, distractions during medication pass and amount of time spent administering medications.
The results of this study was that the percentage of medication errors decreased following the implementation of eMARs. Although medication errors were decreased, the authors found that the eMAR system decreased efficiency and disturbed workflow. The authors state that factors such as missing medications, preparing medication at the bedside, and distractions contributed to this and are factors that can be improved. The author’s identified the presence of several limitation in the study. The use of one individual to collect data created a possibility of bias and the observation of nurses may have affected the behaviors of the nurse. Also, the authors state that the study was not a cause and effect study and was only conducted on one unit which decreased the generalizability of the study. According the hierarchy of evidence for intervention studies, this
According to a cross-sectional study involving 237 nurses, approximately 65% of the nurses have made medication error. Only 31% of the participants reported medication errors. According to the study the most common type of reported errors were wrong dosage and infusion rate. The most common causes were using abbreviations of the drugs and similar names of the drugs. However, the study did not find any relationship between medication years and years of experience, age, and working shift. Yet study found association between intravenous injection and gender (Cheragi at al
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.
Nurses are responsible for multiple patients on any given day making medication errors a potential problem in the nursing field. Medication administration not only encompasses passing medication to the patients yet begins with the physician prescribing the medication, pharmacy filling the correct prescription and ending with the nurse administering and monitoring the patient for any adverse effect from the medication. According to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), ‘A medication error refers to any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional,
Based on the patient safety, patient satisfaction, data, and culture of the institution, it is possible to choose different methods of reducing risk in health care settings. Those methods include ancient methods such flow-sheets, Kardex, sticker reminders, checklists. The EMR is a new and convenient method to mitigate error in health care settings.
Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/
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
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
There is no substitute for common sense and diligence, but technological advances may be of use in helping to prevent medication errors. Technological measures include automated medication dispensing machines, computerized IV administration, and the bar coding of both patients and drugs. A research study conducted among a select group of nursing students at a suburban New York university was designed to answer the question: Does the use of PDAs (personal digital assistants) with drug and medication calculation software improve the accuracy and efficiency of medication administration (Greenfield, 2007)? Results of this study upheld the hypothesis that the use of PDAs and medical software did, overall, improve the accuracy and efficiency of medication administration. The author of the study recommends that all nursing students be required to have PDAs with drug and calculation software on them. There is evidence to
EMR concerns are plaguing the health care industry today that requires change. Healthcare professionals, such as nurses, are on the front lines in the defense against medical errors. Closing the gap between current clinical and hospital practices and the various approaches to improving patient safety requires changes that are cultural and systemic in nature. The greatest challenge to hospitals using an EMR system is the expense of the new system, and the challenge nurses face with technology adoption in usage of EMR and protection of records. Even though spending depends on both the hospital size and the technologies were chosen, implementation and installation of a Health Information Technology system, which includes EMR, are often multi-year investments. The transition from a paper-based system to an electronic system is a very complicated process within every hospital establishment. The transformation is time-consuming and involves numerous staff from across the hospital, including Information Technology personnel, physicians, nurses, ancillary providers, etc. Although hospitals work hard at managing the changes required to move toward an electronic environment, there is no guarantee that hospital personnel will properly utilize the expensive new IT system or EMR. Therefore, the training in the EMR integration is required to all medical staff to have an efficient and uncomplicated system.
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 (
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.
After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when
Nursing in today?s society involves more than technical skills, critical thinking, and compassion. It also is changing to add the ability to not only understand but be able to utilize technology to impact a patient?s health. There are many technological changes employed in healthcare practices, however, I have chosen to address bar-code medication administration or BCMA. According to an article in the Journal of Patient Safety, ?bar-code medication administration has been shown to be effective in reducing patient medical errors, yet is still only utilized in 5% of the country?s health care facilities? (Sands, Slebodnik, & Young, 2010). Medication errors are common in hospitals and often lead not only to patient harm, but also lengthy hospital stays and law suits. ?One study identified 6.5 adverse events related to medication use per 100 inpatient admissions, more than one fourth of these events were due to errors and were therefore preventable? (Bane, et. al., 2010).
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
Electronic medical records had a great impact in the ushering in of the age of Nursing Informatics. (Himss, 2010)EMRS present healthcare professionals with the ability to retrieve and organize data in a quick and efficient approach. With information so readily available, patient safety increases and we know that patient cost goes down. This happens because patient medications, allergies, history, demographic, and treatment information is more collectively available.