Medication errors commonly occur in healthcare facilities. According to the Joint Commission, these medication errors are believed to be the most common type of medical error and are a significant cause of preventable adverse events (The Joint Commission, 2008). Many experts agree with the research that medication errors have the potential to cause harm within the pediatric population about three times as higher than in the adult population. This is due to medication dosing errors that are weight-based dosing calculations, fractional dosing, and misplacement of the decimal point that can lead to overdosing or under dosing (The Joint Commission, 2008). Children are at greater risk than adults for medication errors because they have an immature physiology as well as developmental limitations that affect their ability to communicate and self-administer medications (The Joint Commission, 2008). Another important factor is that the great majority of medications are developed in concentrations appropriate for adults; therefore, pediatric indications and dosage guidelines often aren 't included with a medication, necessitating weight-based dosing or dilution (The Joint Commission, 2008). The need to alter the original medication dosage requires a series of pediatric-specific calculations and tasks, each significantly increasing the possibility of error (The Joint Commission, 2008). Additionally, an observation of safety regulations and practices by Nemours Children’s
The issues addressed are Findings 1 and 3: Finding 1 is patient medication errors are up and there is a perception of shady hiring practices and playing favorites. All employees are responsible for compliance. Policies and professional standards exist for the medical profession. The challenges will be reintroducing employees to Federal and state law that govern the profession. For hiring practices and playing favorites the challenges faced are the lack of compliance reporting structure or training for understanding compliance. There is a perception that work rules are not being enforced. Finding 3 is high job turnover and low employee morale. The challenges faced will be building communication strategies, building confidence in leadership,
Older adults are at high risk for adverse effects of medication error more than their counteract younger adults. This is because they depend on more than one medication in order to treat or prevent disease, syndromes and sickness (Lindenberg, 2010). It is inevitable that the elderly face adverse effects of drugs while on medication especially when they still live independently. However, chances of errors in hospitals and care homes are more frequent when the medication process connects several departments (Belen et. al., 2009). Therefore, tactical measures are required in the provision of drug therapy in order to optimize safe medication in older adults. This paper discusses the issue by analyzing the existing structure of administering medication, reviewing the occurrence of medication errors; evaluating systems developed to advance safe medication administration. Finally, addressing the implication for professional nursing practice.
The world of pharmacy is a world of continuous change; there are so many specialties that the average person does not know what a pharmacist does, besides counting pills behind a counter at the local drug store. Pediatric pharmacy is a much needed specialization in the pharmacy world, and there is so much involved with it. The role of a pediatric pharmacist is in an inpatient setting, looking at medications, disease states and drug interactions to ensure the child’s safety. When it comes to dosing implications, the dosing guide for children is much different than it is for adults, as it depends on the age, weight, disease state, and much more. Dosing in children is a major part of a pediatric pharmacist’s job because a medication error can result in death easier than it can in an adult.1 These are all things that a pediatric pharmacist has to take into consideration during their daily job. Additionally, parents want to be able to trust the person responsible for their child’s medications. In order to become a pediatric pharmacist, more training than just a doctorate of pharmacy is required.
Approximately 440,000 people die every year from preventable medication errors. This is is the third leading cause of death in the United States. Many of these errors could be avoided if Medical facilities would use standard precautions when administering medications. Health care workers should be better educated in patient care and preventable medical errors, this extra knowledge could save millions of lives and save millions of dollars. To keep these medication errors from occurring, it is important that all medical staff keep increasing their knowledge about medication errors and patient care. This will help decrease the death tolls in all Medical facilities.
This paper addressed the problem of medication errors in the healthcare setting and how they occur. Although medication errors sound harmless it actually injures hundreds of thousands of individuals a year in the United States. The significant of this subject is that medication errors occur according to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although medication errors can occur in any floor at any moment it is more prevalent to occur in the modes of transferring a patient. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.” During this time frame the patient is changes settings and, the person responsible for the health care decision is also changed. The specific clinical question guiding the search for quantitative research article is as follows: In hospitalized patients that are being transferred would proper communication decrease the risk of medication errors? The Population would be hospitalized
Medication errors have contributed to healthcare issues and created problematic discrepancies affecting costs, safety issues, qualitative concerns, and economic effects. This review will provide the background, rationale, and the overview of multiple issues causing medication errors. Issues contributing to negative effects of the health system will be identified including how specific issues affect patients, and adverse drug effects. Effects on health costs will be reviewed as they relate to higher health costs, in addition to the impact higher costs have on the economy.
Medication errors are one of the most costly errors for a hospital to encounter. According to the Institute of Medicine (IOM), there is an estimate of over 90,000 people who dies annually as a result of hospital mistakes arising from medication errors. The IOM estimates that medical errors alone cost the U.S. over $37 billion each year. In resents studies, it has been revealed that preventable adverse events (PAEs) lead to 350,000 patients who seek care in hospitals. The CDC reports that these figures make medication error to be the third leading cause of death second to heart disease and cancer. The purpose of this case study is to bring awareness to staff and educate them about the seriousness of this matter. Sentinel outcomes within the hospital settings are preventable with better patient’s outcomes projected. The Chief Nursing Officer (CNO) must remain knowledgeable and direct change that will promote a Healthy Reliability Organization that is supported and guided by the practice of evidenced-based medicine. The CNO can address leaders within the organization to tackle such an issue now before further damage is done. This will allow the organization to incorporate a more comprehensive approach to improving care within the hospital with better quality outcomes implemented. Hospitals by adopting the TeamSTEPPS principles can promote high-quality patient care that is supported by evidence-based practices (Crane & Crane, 2006; Kohn,
This paper addressed the problem of medication errors in the healthcare setting and how they occur. Although medication errors sound harmless, it actually injures hundreds of thousands of individuals a year in the United States. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although medication errors can occur in any floor at any moment it is more prevalent to occur in the modes of transferring a patient. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transit of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.” During this time frame the patient is changing settings and, the person responsible for the health care decisions is also changed.
“Any error in the process of prescribing, dispensing, or administration of a drug, irrespective of whether such errors lead to adverse consequences or not, are the single most preventable cause of patient Harm.
Our study has several limitations. The comparison of our data with other studies was challenging due to the lack of studies investigating intra-operative medication errors in the pediatric population, in addition to differences in the healthcare systems, definitions of medication errors and methodology used. We studied errors in the surgery department in one teaching Children’s hospital in Egypt, so our results may not be applicable to non-academic hospitals where patients are expected to receive more care, but may be generalized to other departments in the hospital as errors are usually committed by residents who rotate among several departments in the hospital. Even with an integrative methodology to data collection, we probably failed to
Before giving any medication to their children, parents read the suggested dosage on the label of the medication to determine how much they should give the child. In most cases the labeling on the side of the medication is incorrect for children, because of their weight, height, and metabolism (Christensen). More often than not labeling companies just size down the doses for children rather actually testing the effects (Christensen). By doing so children do not receive a correct dose size that would efficiently treat the symptoms that they are experiencing. However, some medication is tested on children and is safe to use. Most pharmacists will take a pill and turn it into a liquid form for child usage (Christensen). Even so only five out of the eighty most commonly used Over-The-Counter drugs are approved and safe for pediatric use (Christensen). As stated earlier people are incorrectly treating illnesses whether it is an incorrect size or an incorrect medicine altogether. In another study that was conducted, it was found that the medication Mevacor, a medicine used to lower cholesterol, had the same effects in treating patients using only half of the starting dose of 20 milligrams a day (Consumer Reports). This goes to show that even with modern day research misdosage can still be very common. The main goal of any parent or caregiver is to make sure that the child they are raising is healthy is receiving the proper care they deserve. In doing so they may make irrational decisions in order to treat the child as soon as possible, instead of doing research or contacting their local pediatrician. This is why it is so often that children receive medicine that does not actually benefit the child, like antibiotics for a cold.Another equally important reason that supports the idea that children are being over medicated is the notion that it
Within the first seven days of admission and readmission in a skilled nursing facility older people have an increase in medication errors. The study was put together to evaluate the process-related factors and structure that my cause and increase in medication errors as well as harm. The residents in North Caroline skilled nursing facilities during months of October 2006 to September 2007 showed medication errors from the medication error quality initiative-individual error database. When looking at the prescribing errors they were much less common than administration errors. However, they were much more likely to cause harm to patients. On the contrary looking at structure and process measures of quality, they were related to the volume
Medication error is any preventable event that may cause or lead to inappropriate use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Unfortunately, among the 98,000 deaths that occur every year from medical errors in the U.S hospitals, a significant number of those deaths are associated with medication errors. This is a most significant issue we see today affecting patient safety and in turn costs in hospitals very often, poses dangerous consequences to the patients.
Simple medication errors can place patients at high risk for injury or even death. Doctors and nurses factor primarily as the main contributors in causing these errors. Prevention may be the key to decreasing medication errors through the use of a few simple steps. For example, doctors clarification of medications with the patient or family members, the writing of orders or prescriptions accurately and legibly, and nursing applying the five rights rule, right patient, right medication, right dose, right route, and right time. Additionally, the result of current statistical data has also proven the need to prevent medication errors in hospital setting. Some hospitals have utilized ways of preventing medication errors by using new technologies, one called the Pixus machine, a computerized system for dispensing drugs, another is a new bar code system that scans patient arm bands and nurses name badges. Unfortunately, system medication errors still occur because technicians have to fill those machines with medications. The technician can easily misread the dosage label and place them in wrong drawer. Through the rate of errors has decreased since these practices have been put in place in various hospitals, increased precautions should still be in place to insure patient safety.( Taylor Book, p736)
Medication administration is one nursing task that is considered a high-risk area for patient care (Gladstone, 1995). Studies had shown that “medication errors are the most common and preventable cause of patient harm… and should be immediately reported in order to facilitate the development of a learning culture” (Haw, Stubbs, & Dickens, 2014, p. 797). Thus, a nurse who