Synvisc Injection Case Study

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

It’s not simply the particular giving of the medications that fare up all the time. It is checking the medical record with the hand written prescriptions, grouping the varied medications and also the instrumentation for giving them, and ensuring all the patients safety measure are covered.

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

* All medication should be recorded and signed for by the receiving pharmacist and a proper record maintained in-house.

All medication was clearly labelled with the resident’s name and stored in the medicine trolley they were only allowed to be issued by authorised members of staff. This is to prevent medication being given out more than once which could cause an accidental overdose.

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

As clinical site co-ordinator with many years of clinical experience I feel competent in the drug administration via a variety of routes. Generally the patients I attend have become acutely unwell with most prescriptions not having the third eye of a pharmacist and most drugs being delivered intravenously. It is imperative therefore that the prescription and drugs always be thoroughly checked which relies on good communication throughout. Furthermore, most emergency drugs have a protocol for administration developed by the hospital. However within this situation the nurse is generally the last defence before any medication error actually occurs, therefore it is the nurses responsibility to ensure the prescription is correct and to challenge prescription written

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).

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.

For many patients the scariest part of being in the hospital is having to rely on other people to control your life changing decisions. One large part of this is the medications one is given while in our care. I can only imagine what it must be like for patients to have a stranger to come in and start administering drugs to me. This would be especially scary if I did not know what these medications did, or what negative effects could be caused by taking them. Unfortunately, the fear of medication errors that many patients have are not unfounded. Estimates range from 1.5 to 66 million patients a year have medication errors occur while they are in the care of health care professionals. Considering all of the technology we have at our

Patient’s medications list are received on admission and reconciliation completed upon admission. Nightingale nursing staff insures patients receive discharged medications instructions. Nursing staff educates patients on the importance of managing medications currently ordered from the discharge list.

            As electronic health records, have been a former nursing present transition, medication list equally compare in a transition as medication reconciliation is addressing preexisting medications that are no longer being taken by the patient, removed from the patient's medication list. The development of medication reconciliation is becoming the up and coming push to obtaining patient medication list accurately, precisely, and safely beginning in outpatient settings.  Similarly, nursing presences theory supports direct nursing practice to improve direct patient care, safety among medication treatment, as well as engagement to providers with patients (Presence in nursing practice: a concept analysis,

In healthcare today, when hospitals are judged upon patient safety standards, it is critical to prevent errors involving medication administration. Distractions while preparing and administering medications, has been report as one of the leading causes of medication errors. Distractions while nurses are administering medications can lead to poor patient outcomes and even sentinel events. Nurses and nurse managers are responsible for maintaining a unit with minimal distractions. When distractions are minimized throughout medication administration process, a decrease in medication errors will occur and lead to increased patient outcomes.

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 (

Another important reason of screening is to avoid medication errors. These errors can be fatal and risky for the patient. The risk can be significantly reduced by medication reconciliation. The process involves acquiring,confirming and documenting the list of the patient's current medicines and scrutinize this list to the ordered medicines and the patient's health to identify and resolve any variances. The best practice is to record it electronically or in writing in patient's chart or notes for the easy access for clinicians to review before writing any medication orders. The process of medication reconciliation using a structured approach involving patients provides shared accountability, can reduce the morbidity and mortality of medication