Medication Dilemm A Case Study

When Jill arrive back in North Carolina she called Dr. Smith office and was told she needed an appointment before she could get medication. The next available appointment was in 4-days. Jill than showed up in person at Dr. Smith office to try to get a prescription. The reception explained that there policy was to make an appointment for prescription refills and it was her responsibility to know there policy. Jill’s Primary care finally wrote her a prescription, however when she went to fill her prescription and her insurance declined the prescription because it was already filled in Boston the day before. The pharmacist resolved the situation and filled Jill’s prescriptions. The lack of effective communication with his patient was responsible for her medication crisis. The system level failures were the lack of communication by all parties involved in Jill

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

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.

Medication errors are preventable and cause great harm to the patients and their families. Every year in Australian hospitals, medication errors occur as nurses do not follow the 9 rights of medication administration. The 9 rights are right patient, drug, route, time, documentation, response, action and form (Fossum et al., 2016). Medication errors can be caused by

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.

Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of

If testing results support the suspicions of impairment, then management is mandated to report the incident to the North Carolina Board of Nursing (NCBON, 2011). With increased medication errors, Beverly failed to provide a safe and effective nursing care to the patient, therefore violating the laws of the Nurse Practice Act (NCBON, 2009).

a) Pharmacists have ethical and legal obligations to ensure that the prescriptions they fill are valid, both in that the physician must be prescribing the medication for a valid reason and that the person filling the prescription must be doing so for valid therapeutic reasons (ASHP, 2008; Brushwood, n.d.). The court needs to take these obligations into account, and then must determine whether the frequency with which the prescription was refilled would have required a pharmacist to check with the patient's physician or at least another pharmacist in order to determine if the pattern represented abuse (Brushwood, n.d.). The basic considerations before the court, then, are the pattern of behavior (i.e. prescription refilling) represented in the facts and the relationship of this pattern to the legal and ethical standards of pharmacists. The addition was certainly a foreseeable consequence, and this means that standard applications of negligence torts might also be applicable.

While this is a serious error by institutional standards, it fails to meet the tort definition of negligence. There was a duty of care to this patient who was admitted to the hospital. A breach of that duty occurred when the patient was given the incorrect medication. The requirement of injury necessary to meet the definition of negligence was not me. There was no reported adverse outcome reported from the single dose of the incorrect medication. Due to lack of injury, there appears to be no risk to the institution from negligence surrounding the medication

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.

This journal talks about it takes failure to resolve medications across changes in care is an important cause of harm to patients. There is not a lot to known about medication discrepancies before patients are admitted to a skilled nursing facilities. To describe the prevalence of, type of medications involved in, and sources of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies, defined as unexplained differences among documented medication regimens, including the hospital discharge summary, patient

Safety is a priority to delivering healthcare, however, medication errors have been identified as a safety issue in healthcare. The Institute of Medicine (IOM) has released two landmark reports that identify adverse outcomes that occur yearly from medication errors (Kohn, Corrigan, Donaldson, 2000; Institute of Medicine [IOM], 2001). Because nurses are intimately involved in providing patient care and medications, as a result of these reports attention was directed at the nursing profession to improve the mathematical competence of nurses. Therefore, it is imperative that nursing students are competent in converting between measurement systems, identifying common pharmacological abbreviations, methods of medication administration, reading medication labels, and calculating medication dosages in order to provide safe care. In the article, Teaching the Culture of Safety, the American Nurses Association (ANA) affirms that pre-licensure programs should include education on patient safety and system vulnerabilities that is expanded on throughout all nursing education and practice to promote a culture of safety (Barnsteiner, 2011). Therefore, the implementation of early medication calculation in a nursing program helps establish fundamental nursing mathematical skills to help nursing students become competent in medication calculation skills and combat medication errors and promote the delivery of safe nursing care (Newton, Harris, Pittilgio, & Moore, 2009).

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.

Over past decade, several investigator groups have attempted to create, validate, and implement screening tools to detect prescription errors, and listing the drugs that carry a high risk of inappropriate in elderly patients. Screening tools including USA Beers Criteria [6], Medication Appropriate Index (MAI) [7] and the European Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to the Right Treatment (START) [8] are the most widely used criteria for the detection of prescription errors. Explicit criteria of STOPP/START criteria contains specific clinical and drug recommendations that can reduce PIP in older patients and was considered ‘most promising’ compared to other existing

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