Clinical Question 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.
The specific clinical question guiding the search for a 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 patients being transferred. The intervention
The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. 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.”
b) I choose this topic because during my experiences in clinical area as well my experience in Hospital where I worked, I have came across different types of medication errors which involve patients and this could be a cause for serious problems to patients and in some cases will lead to death. It is a serious matter. Also drug error can have bad effect on nurses, both personally and professionally.
Errors made while administering medications is one of the most common health care errors reported. It is estimated that 7,000 hospitals deaths yearly are attributed to medication administration errors.
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
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
Researchers have identified that hospitalized patients are subject to one medication administration error per day, implying that approximately 1.5 million preventable drug event arise yearly in the United State. Medication errors are among the most common medical error, costing more than 3.5 billion
The purpose of this project is to decrease potential medication errors in the facility. This will be done by following some strategies:
This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions
Woten (2016) attributes, National Patient Safety Goals (The Joint Commission, 2016): Medication Reconciliation – an Overview acknowledges effective communication is a driven force to accurate medication reconciling. Communication to patients, families, professional to professional provides honesty along with direction in role responsibilities. Poor communication was recognized from a study at Mayo Health system, reporting, “medical information at transition points was responsible for as many as 50% of all medication errors in the hospital and up to 20% of ADEs”(Vogenberg & DiLascia, 2013). The evidence in transitions throughout care directly connects to communication validating how medication lists, if not updated or accurate cause harm to
Majority of errors are thought to be preventable, and multiple interventions may be required to significantly decrease medication errors, particularly when patients transition between healthcare settings.
In 2011, over 3,800 of these “never events” where reported to the Joint Commission (psnet, n.d.). Being an Administrator in a hospital setting, it is import to know what SRE’s mostly occur. Many of the SRE’s reported in 2011 were linked to surgical events such as wrong-site surgery, air embolism, death or disability due to medication errors, patient suicide and environmental events such as fires, which can harm anyone in the facility (psnet, n.d.). 8.2% of the serious reportable events reported to the joint commission where medication errors, nearly 600 reports are medication errors. This happens when a patient dies or is seriously injured due to a medication error such as being administered the wrong drug or the wrong dose, it was given to the wrong patient, at the wrong time or wrong rate or had the wrong preparation, or wrong route of administration (psnet, n.d.). Mediation errors are the most important or relevant to hospital setting
Thank you for educational and insightful post. You did an excellent job explaining all necessary steps how to deal with medication errors. According to Anderson and Townsend (2015), medication errors are the most common healthcare errors. Each error can cost somewhere between $2,000 to $ 8,750 of in-patient expenses and leads to more than 7,000 deaths annually. Interruptions and distractions, if it is to a prescriber or whoever is administering the medication, are among most common reasons why medication error occurs.
One patient required treatment with naloxone and the other required additional monitoring, ISMP Canada alerted the manufacturer who subsequently made changes in their packaging.” (Koczmara, C., Dueck, C., & Jelincic, V., 2006).
Strategies targeted at preventing medications errors are discussed in the subsequent sections. These strategies are aimed at distinct stages of the inpatient medication delivery process and other risks that often contribute to medication errors.
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