Essay on Patient Safety: An Evidence-Based Analysis of Medication Errors

📌Category: Drugs, Health, Health Care, Medicine
📌Words: 1279
📌Pages: 5
📌Published: 05 September 2021

Over the past decade, technological advancements have greatly decreased the percentage of medical errors seen in hospitals across the world. These advancements have changed the practices executed by clinical staff and have improved patient outcomes. However, despite these advancements, medication errors continue to be highly prevalent across the healthcare field and have subjected patients to a series of complications (Bravo et al., 2016). Medication error is one of the most common types of medical errors, it consists of a range of mistakes including incorrect dosages, incorrect medication administered, and more. While it may be assumed that technological applications can prevent these errors from occurring, literature continues to suggest that the administrator of the medication has more of an impact regarding these errors. With nurses being the primary administrators of medications in acute care settings, it is essential to review and analyze evidence-based measures that can stop the issue and thereupon promote and maintain patient safety (Bravo et al., 2016). With this importance, the purpose of the following is to provide a comprehensive overview of evidence-based practice, ethical principles, and nursing prevention and interventions regarding medication errors for inpatient safety in acute care settings.

Evidence-Based Content

Frequency of General Medication Errors

The rise of medication errors has not only greatly impacted patient safety, but the trust patients have for clinical organizations. In the United States, this impact can be seen in the frequency of medication errors, which is in general reported to be over one million each year. With this high frequency of errors, a similar high frequency of death occurs. Approximately 30.5% of medication errors lead to death each year (Jember et al., 2018). In general, it has been found that nurses play an essential role in identifying errors, with 86% of potential errors being caught by nurses (Jember et al., 2018). Of the errors that do occur, it is believed that nearly 50% are preventable and rely on the clinical personnel (such as nurses) to actively identify potential errors before they occur (Jember et al., 2018). This evidence paves the way to establishing a more vigilant role for nurses in the medication administration process.

Common Causes for Medication Errors Among Nurses

With most medication errors being preventable, it is important to evaluate the causes seen for these errors. The factors that have been found to greatly contribute to such errors include a lack of sufficient training among nurses, insufficient staffing (high nurse workload), incorrect prescription, frequent order changes, incorrect dispensing, and years of nursing experience (Tsegaye et al., 2020). Studies show that without intervention to improve these factors, medication errors will continue to flourish. With that, it is noted that certain measures, including the development of consistent guidelines, nurse training, and strategies to minimize distracters must be undertaken to mitigate the factors contributing to the high rates of medication errors (Tsegaye et al., 2020).

Medication Errors in the Acute Care Setting

In the acute care setting specifically, identifying and mitigating medication errors are critical in ensuring optimal patient safety is achieved. While the same factors contribute to medication errors in this inpatient setting (including incorrect medications ordered and incorrect dosages dispensed), certain measures are believed to be more effective in this setting compared to others (Khalil et al., 2020). This includes medication administration education for nurses, medication review, and increased medication reporting. It is believed that with one or more of these measures, medication errors can be strongly reduced in the acute care setting and patient safety related to medications can be greatly improved - ultimately improving outcomes for both patients and the clinical staff (Khalil et al., 2020).

Two Ethical Principles

Non-Maleficence

The ethical principle of non-maleficence refers to ensuring the safety of the patient in all care delivered. This principle requires nurses to avoid or minimize risks, including active actions to avoid negligent care of the patient. With medication errors, it is critical for nurses to actively improve and utilize medical competence to prevent patients from being subjected to complications commonly seen with errors. This may include nurses actively implementing preventative measures into their own practice to reduce the number of errors from occurring, improving patient safety, and upholding the ethical principle of non-maleficence by proactively reducing harm to patients (Brännmark, 2019). For nurses that do execute this route, the percentage of medication errors has been shown to decrease.

Autonomy

The ethical principle of autonomy refers to the respect for a patient’s decision-making as well as the right of self-determination. With this principle of autonomy, it is the patient’s right to have all of the information regarding the course of treatment including errors that may have occurred (Brännmark, 2019). If a medication error does occur, it is then the patient’s right to be informed of the error and any complication that may have transpired as a result. Because explicitly notifying patients of the error often negatively impacts both the provider and the patient, the action of taking measures to prevent the errors from initially occurring often increase after an error takes place. These actions may include a nurse meticulously confirming the correct medication administration components, and even validating the results with another nurse. Ultimately, the ethical principle of autonomy can not only improve the care provided by nurses, but can also increase patient safety and satisfaction (Brännmark, 2019).

Nursing Prevention and Interventions

Prevention

Prevention measures are essential in mitigating the medication error issue that is currently decreasing patient safety. For nurses, feasible prevention measures are focused on accountability, knowledge, and collaboration. For instance, nurses taking accountability and reporting errors when they do occur can subsequently serve as an advocacy for new policies and procedures to better prevent such errors from initially occurring (Kavanagh, 2017). Additionally, nurses enhancing and improving upon their own knowledge can serve as a prevention measure due to an increased likelihood of being able to identify incorrect medications and/or dosages for a patient before administration occurs (Kavanagh, 2017). Finally, collaboration is a crucial prevention measure as it pertains to nurses collaborating with one another to verify any uncertainty surrounding medications and/or to verify the administrating nurse is delivering the correct medication and/or dosage to the correct patient (Kavanagh, 2017). This measure ultimately aids in the prevention of medication errors with two clinical personnel identifying potential errors rather than relying on the knowledge of one. Ultimately, these preventive measures can feasibly help improve the percentage of medication errors without the implementation of new policies, procedures, and/or applications.

Interventions

There are many evidence-based interventions that can be implemented to decrease medication errors and improve patient safety. One intervention involves the hospital administration establishing new policies to decrease the overall nursing workload. A high nursing workload is directly associated with a higher number of medication errors. An intervention that essentially caps a nurse’s workload can allow a nurse to have additional time to verify all of the components associated with the medication administration process, helping to decrease the related errors (Magalhães et al., 2019). An additional intervention is the establishment of a medication administration course that educates nurses on the correct steps for administering medications while decreasing errors, such as verifying the medication, dosage, route, time, and patient. This course may also discuss information pertinent to different types of medication to better improve the nurses’ abilities to identify incorrect medications prior to administration (Khalil et al., 2020). A final intervention involves the implementation of a current barcode medication administration system that holds the ability to verify the correct medication administration components, as well as the patient, with high accuracy and precision (Macias et al., 2018). This intervention will ultimately be able to improve patient safety by flagging potential errors to the nurse before administration occurs, preventing the patient from being affected by the error.

Conclusion

Medication errors continue to hinder patient safety and the quality of care received by nurses. Despite continuous advancements in the healthcare field, medication errors continue to rise due to the lack of specific interventions designed to target this concern. In general, medication errors are highly preventable and primarily associated with incorrect medications, dosages, and/or patients involved in the process (Bravo et al., 2016). To overcome this issue, it is the ethical responsibility of providers to integrate preventative measures/interventions targeted to improve patient safety (Cherry & Jacob, 2019). This may include medication education workshops, decreasing nursing workload, and increased nursing collaboration. Because evidence-based principles point towards a consistent process to ensure adequate medication administration, it is important this process is considered and implemented to ultimately decrease medication errors and increase patient safety.

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