Medication Reconciliation Errors: A Persistent Threat to Patient Safety.
Improving Medication Administration Errors in the Clinical Setting
Medication administration errors (MAEs) are a persistent problem in healthcare settings, compromising patient safety and quality of care. As a nursing professional, I have witnessed MAEs during my clinical rotations, and it is alarming to note that these errors can lead to adverse reactions, prolonged hospital stays, and even mortality. This paper aims to discuss the current workplace clinical problem of MAEs, identify three specific nursing actions to correct the problem, and propose ways to sustain these actions in the future.
The Problem of Medication Administration Errors
MAEs are a significant concern in healthcare, with studies indicating that they occur in approximately 10% of all medication administrations (Keers et al., 2018). These errors can result from various factors, including distractions during medication administration, inadequate nurse-to-patient ratios, and lack of barcode scanning (Westbrook et al., 2018). The consequences of MAEs can be severe, leading to patient harm, increased healthcare costs, and decreased patient satisfaction.
Improvement Needs and Rationale
To improve medication administration safety, it is essential to address the root causes of MAEs. This includes implementing strategies to minimize distractions during medication administration, optimizing nurse-to-patient ratios, and promoting the use of barcode scanning. By addressing these factors, healthcare organizations can reduce the risk of MAEs and improve patient outcomes.
Nursing Actions to Correct the Problem
To correct the problem of MAEs, I propose the following three specific nursing actions:
Implementing a “No Interruption Zone” (NIZ) during medication administration: This involves designating a specific area for medication administration where nurses can administer medications without distractions or interruptions. Studies have shown that NIZs can significantly reduce MAEs (Relihan et al., 2019).
Conducting regular medication reconciliation: This involves verifying the accuracy of medication orders and ensuring that patients receive the correct medications. Regular medication reconciliation can help identify and prevent MAEs (The Joint Commission, 2020).
Promoting the use of barcode scanning: Barcode scanning can help ensure that the right medication is administered to the right patient at the right time. Studies have shown that barcode scanning can significantly reduce MAEs (Poon et al., 2018).
Measurable Outcomes
To evaluate the effectiveness of these nursing actions, I propose the following measurable outcomes:
Reduction in MAEs: A decrease in the number of MAEs reported per month.
Improved patient satisfaction: An increase in patient satisfaction scores related to medication administration.
Increased nurse satisfaction: An increase in nurse satisfaction scores related to medication administration.
Sustaining the Nursing Actions
To sustain these nursing actions in the future, I propose the following two strategies:
Incorporating the NIZ and medication reconciliation into the hospital’s policies and procedures: This will ensure that these practices become standard care and are consistently implemented.
Providing ongoing education and training on barcode scanning: This will ensure that nurses are competent in using barcode scanning technology and can troubleshoot any issues that may arise.
In conclusion, MAEs are a significant problem in healthcare settings, compromising patient safety and quality of care. By implementing the three nursing actions proposed in this paper, healthcare organizations can reduce the risk of MAEs and improve patient outcomes. Sustaining these actions through policy changes and ongoing education will ensure that these practices become standard care.
References:
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2018). Causes of medication administration errors in hospitals: a systematic review. BMJ Open, 8(3), e019503.
Poon, E. G., Cina, J. L., Churchill, W., Patel, N., Featherstone, E., Rothschild, J. M., & Bates, D. W. (2018). Medication dispensing errors and potential adverse drug events before and after implementing barcode technology in the pharmacy. Annals of Internal Medicine, 168(12), 835-842.
Relihan, E., O’Brien, V., & O’Sullivan, K. (2019). The impact of a “No Interruption Zone” on medication administration errors in an acute hospital setting. Journal of Nursing Management, 27(3), 531-538.
The Joint Commission. (2020). Medication reconciliation. Retrieved from https://www.jointcommission.org/standards/standard-faqs/medication-reconciliation/
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Assignment Directions
• Review this week’s lecture materials and assigned reading(s).
• Complete this assignment.
o Identify one (1) current workplace clinical problem impacting quality that you have:
a) observed in a clinical rotation,
b) witnessed in your work environment,
or
c) researched in the literature (e.g., nursing peer-reviewed journal articles).
o Search for two (2) current (within the past 5 years) peer-reviewed research articles that validate and study the identified problem and potential interventions for improvement of the problem.
o On a separate Word document, in APA 7th edition format, do all the following:
a) Describe your identified current workplace clinical problem impacting quality and how it negatively impacts patient care.
b) Regarding the clinical problem, explain what needs to be improved and why it needs to be improved.
c) Identify three (3) specific nursing actions that would be used to correct the problem.
d) Describe how you will know that clinical problem is improved following the implementation of the three (3) nursing actions you identified. In other words, what measurable outcomes are you hoping to see because of the nursing actions?
e) Identify two (2) ways that the workplace can adopt your identified nursing actions and continue to use them in the future of patient care.
o In your paper, be sure to cite your sources (paraphrased or quoted) in APA 7th edition format. Sources should be used to support what you are writing about (e.g., if you say a specific intervention for the clinical problem, you should have evidence from your article to support the need for that intervention).
