Issues With Medication Safety – Impact On Patient Health And Wellbeing

Factors Contributing to Medication Safety Errors

Discuss about the Issues With Medication Safety.

Medical drugs or medication is a fundamental part of the health care, the concept of health care will be left absolutely incomplete if the element of medication is withdrawn. Any patient, that seeks out health care services for any kind of ailment that they may be suffering with, are provided with one or more kind of medication to relieve them of their predicament (Collins et al. 2014). Hence, the importance of medication in providing health care is undoubtedly extreme, however, there are certain issues associated with medication and its administration in the context of health care. According to the first quality chasm report by the Institute Of Medicine, one of the greatest contributing factors behind the mortality and morbidity in health care is due to the extremely high percentage of medical errors, most of which falls back to medication safety and flawed administration procedure. A medication safety concern can be of different types, it may be a wrong administration, wrong dosage or wrong transmission route, however each and every type further complication for the patient and increases the hospital stay; and along with that imparts a significant effect on the professional competency of the nurse involved (Popescu, Currey and Botti 2011). This assignment will reflect on the medication safety issues prevalent in the health care issues, its impact on patient health and wellbeing, concluding with a few strategic recommendations to overcome the issues.

Medications and its usage is undoubtedly central to health care delivery, however the impact of flawed administration is also significantly high on the health and wellbeing of the patients; there are considerable risks associated with medication administration, and a single flaw can even cost the patients their lives (Martin 2002). Now it has to be understood in this context, that medication and its administration is a responsibility that is mostly endowed on the nursing professionals. According to the most of the data provided in the previously published literature indicates at the fact that most of the hospital acquired complications in the health care related scenario is associated either directly and indirectly with the faulty medication administration issue (Kalisch et al. 2011). There are numerous instances of medication administration errors that occur in the health care facility, and most of the times it increases the hospital stay for the patients and reduces the recovery potential of the patient as well. However, in order to explore medication safety issues in the nursing care setting, it is imperative to identify and characterize the key contributing factors that lead to extreme medical errors.

Impact on Nursing Professionals

One of the most significant causes behind the medication safety errors is the lack of experience in the nursing workforce. According to the articles by Latimer, Chaboyer and Hall 2011, the level of nursing experience and expertise is a key confounding factor affecting the concept of medication safety in the health care setting. Along with that, another key contributing factor is burnout and computerized system failure. In many instances, the excessive workload and recurring shifts result in exhaustion and frustration which is inevitably reflected onto their performance; and due to the extreme burnout, the inevitable outcome is professional neglect manifesting as errors in medication administration. Interruption or distractions in crowded hospital wards have also been identified as one of the key causes behind the medication errors, according to the data published by Raju, Suresh and Higgins 2011, 17% of the medical errors had been accounted as the result of interruption, burnout and personal incompetence in the clinical setting, where interruption only took up 6.6% of the entire ratio.

Whatever may be the cause of the medication safety issues, it has a huge impact on the nursing professional who is responsible for the medical error. In most cases, there are various other external factors that propel a medication safety concern, although the nursing professional is the only individual accounted for the mishap and they have to bear the burn of penalization. According to the study of Anthony et al. 2010, the impact of a medication safety issue that resulted in critical complication for the patient is huge on the career for the nursing professional. Depending on the severity of the issues the faults in the medication administration the penalization can range from suspension, monetary penalization and in extreme cases even revoking of practice license. Other than that, the psychological impact of the professional issue on the nursing professional cannot be ignored as well. In most cases nurses have to take the entire blame of a particular medication safety error even if there are other contributing factors and it impacts the job satisfaction and professional confidence effectively (Banja 2010).

Other than the impact on the nursing profession, the most significant and detrimental impact of the medication errors is on the patient safety (Brown and Crookes 2016). There are different kinds of medication safety errors, it can be with drugs with similar names or composition, common medications that the patient might be allergic to, or medications that require nontoxic therapeutic usage testing like warfarin, lithium, etc. However, regardless of the type of medical error, all result in severe consequences for the patient. Though all drug administration errors might not lead to adverse drug event (ADE), however the impact is nonetheless threatening to the health and wellbeing of the patient.

Impact on Patients

Medications that have complex dosing regimens or are administered only in specific concerns cause the most of the ADEs. According to a recent study by Choo, Hutchinson and Bucknall 2010, the most of the adverse drug events are caused by a medication safety error involving CNS agents, cardiovascular drugs and antineoplastics. The medical errors that involve faulty dosage calculation attest to close to 40% occurrence of medication errors and most of them cause ADEs. 16% of the medical errors are usually due to wrong drugs prescribed and 9.5% are due to transmission route errors.

On a more elaborative note, an adverse drug reaction leads to a medication injury. The mechanism of medication error can impact two categories of consequences on the patient safety, either inducing abnormal pharmokynetics, or causing synergistic effect on the patient. And it can lead to death, life-threatening situation, physical or cognitive disability, or congenital anomaly. Hence adverse drug events, depending on the severity of the ADE, can potentially impart differential impact on the patient safety and wellbeing (Sears, Goldsworthy and Goodman 2010). And hence, there is a pressing need for strategies to overcome the challenges and reduce the percentage of medical errors in health care facilities inducing better medication safety.

As medication errors among nurses occurs both by personal and organizational factors, it is necessary to work on these area to minimize the harmful effect of medication errors on patient safety and nursing practice. The effective strategies to minimize rate of medication errors and its impact are as follows:

1. The first strategy that nurses can use to overcome challenges associated with medication errors is to detect errors through active management and effective reporting about errors. The research by Elden and Ismail, (2016) showed that by the establishment of effective reporting system and training the nurse and clinicians regarding medication safety at all stage of drug administration, the rate of errors in the hospital was reduced. The targeted training program mainly focused on improving the awareness of nurses and clinician regarding the importance of medical sheet and the common cause of medication errors. They were also explained about the importance of error reporting and appropriate communication in promoting patient safety. The final outcome of the training program was that it decreased the percentage of medication errors. Hence, error detection and effective reporting helps to build a safe culture and minimize the impact of medication errors on nursing practice and patient safety.
2. As the nursing practice environment and the distraction around them is a major cause of medication errors by nurse, implementation of distraction free practice can be regarded as effective in reducing adverse events rates due to medication errors (Yoder et al. 2015). A nurse mainly encounters interruptions during medication administration due to phone calls, malfunctioning equipment and coping with the extreme workload (Hayes et al. 2015). The innovative approach that nurse can take to minimize avoidable distractions during the process includes avoiding non-emergent phone calls while giving medication at patient’s bedside. In addition, the role of health care organization is also found to be critical in establishing accurate distraction free protocol to promote medication safety during medication administration. Focused handoffs at shift change and appropriately communicating about medication administration with other health care team members is also crucial to avert medication errors (Arnado 2014).

The essay focused on the professional challenges faced by nurse due to medication error in nursing practice. The consequences of such error is huge as it just not only jeopardize the quality of nursing care, but also has significant impact on morbidty and mortality of patients. Such errors increase the overall hospitalization cost as well as the burden of the nurses. The review of cause of medication errors has mainly showed that these errors mainly occurs due to poor knowledge about medication administration safety, lack of safety culture, workload, distractions and faulty medical equipments. In response to these issue, thee essay proposed the strategy of training nurses regarding error reporting and common cuase of medication errors and engaging in distraction free practice. These two approach is likely to reduce the professional challenges faced by nurses due to medication errors and promote safety of patients too.

References:

Anthony, K., Wiencek, C., Bauer, C., Daly, B. and Anthony, M.K., 2010. No interruptions please: impact of a no interruption zone on medication safety in intensive care units. Critical care nurse, 30(3), pp.21-29. Published in USA.

Arnado, J.A., 2014. Minimizing Avoidable Interruptions During Medication Administration.

Banja, J., 2010. The normalization of deviance in healthcare delivery. Business horizons, 53(2), pp.139-148.

Brown, R.A. and Crookes, P.A., 2016. What are the ‘necessary’skills for a newly graduating RN? Results of an Australian survey. BMC nursing, 15(1), p.23.

Choo, J., Hutchinson, A. and Bucknall, T., 2010. Nurses’ role in medication safety. Journal of nursing management, 18(7), pp.853-861. Published in San Francisco

Collins, S.J., Newhouse, R., Porter, J. and Talsma, A., 2014. Effectiveness of the Surgical Safety Checklist in correcting errors: a literature review applying Reason’s Swiss Cheese Model. AORN journal, 100(1), pp.65-79. Published by Elsevier.

Elden, N.M.K. and Ismail, A., 2016. The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services. Global journal of health science, 8(8), p.243. published in Canada.

Hayes, C., Jackson, D., Davidson, P. M., and  Power, T. 2015. Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration. Journal of clinical nursing, 24(21-22), 3063-3076.

Kalisch, L.M., Caughey, G.E., Roughead, E.E. and Gilbert, A.L., 2011. The prescribing cascade. Issues, p.1. published in Australia.

Latimer, S.L., Chaboyer, W. and Hall, T., 2011. Non?therapeutic medication omissions: incidence and predictors at an Australian Hospital. Journal of Pharmacy Practice and Research, 41(3), pp.188-191. published in Australia.

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Popescu, A., Currey, J. and Botti, M., 2011. Multifactorial influences on and deviations from medication administration safety and quality in the acute medical/surgical context. Worldviews on Evidence?Based Nursing, 8(1), pp.15-24. published in Australia.

Raju, T.N., Suresh, G. and Higgins, R.D., 2011. Patient safety in the context of neonatal intensive care: research and educational opportunities. Pediatric research, 70(1), p.109.

Reason, J., 2000. Human error: models and management. BMJ: British Medical Journal, 320(7237), p.768. published by BMJ publishing group.

Sears, K., Goldsworthy, S. and Goodman, W.M., 2010. The relationship between simulation in nursing education and medication safety. Journal of Nursing Education, 49(1), pp.52-55.

Yoder, M., Schadewald, D. and Dietrich, K., 2015. The effect of a safe zone on nurse interruptions, distractions, and medication administration errors. Journal of Infusion Nursing, 38(2), pp.140-151.