Medication Errors By Nurse Professionals In Clinical Settings

Prevalence of Medication Errors by Nurse Professionals

Medication errors by the nurse professionals relate to the administration of inappropriate infusion rate and dosage and committed by more than 64.55% nurses in the clinical settings (Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013). Evidence-based clinical literature reveals more than 60.78% errors attributed to the nurse professionals in relation to the administration of intravenous injections to the eligible patients. Excessive utilization of drugs in accordance with the medical necessities substantially elevates the probability of inappropriate administration of drugs to the patient population (Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013). Errors in infusion administration might lead to serious fatalities and death incidences among the predisposed patients. Systematic level of planning and supervision required by the practicing nurses as well as the prescribing physicians in the context of surpassing the scope of occurrence of medication errors in the clinical setting (Keers, Williams, Cooke, & Ashcroft, 2013). The deviation of the administered medication from the recommended prescription leads to the occurrence of serious medication errors and associated adverse events. Findings in the evidence-based literature reveal the lack of communication skills and inappropriate training among the nurse professionals as the preliminary cause of medication errors across the hospital environment (Keers, Williams, Cooke, & Ashcroft, 2013). Indeed, the general work culture and environment also influence the level of efficiency of the nurse professionals and significantly contribute to the percentage of medication errors in the clinical setting.

Medication errors that remain unreported by the medical professionals replicate in the hospital settings, thereby leading to adverse events among the treated patients (Weant, Bailey, & Baker, 2014). Many types of medication errors emanate due to serious deficits in the associated systems of clinical practice, rather than manual mistakes by the nurse professionals as well as physicians. The findings in clinical literature reveal the occurrence of 71% of medication errors because of serious flaws in the prescribing stages. Medication errors sometimes also occur due to the errors performed in transcribing the medication for their effective dispensing (Weant, Bailey, & Baker, 2014). The effective monitoring of the prescribed medication is therefore, highly required in the context of minimizing the scope of occurrence of medication errors in the hospital environment. Limited automatic dispensing cabinets in the emergency room settings lead to the manual interventions by the nurse professionals in terms of administering drugs to eligible patients. Resultantly, the urgent manual dispensing of the medicines leads to the occurrence of medication errors and associated adversities in the emergency room setting. The unprofessional and inconsiderate behaviour of the nurse professionals under the influence of stress and workload also leads to the occurrence of medication errors (Feijter, Grave, Muijtjens, Scherpbier, & Koopmans, 2012). The nurses with such kind of behavioural orientation administer the prescription in haste that leads to the inappropriate administration of oral as well as intravenous medication to the treated patients.

Causes of Medication Errors among Nurse Professionals

Errors in medication administration remained prevalent in the medical facilities over decades and considerably impacted the pattern of health and wellness of the patient population. The mistakes in medication administration remain preventable and therefore utmost care and caution warranted in the context of reducing their frequency in the clinical settings. The errors in diagnoses as well as delay in treatment reciprocally influences the activities of nurses and elevates their work burden. Resultantly, they remain prone to the execution of mistakes while administering desirable medication to the patient population (Feijter, Grave, Muijtjens, Scherpbier, & Koopmans, 2012). Evidence-based clinical literature describes medication errors in terms of preventable events that result in the administration of inappropriate drugs by the healthcare professionals that might cause internal injury or adversity in the treated patients (Koch, Gloth, & Nay, 2010, p. 53). Mistakes in the prescription, dispensing and utilization of drugs lead to adverse implications on the healthcare professionals as well as the treated patients. They reduce the pattern of patient’s compliance as well as trust on the prescribed medication regimen. Evidence-based research literature reveals the increased risk of occurrence of medication errors following the utilization of potential and complex medication regimen to the elderly patients affected with various morbidities as well as co-morbid states (Koch, Gloth, & Nay, 2010). Therefore, nurse professionals need to practice caution in administering complex prescriptions to the aged patients in the clinical settings. The long-term medication administration requires the systematic healthcare management by the nurse professionals and the physicians in the hospital settings (Koch, Gloth, & Nay, 2010).

Medication errors elevate the predisposition of the pediatric patients in terms of experiencing exacerbated mortality and morbidity across the hospital environment (Cima & Clarke, 2012, p. 101). Nurse professionals need to acquire expertise and proficiency in terms of administering the medication to the pediatric patients in accordance with the pharmacokinetics and pharmacodynamics of the prescribed drugs. The dosage regimen requiring administration should be configured in a manner to minimize the scope of occurrence of adverse events, after its effective administration. Indeed, direct communication between the parents of pediatric patients and the nurse professionals is highly warranted with the objective of reducing the complexities in healthcare and associated medication errors. This is because the parents as well as the caretakers of the treated patients prove to be the first observers of the problems and adversities that might arise after the inappropriate administration of the dosage regimen (Britten, 2009). The clinical database in the hospitals as well as clinical settings require regular upgrading with the objective of registering adverse drug reactions experienced by the patients in the past under the influence of medication errors (Britten, 2009). This step is highly warranted in the context of elevating the knowledge of nursing professionals through the evaluation of their prior experiences of the medication errors. Resultantly, they will acquire a thorough insight regarding the proactive configuration of systematic strategies warranted for overcoming medication administration inadequacies while undertaking prospective healthcare interventions.

Solutions to Minimize Medication Errors

The lack of an efficient errors tracking system in the hospitals as well as the clinical settings leads to the treatment failures and absence of corrective actions for surpassing the scope of occurrence of medication errors by the nurse professionals (Naveh & Katz-Navon, 2014). The provision of voluntary reporting of medication inconsistencies requires encouragement by the medical facilities as well as the federal agencies for minimizing the scope of occurrence of adversities encountered after the erroneous administration of medication by the nurse professionals. Medical facilities require configuring amicable environment as well as working conditions with the objective of reducing the scope of elevating in mental stress of the nursing professionals (Naveh & Katz-Navon, 2014). In this manner, the nurse professionals would be able to efficiently cater to the healthcare requirements of the treated patients and remain focussed while administering medication interventions in accordance with the physician’s prescription. Resultantly, medication errors will be minimized across the hospital environment (Naveh & Katz-Navon, 2014). The pattern of medication errors might also arise from the cognitive inadequacies experienced by the nurse professionals under the influence of mental manifestations (Swaminath & Raguram, 2010). The pattern of biased thought processes and inappropriate judgement considerably influence the pattern of medication administration and the resultant adversities experienced by the treated patients. Inconsistencies in perceiving the medication regimen by the nurse professionals also lead to the inappropriate judgement regarding the time of their administration as well as the required dosage (Swaminath & Raguram, 2010). This leads to serious lapses and mistakes in the treatment administration that leads to the occurrence of serious patient fatalities in the clinical setting.

Evidence-based clinical literature describes the omission of dosages in terms of treatment errors (Trief, Cibula, Rodriguez, Akel, & Weinstock, 2016). Therefore, nurse professionals need to ascertain the legible recording of the dosage requirements as well as time and duration of medication administration in the context of avoiding the scope of omitting the treatment dosage under unprecedented circumstances. The absence of standardized conventions and protocols for the dosage administration also predisposes nurse professionals in terms of committing medication administration errors in the clinical setting (Hughes & Blegen, 2008). The medications as well as the treatment regimen that are not conventionally prescribed by the physicians and uncommonly administered in the hospital settings elevate the scope of their inappropriate administration by the nurse professionals (Hughes & Blegen, 2008). Similarly, the lack of knowledge regarding the allergy profile of the patients results in the inappropriate medication administration that leads to the development of allergic reactions among the treated patients (Hughes & Blegen, 2008). The absence of a well-defined protocol related to the administration of parenteral medication increases the scope of its erroneous administration by the nurse professionals (Schilp, Boot, Blok, Spreeuwenberg, & Wagner, 2014). The absence of perspective conventions regarding the administration of elevated risk medications to the treated patients also elevates their risk of receiving incorrect dosages under inappropriate time intervals. Nurse professionals need to prepare a checklist of the pre-requisites of medication administration in relation to the medical necessities of the treated patients (Thakur, Thawani, Raina, Kothiyal, & Chakarabarty, 2013). They must avoid acting on the verbal prescription orders and should always opt for acquiring legibly written physician prescriptions in medical emergencies. The hospital administration must also ensure the replacement of replacing the messy prescriptions with printed physician orders in the context of avoiding any confusion in reading and interpreting the treatment regimen. Physicians should also avoid using medical abbreviations while prescribing drugs to the eligible patients. The concomitant establishment of these conventions can effectively reduce the risk of occurrence of medication errors and associated fatalities in the clinical settings.

The elderly patients affected with the pattern of polypharmacy also remain predisposed towards receiving inappropriate medication dosages during their treatment interventions (Fialová & Onder, 2009). The inappropriate pattern of coordination between the healthcare system, physicians, nurses and patients adversely influence the therapeutic value of prescriptions in the elderly patients. The inclusion of chronically ill patients in various disease management programmes and fragmented care interventions elevates the risk of their non-compliance with the recommended treatment regimen (Fialová & Onder, 2009). This eventually results in the inappropriate administration of therapeutic dosages, thereby leading to the development of debilitating as well as life threatening conditions among the affected patients. The nurse professionals must understand and analyse the therapeutic limitations and evaluate the extent of willingness of patients in terms of receiving the therapeutic regimen in the desirable dosages and intervals (Fialová & Onder, 2009). They must identify the individualized treatment challenges experienced by the patient population and coordinate with the prescribing physicians in the context of modifying the therapeutic dosages and their administration intervals for minimizing the extent of discomfort in the treated patients. Indeed, the pattern of under-use of medications is also considered as a medication error (Peron, Marcum, Boyce, Hanlon, & Handler, 2011). The under-use of the treatment regimen might reduce the therapeutic value of the administered drugs and prove to be a potential barrier to the acquisition of therapeutic advantage among the treated patients. The under-use of the therapeutic regimen might result from the pattern of under-prescribing of the treatment dosage by the treating physicians or the under-administration of the desirable dosage to the eligible patients (Peron, Marcum, Boyce, Hanlon, & Handler, 2011). Both scenarios considerably downgrade the therapeutic outcomes of the treatment approaches customised for the treated patients in accordance with their medical necessities. This rationally indicates the requirement of conducting training sessions for physicians as well as nurses in the context of reducing the scope of inappropriate medication administration to the treated patients.

The evidence-based analysis presents various inconsistencies in the process of medication administration that eventually leads to the establishment of preventable disease conditions as well as traumatic states among the treated patients. The pattern of medication errors not only impacts the health and wellness of the treated patients, but also adversely influence the cost of healthcare interventions in the clinical settings. Systematic coordination between the multidisciplinary healthcare teams is necessarily warranted in the context of reducing the scope of occurrence of medication errors and their associated adverse manifestations. The caregivers, patients as well as the treating medical professionals must understand and identify the root causes of medication errors and collaboratively facilitate their elimination in the context of enhancing the pattern of wellness outcomes requiring acquisition after the administration of the recommended treatment interventions.

References

Britten, N. (2009). Medication errors: the role of the patient. BJCP, 67(6), 646-650. doi:10.1111/j.1365-2125.2009.03421.x

Cheragi, M. A., Manoocheri, H., Mohammadnejad, E., & Ehsani, S. R. (2013). Types and causes of medication errors from nurse’s viewpoint. Iranian Journal of Nursing and Midwifery Research, 18(3), 228-231. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748543/

Cima, L., & Clarke, S. (2012). The Nurse’s Role in Medication Safety. USA: JCR.

Feijter , J. M., Grave, W. S., Muijtjens, A. M., Scherpbier, A. J., & Koopmans, R. P. (2012). A Comprehensive Overview of Medical Error in Hospitals Using Incident-Reporting Systems, Patient Complaints and Chart Review of Inpatient Deaths. Plos|One. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031125

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Koch, S., Gloth, M. F., & Nay, R. (2010). Medication Management in Older Adults: A Concise Guide for Clinicians. New York: Springer.

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Schilp, J., Boot, S., Blok, C. D., Spreeuwenberg, P., & Wagner, C. (2014). Protocol compliance of administering parenteral medication in Dutch hospitals: an evaluation and cost estimation of the implementation. BMJ Open, 4(12). doi:10.1136/bmjopen-2014-005232

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Thakur, H., Thawani, V., Raina, R. S., Kothiyal, G., & Chakarabarty, M. (2013). Noncompliance pattern due to medication errors at a Teaching Hospital in Srikot, India. Indian Journal of Pharmacology, 45(3), 289-292. doi:10.4103/0253-7613.111899

Trief, P. M., Cibula, D., Rodriguez, E., Akel, B., & Weinstock, R. S. (2016). Incorrect Insulin Administration: A Problem That Warrants Attention. Clinical Diabetes, 25-33. doi:10.2337/diaclin.34.1.25

Weant, K. A., Bailey, A. M., & Baker, S. N. (2014). Strategies for reducing medication errors in the emergency department. Open Access Emergency Medicine, 45-55. doi:10.2147/OAEM.S64174