Discuss about the Analysis Of Medication Error Using The Wadula Tool.
The rates of different health care adversities are increasing every day, hence, the demand for quality health care services are increasing every day as well. However, it has to be mentioned that the staff shortage is increasing every day and hence the excessive workload and ever rising issue of burnout has paved way for many different consequences compromising the quality of the care provided to the patients. One of the greatest consequences can be mentioned as the medication errors. According to the article by Hellström et al. (2012), medication error has become one of most crucial factors affecting the nature and quality of care that is provided to the patients. It has to be mentioned in this context that the health care service cannot be treated like any other commodity in the society, it is one of the basic necessities of human life and each and every individual has a right to safe and effective care provided to them, even a single error can lead to fatal consequences for the patients and can lead to cost them with their lives. Hence, despite the acute pressure on the care professionals, especially the nurses, the need for better management and educational training for the nurses to reduce the frequency of medication error has become crucial. In my own health care industry as well, medication error has become one of the greatest causes for exacerbations and prolonged stay in the health care facility (Kaushal et al. 2010). Hence, in this assignment, the nursing issue of medication error will be explored with the help of the wadula puzzle tool.
The idea of the initiative behind this puzzle is based in the issue of medication error. It has to be mentioned in this context that, by definition, medication error can be defined as the varied range of different preventable events that can cause or facilitate to the condition where improper or inappropriate use of medication can harm the patient exponentially. There are different kinds of medication errors and each and every one often leads to singular harm being caused to the patient and can even lead to the death of the patient (Radley et al. 2013). In this puzzle, the issue will be analyzed if the implementation of EHR coupled with adequate training and skill enhancement of the nursing professionals can decrease the frequency of medication errors in the facility.
Puzzle question:
How can we reduce the frequency of medication errors in the facility by the help of EHR implementation and professional development of the nurses.
Hence, it can be mentioned that the puzzle chosen for this study is positive as it does not imply any criticism, is generative requiring more than a yes or no response and is a question framed as a puzzle.
The main purpose of this puzzle is to check the effectiveness of implementation of electronic health records in combination of advanced training of the nurses to reduce the frequencies of medication error occurring in the facility.
With this solution identified for the puzzle, our patients would be able to attain a safer care with minimal medication error facilitated by the digitalized patient record documentation with the help of the EHR.
The staff would be able to decipher and understand the exact medication and the exact dosages with the EHR system implemented and there will be reduced risk for miscommunication among between different nurse shifts.
Our service would benefit greatly from the EHR implementation and the training will help in enhancing the skills and competence of the nurses as well (Radley et al. 2013).
Overall, as our area of work is to provide safe and effective care to the patients and enhance the standard of care that the patients receive, this puzzle will help in reducing the key complication caused by the medication errors.
According to the research, medication error is the most common and frequently reported type of medical error and it causes the most of the harm to the patients. In the wake of a multidisciplinary health care, the patients are seen by varied different care professionals, the chances of medication errors are even more enhanced. Among the different types of medication errors, wrong dosage administration, wrong route administration and allergic interaction to certain medication by the patient not knowing the exact patient data is the most frequent ones reported in our health care facility. As opined by the Wetterneck et al. (2011), the HER system can help in keeping the health acre professional continuously updated regarding the monitoring and follow up care. In support, the article by Zhang and Walji (2011), has stated that using the paper charts has been reported to be very difficult and troublesome to keep track of the exact medication requirements and hypersensitivity information of the patient. The implementation of EHR services will reduce the complications associated with using paper charts to document and convey care information from one nurse to another at the end of shifts. As per the article by Yackel and Embi (2010), the EHR can prevent medical errors by means of flagging the potential drug interaction and possible hypersensitivity reaction as per the subjective and objective data recorded about the patient to provide the exact information regarding the patient. Hence, the implementation of the EHR has been chosen as the possible solution to the puzzle. Many articles and survey reports supports this puzzle proposal, different databases such as the Cochrane library, PubMed, MedLine and Cinahl can provide authentic literature that will support the cause of this proposal. Different survey reports can also be included in the list of sources to support the cause of this proposal. Different systematic review, randomized control trials and case control studies can be strong evidence for the proposal study. According to my own opinion, the evidence behind this particular puzzle is strong supporting the facilitation of change in the care facility to drastically reduce the frequency of medication errors that occur in the facility.
For this project proposal the interested parties will be:
? Patients and families
? Administrative department
? Operational managers
? Monitoring committee
? Digital and paper media
Among the people identified, the key partners for this project will be nursing workforce, nursing supervisor, wardens, physicians, allied healthcare professionals administrative department, and operational managers along with the human resource department of the healthcare facility.
For the consultation procedure the EHR implementation officials and IT experts, monitoring committee, media officials, social activists, and administrative department will need to be involved in the consultation.
The patient welfare peer support groups, social workers, and the monitoring committee will need to be informed. The patients and the family members of the patients included in the study would need to be involved and communicated along with taking informed consent.
According to my own impression all the parties involved are communicating properly will approach the engagement with intention of success. As the better interest of the patients and the safe and effective care is involved in this scenario I don’t think there will be any three conditions to engaging with this procedure. I think and already have a solution in my hand and I feel attached to this particular solution however I have not previously tried to engage around this issue. There are a few questions in my mind regarding the response from the media and social activist along with the monitoring committee regarding the implementation of the solutions the puzzle. How you feel upon reflection on the different people acting as stakeholders to this puzzle I can conclude that the positive aspects about this puzzle outweigh the few negative aspects are questionable outcomes that are associated with the scenario.
For the purpose of engagement would like to mention that this puzzle proposal will take place and the environment of the surgical ward in the Healthcare facility as it is associated with the most medication errors. The implementation and training procedure will take close to 3 to 6 months to take effect and 30 time and night time shift nurses will be involved with the procedure.
The participants of the proposal will invest honest efforts and energy into this project. The staff and peoples included in the service will be given up preliminary consultation and training workshop to enhance their emotional and cultural capacity to cope with the puzzle at the time.
The puzzle project is going to take only 3 to 4 months tissue effects and will involve a total of 25 nurses addressing 45 patients in the surgical Care Unit, the sampling for this project is feasible acceptable meaningful and effective.
We will monitor the rates of medication errors conducted 3 weeks, 2 months and 3 months interview after implementation of EHR to measure the change made by the puzzle to patient
We will conduct interviews and feedback sessions from nursing supervisors and the staff involved in the puzzle to check is there competence levels enhanced and whether they feel confident that the HR Services has reduced the chances a possibility of them ever committing a medication error.
We will analyze the survey report from the monitoring committee of the facility to evaluate whether to change husband beneficial to the service by reducing the total number of medication errors and enhancing the quality of care.
Primary data will be needed to evaluate and are measured the outcome of the change implemented. Electronic data coupled with survey an interview reports will be included in the data collected for the puzzle.
We are already collecting the primary data from the staff regarding their understanding of EHR Services and how they can be enhanced.
In the end we will know the exact explain to office improvement brought forward by implementation of EHR and technological training to the nurses so that they understand how to operate the EHR, and the community effect of this procedure on the improvement in the frequency of medication errors committed in surgical ward of the facility.
I have learnt that I will have to entertain a compassionate and patient approach to facilitate the entire engagement procedure. I will need to be tenuous and yet be conscious not to break the privacy of the patients or be offensive to the nursing workforce or other stakeholders associated with this puzzle.
As per my own opinion mining is very effective and satellite leadership approach my team will readily and positively respond to the proposed change.
It would be useful to seek advice to support from the IT experts and the experienced nursing and administrative staff for guidance and useful advice to better facilitates the change.
Verbal communication along with electronic location with the help of different digital media and social media tools will be the most effective to communicate my person to other stakeholders with a sense of urgency and compassion with extract the most support.
The specific actions that I have identified include interviewing the selected nurse staff regarding their idea of electronic health records and how to operate them, consenting the patients in surgical wards and families, and taking permission from the monitoring committee and administrative department of the Healthcare facilities before taking the puzzle out.
A few services that can benefit relationship building and rebuilding services before launching the person will be surveying hospitals with active EHR involving the key stakeholders to help them understand the benefits of electronic health records in minimizing the rate of medication errors. Team building workshop can also be arranged to enhance their engagement.
The specific actions identified relating to the environment and resources include extensive research from different authentic databases to extract most notable and reliable literature evidence along with survey reports with Healthcare facilities with working EHR.
We would like to discuss with you how we may work together around a proposal to implementation of electronic health records with view to achieving reduced medication errors in the facility. The reason for undertaking this proposal is to explode the effectiveness of electronic health records and trained nursing workforce regarding how to use electronic health records to minimize medical errors and enhance the safety and effectiveness of the care provided. We hope that working together we may be able to generate a solution which is beneficial to us and the clients for whom we care
All the stakeholders will be informed through digital modes of communication to a consultation meeting where this message will be communicated to them by a PowerPoint presentation.
SMART goal:
Implementation of EHR services and training for staff to minimize the rate of medication errors with the sample population of 25 nurses caring for 45 surgical ward patients within the time frame of 3 to 4 months
Rationale:
The specific goal is implementation of HER and training, the measurable goal is to minimize the rate of medication errors, the attainable goal is sampling of 25 nurses, relevant goal is utilizing surgical ward with the most medication errors reported and the timely goal is 3 to 4 months
Actions:
The actions to be undertaken include the implementation of EHR, training the nursing staff to operate EHR, monitor the rate of medication errors committed after implementation, interview the staff to gauge their experience and document the progress.
Support or resources:
The electronic databases will be used for evidence based practice and Gibbs reflection tool will be used to reflect on my own progress.
Outcome measurement:
The measurement of the outcome will be done based on primary data analysis of the EHR data and survey data of the nursing staff.
We are proposing to engage around the puzzle of ‘How can we reduce the frequency of medication errors in the facility by the help of EHR implementation and professional development of the nurses’
The purpose of engaging around this puzzle is to reduce the medication errors in the surgical ward where the highest of the medication errors occur in the entire facility.
We hope that by finding solutions for this puzzle, our patients, staff and service would benefit in the following ways: enhanced safety of the care, reduced rate of penalty imposed for mediation errors, and enhanced competence and skill of the workforce.
The evidence that we have to support our belief that this puzzle is important is According to the research, medication error is the most common and frequently reported type of medical error and it causes the most of the harm to the patients. In the wake of a multidisciplinary health care, the patients are seen by varied different care professionals, the chances of medication errors are even more enhanced. Among the different types of medication errors, wrong dosage administration, wrong route administration and allergic interaction to certain medication by the patient not knowing the exact patient data is the most frequent ones reported in our health care facility. As opined by the Wetterneck et al. (2011), the HER system can help in keeping the health acre professional continuously updated regarding the monitoring and follow up care. In support, the article by Zhang and Walji (2011), has stated that using the paper charts has been reported to be very difficult and troublesome to keep track of the exact medication requirements and hypersensitivity information of the patient. The implementation of EHR services will reduce the complications associated with using paper charts to document and convey care information from one nurse to another at the end of shifts. As per the article by Yackel and Embi (2010), the EHR can prevent medical errors by means of flagging the potential drug interaction and possible hypersensitivity reaction as per the subjective and objective data recorded about the patient to provide the exact information regarding the patient.
Evidence that we still need to collect includes understanding of the nursing workforce of the EHR services, the effectiveness of EHR in the post-operative ward.
The people/services that we have identified as most important to this puzzle are………………………… Patients and families, Nursing workforce (morning, day and night shift), Nursing supervisors, Wardens, Physicians and allied health care professionals, Administrative department, Operational manager, Human resource department, EHR implementation officials, IT experts and Technicians, Monitoring committee, Patient welfare peer support groups, Social activists, Digital and paper media…………………………..and we think that we will need to engage directly with……………………nursing workforce, nursing supervisor, wardens, physicians, allied healthcare professionals administrative department, and operational managers along with the human resource department of the healthcare facility……………….to seek solutions for this puzzle.
We have identified the following features of the current context as being important to supporting the puzzle…………the rates of medication error rising, the reduced medication errors in hospitals with EHR………..
We have identified the following features of the current context as potentially getting in the way of successful engagement with this puzzle………lack of compliance………
We propose evaluating any changes generated through the process by……primary data analysis…..
In order to facilitate the initial engagement of key stakeholders with the puzzle, we will communicate the puzzle by……verbal and digital social media based communication………..
References:
Hellström, L.M., Bondesson, Å., Höglund, P. and Eriksson, T., 2012. Errors in medication history at hospital admission: prevalence and predicting factors. BMC clinical pharmacology, 12(1), p.9.
Kaushal, R., Kern, L.M., Barrón, Y., Quaresimo, J. and Abramson, E.L., 2010. Electronic prescribing improves medication safety in community-based office practices. Journal of general internal medicine, 25(6), pp.530-536.
Mangalmurti, S.S., Murtagh, L. and Mello, M.M., 2010. Medical malpractice liability in the age of electronic health records.
Menachemi, N. and Collum, T.H., 2011. Benefits and drawbacks of electronic health record systems. Risk management and healthcare policy, 4, p.47.
Radley, D.C., Wasserman, M.R., Olsho, L.E., Shoemaker, S.J., Spranca, M.D. and Bradshaw, B., 2013. Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. Journal of the American Medical Informatics Association, 20(3), pp.470-476.
Schiff, G.D. and Bates, D.W., 2010. Can electronic clinical documentation help prevent diagnostic errors?. New England Journal of Medicine, 362(12), pp.1066-1069.
Sittig, D.F. and Singh, H., 2012. Electronic health records and national patient-safety goals.
Wetterneck, T.B., Walker, J.M., Blosky, M.A., Cartmill, R.S., Hoonakker, P., Johnson, M.A., Norfolk, E. and Carayon, P., 2011. Factors contributing to an increase in duplicate medication order errors after CPOE implementation. Journal of the American Medical Informatics Association, 18(6), pp.774-782.
Yackel, T.R. and Embi, P.J., 2010. Unintended errors with EHR-based result management: a case series. Journal of the American Medical Informatics Association, 17(1), pp.104-107.
Zhang, J. and Walji, M.F., 2011. TURF: Toward a unified framework of EHR usability. Journal of biomedical informatics, 44(6), pp.1056-1067.
Zlabek, J.A., Wickus, J.W. and Mathiason, M.A., 2011. Early cost and safety benefits of an inpatient electronic health record. Journal of the American Medical Informatics Association, 18(2), pp.169-172.
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