Potential Causes of Medication Errors †Free Samples to Students

Question: Discuss about the Potential Causes of Medication Errors. Answer: Introduction A medication error is a preventable event which may occur because of inappropriate use of medication while the medication is under the healthcare professional control. According to Blank (2011), the medication error is the commonly reported error in the emergency department with most of the mistakes happening during the administration phase manegement. The purpose of this study is to identify practices that may improve and reduce the dosage administration errors that occur and may lead to adverse effects on the patient (Flynn, 2012). The study took three months where 75% out of the 127 nurses participated in the research, and the method that got used in the study was educational intervention. On the other hand, the Do not Interrupt approach to medication refers to the interrupts that occur when nurses are administrating medication. The study took eight weeks where 227 nurses participated in the study, and they administered 4781 medications. Therefore, the Back to Basic and Do not Int errupt approaches to medication are directly related because when interruption of the nurse occurs when she is administering medicine, this may lead to a medication error. The purpose of the Back to Basic approach study is to reduce the medication administration errors that occur often in the emergency department. Medication errors can get classified into different categories which include action-based slips, knowledge-based mistakes and memory based lapses. On this study, the Back to Basics' study involved an examination of 95 nurses based on their knowledge on medication administration procedures, the reflection of their behaviors towards recommended medication practices and their medication administration errors. The study was conducted in three months by assessment through tests, surveys and observations on the nurses' chart reviews and voluntary error reports (Blank, 2011). In the Back to Basics approach to medication, the pre-test conducted reported that 69% of the nurses achieved perfect scores while 91% achieved perfect scores in the post-test. In the post-survey, the clinicians in their specific proportions said they followed the recommended p ractice most of the time which increased in 8 of the ten survey questions. The results, however, showed that there was no significant change from the survey conducted (Blank, 2011). Moreover, the review of charts revealed little difference in total medication errors (25% and 24% respectively). It, therefore, means that the nurses scored 299 during the pre-test and 295 during the post-test. During the voluntarily reported medication errors dropped from 1.28 to 0.99 per 1000 patients (blank, 2011). Critique of the Back to Basic Approach to Medication The sample size used for the research was sufficient because majority of the nurses participated in the study where 75% out of 127 nurses participated. The time taken for the study was sufficient because it took 3 months to get the results of the study. Educational intervention got used as the dependent method for the study since it provides nurses with the required knowledge of the medication administration practices. The method of education is however not sufficient in delivering the change necessary in medication administration practices. Hence, the survey and the chart review are classified as the internal validity of the study because they provide the required emphasis that are made by the research management. Furthermore, External validity is the general method that got used for the whole study which is the educational intervention (Blank, 2011). On the other hand, the aim of the Do not Interrupt study was to divert interruptions, educate clinicians and patients and to give reminders regularly and reduce the number of interrupts that happen when nurses are administering medication. This particular study was carried out in a major teaching hospital in Adelaide (Australia) where four random wards were selected to take part in the study while the control wards got blinded in the intervention. Furthermore, the period chosen for the study was two months (8weeks), and the methods used for this approach were administering vests to the clinicians, the general survey of the participating nurses and giving educational lessons to the patient and nurses (Westbrook, 2017). After the elapse of the study period, the Do not Interrupt approach yielded that 227 nurses were administering 4781 medications. The nurses experienced 57 interruptions per 100 medication administrations, whereby 89.7% were unrelated to the task at hand (Westbrook, 2017 ). The four wards experienced a significant reduction in non-medication related interruptions from 50 interruptions per 100 medication administrations to 34 disruptions per 100 medication administrations. Despite the decrease in interruptions, the post-study survey results stated that the intervention ward nurses found the vests to be time consuming and bulky; therefore only 48% seconded the idea becoming hospital policy (Westbrook, 2017). The sample size of the research was sufficient because it comprised of 227 nurses who were able to administer 4781 medications during the eight weeks of the research. Furthermore, the time taken for the research was enough because it took 2 months for the study to get completed. One can identify the internal validity of the study as the use of vests during medication administration, the putting of strategic measures aimed at preventing interruptions and the education of nurses and patients. The external validity of the study was the randomization of four wards that were supposed to be used in the research. The method was however not seen as sufficient because only 48% of the nurses applauded it to become a hospital policy management (Westbrook, 2017). Comparison of the Two Approaches to Medication These two approaches of medication go hand in hand in that through the reduction of the number of interruptions during operations; medical personnel can focus solely on medication administration which eventually reduces the medication errors. According to Blank (2011), the Back to Basics approach improves the nurses knowledge of the recommended medication administration practices. Inadequate knowledge, incomplete information about clinical characteristics and the lack of previous patient records can result in prescribing inappropriate medications. For instance, some infants died to an overdose of heparin drugs due to the wrong labeling of the medicine and the bad packaging of the medicine which resulted to the medication error that caused the death of the infants (Anderson, 2010). Another example is when the clinician prescribes penicillin without having established whether the patient is allergic or not. This means that the Do not Interrupt approach of medication is the most signifi cant compared to the Back to Basic approach because it often happens before the medication error occurs. This means the dosage error must occur for the medication error to happen which is the Back to Basic error. Moreover, the insufficient nurse experience may lead to medication errors where the nurse does not know the required dosage for a specific drug and this may lead to wrong prescriptions that may be fatal to a patient. Therefore, when the nurse has adequate skill and experience in their particular fields such errors may be avoided because the nurse knows the required dosage a patient should take (Karavasiliadou, 2014). Furthermore, the lack of sufficient protocol regarding the arrival time of medicines to the hospital may lead to late medication administration (Karavasiliadou, 2014). Observations made indicate that the rate at which medication errors get reported as voluntary is low (Aronson, 2009). For instance, when a patient was to be given a dosage of a particular medicin e at nine in the morning, and the medication happens to arrive at eleven, it means that the dosage will happen more than two hours past the correct administration time. Though this may not have severe effects on the patient, the patient may still have minor effects due to the delay of their medication. According to Velo (2009), another factor that can lead to clinical issues is the poor legible handwriting by the nurse when prescribing medication to a patient. The nurse can use abbreviations and not write the required dosage information entirely. This shows that the prescription error must occur for the medication error to happen. This is significant in that the Do not Interrupt which is the prescription error often takes place before the Back to Basic approach happens. The Back to Basic approach is often stated as the medication error. From the article, the two approaches of medication have a relative contribution in the clinical issues that often occur because irregularity must ha ppen during medication administration so as for the medication error to occur. Therefore, the Do not Interrupt approach is the most significant approach to medication because it determines whether the medication error (Back to Basic approach) may take place. Hence, it is essential for the nurses to get regular updates regarding the medication errors that occur within their facility so that they have an understanding of the best ways in which they can administer medication. According to Svitlica (2017), it is crucial when the nurses have an understanding of the errors that occur and the importance of reporting them in case they happen. From these two papers, we can conclude that improved education and improved working conditions may help in reducing the risk of medication errors. References Anderson, P., Townsend, T., CCRN-CMC, C. B. (2010). Medication errors.American Nurse Today, 23-27. Aronson,J.K. (2009) Medication errors: what they are, how they happen, and how to avoid them. QJM: An International Journal of Medicine, Volume 102, Issue 8, 1 August 2009, Pages 513-521,https;//doi.org/10.1093/qjmed/hcpo52 Blank,F.S.J.,Tobin,J.,Macomber,S.,Jaouen,M.,Dinoia,M.,Visintainer,P.(2011).A Back to Basics Approach to Reduce ED Medication Errors. JEN: Journal of Emergency Nursing, 37(2), 141-147.doi:10.1016/j.jen.2009.11.026 Flynn, L., Liang, Y., Dickson, G. L., Xie, M., Suh, D. C. (2012). Nurses practice environments, error interception practices, and inpatient medication errors.Journal of Nursing Scholarship,44(2), 180-186. Karavasiliadou, S., Athanasakis, E. (2014). An inside look into the factors contributing to medication errors in the clinical nursing practice.Health science journal,8(1). Svitlica, B. B., Simin, D., Milutinovi?, D. (2017). Potential causes of medication errors: perceptions of Serbian nurses.International nursing review,64(3), 421-427. Westbrook,J.I.,Ling,L.,Hopper,T.D.,Raban,M.Z.,Middleton,S.,Lehnbom.E.C.(2017).Effectiveness of a Do not interrupt hundled intervention to reduce interruptions during medication administration: a cluster randomized controlled feasibility study Velo G.P, Minuz,P. (2009) -British journey of clinical pharmacology, Medication errors: Prescribing faults and prescription errors. Academic Emergency Medicine 7(11), 1239-1243, 2000