How long hours would cause medication errors - Essay Example

How long hours would cause medication errors Introduction In 1859, Florence Nightingale the founder of modern nursing expressed her meaning of nursing as “the goal of nursing is to put the patient in the best condition for nature to act upon him primarily by altering the environment”. However, today the nursing profession is serious problem of shortage of staff that it becomes difficult for giving the patients the best risk free environment. The worldwide nursing shortage is a matter of concern to every one. If we look at the health care industry, it is growing fast when compared to other industries.  However, with the increase in population, an increased number of healthcare professionals are needed to care for them particularly in the case of epidemics and disasters.  Increased numbers of healthcare professionals in the nursing profession are needed not only to care for elderly patients, but also to replace retiring professionals (iHireNursing, 1999). As study by Wagner et al, (2005) said that there are three major reason for shortage of nurses this include shortage of hospital nurses, faculty shortage, and a shortage of highly- trained nurses. In addition, issues such as job burnout and dissatisfaction with the current working nurses also add to these problems (Wagner et al, 2005). Today, the existing nursing staff faces problems due to the shortage of staff. They have to work overtime and long hours. This not only put their personal life into trouble but also put the patients at serious risk. Patient safety is a top priority for all physicians, nurses and other health care workers (healthsmart, N.D.). However, error is always a possibility, especially with medications and particularly with the nurses who have to work more than 12 hours on an average. Such kind of medication administration errors can threaten patient and are a dimension of patient safety which is directly linked to nursing care (Stratton, et al., 2004). Although nurses compose the largest single group of health care professionals, only a few studies have addressed the effect of long shifts on their performance. This paper presents a literature review on how long hours could cause medication errors by nurses. Literature Review Ann Rogers, PhD, RN, FAAN, Associate Professor, along with her colleagues at University of Pennsylvania School of Nursing, Philadelphia, followed and analyzed the work habits of 393 hospital nurses over a period of four weeks. The researchers looked at data from 5317 shifts and found that more than 40 percent of the time, the nurses who were a part of this study worked shifts longer than 12.5 hours. One-third of the nurses put in overtime every day which accounts to an average of 55 minutes longer than scheduled during the four week study period. This overtime was not planed in advice. The longest shift lasted as long as 23 hours and 40 minutes. This study found that there were 199 medication errors and 213 near errors that occured. Ann and her associates concluded that all nurses in the study had an increased probability of making at least one medication error whenever they worked past the scheduled 12-hour limit (Reuters, 2004). According to a study conducted by Aiken and his associates trends in hospital use and staffing patterns have converged to create potentially hazardous conditions for patient safety. The study revealed the fact that high patient acuity levels, together with increase in admission and discharge cycles and less number of nurses pose serious challenges for the delivery of safe and effective nursing care for hospitalized patients (Aiken, et al., 1996). The increased number of patients also increases the pressure on existing nursing staff. They will have to work on an average twelve to even sixteen hours long. Besides, it may not follow the traditional pattern of day, evening, and night shifts. These shifts may be randomly scheduled. It is seen that nurses working on specialized units such as surgery, dialysis, and intensive care are often required to be available to work extra hours other than their regular shifts. In emergency units twenty four hour shifts are becoming more common (Rogers, et al., 2004). The results of this study also found that working extra hours creates stress in the nursing staff and may end in medication errors. Every human need sleep and it is the basic need of every one. In today’s busy schedule of nurses they face serious problems of sleep depriving. Nurses frequently shortchange themselves on sleep, getting by on an average of 6.8 hours of sleep on their work days instead of the commonly recommended 8 hours per 24-hour period. This may result in reduced vigilance, reaction time, memory, psychomotor coordination, and decision making (Stutts, et al., 1999). Besides, studies show that speed of mental processing also slows during the night under conditions of sleep deprivation (Monk, et. al., 1997). In another study it was found that nurses who worked rotating shifts were more sleep deprived and more likely to fall asleep while they are at work as a result they were nearly twice as likely to make a medication error when compared with other nurses who predominantly worked day shifts (Gold, 1992). In fact, some research also point at the reality that nurses ignore the role of fatigue that might play in critical incidents. Nurses working in intensive care and operating room were questioned about error, stress, and teamwork, approximately 60% of them agreed to the fact that they work even when they feel fatigued and they think that in critical times they perform effectively (Sexton, et al., 2000). In yet another study conducted by Landrigan, et al, (2004) in was reported that interns made significantly more serious medical errors when they worked repeatedly on shifts of 24 hours or more than when they worked in shorter shifts. This study took into consideration a total of 2203 patient-days involving 634 admissions. The results point at the fact that interns made 35.9 percent more serious medical errors during the traditional schedule than during the intervention schedule (136.0 vs. 100.1 per 1000 patient-days, P Read More