Errors in H1N1 Medication Involving Healthcare Workers - Essay Example

 Errors in H1N1 Medication Involving Healthcare Workers Problem Definition A considerable number of healthcare workers make errors in medication during emergencies. During the recent Influenza A (H1N1) epidemic, there was a rise in the number of medication errors made by healthcare professionals. Patients received the wrong medicine, or the incorrect dose, resulting in adverse effects, such as death. Studies have indicated that the number of cases with such errors is increasing significantly (Acosta et al, 2009). Discussion of some of the issues that involve healthcare workers, specifically in the context of H1N1 influenza in a detailed and critical manner that they face while pursuing their profession, needs to be acknowledged (Peters, 2007). In particular, the foremost objective of healthcare professionals is to ensure quality attention and great care to the patients; however, they are confronted with various issues such as that of the problem statement, which entails errors in the H1N1 influenza medication. This essay explores specific causes and risk factors associated with errors in medication from crises, such as the H1N1 influenza, and provide a long-term and short-term action plan to help prevent medication errors from happening in the future. Diagnosis ‘Medication on error’ is one of many severe issues that have been affecting healthcare professionals globally (Allegra, 2008). In specific, ‘medication on error’ occurs in circumstances where there existed possibility of its prevention; however, its occurrence resulted in substantial damage to the patient due to usage of inappropriate medicine. The possible factors of such medication errors in H1N1 cases include inadequate knowledge of medication, errors in understanding risk factors associated with the H1N1 influenza, and errors in supply or packaging of medicines. In various reports, healthcare workers made mistakes in observing patients’ pathophysiology and symptoms, misunderstanding patients’ conditions, and lacking knowledge about the patients’ history (Peters, 2007). These all play an important role in prescribing medication in cases of the H1N1 influenza. Analysis has indicated that outcomes of such an important issue are very catastrophic for healthcare workers, as well as for the patients (Huber, 2006). Additionally, some reports indicated that healthcare workers gave insulin instead of the H1N1 influenza vaccine, which resulted in deaths and deteriorated conditions of the patients. Although the H1N1 influenza is new and very few studies relate the ‘medication on error’ issue with this influenza, in the past, it has been observed that such errors by healthcare workers during other emergencies caused deaths as well (Kramer et al, 2006). This resulted in ineffectiveness of proper medication for the patients, which is a serious and adverse outcome of this critical issue (Kramer et al, 2006). In this regard, healthcare authorities on the state and federal levels have already considered this practice as illegal and unethical, as it causes dreadful outcomes for both patients and the medical profession (Shetty, 2009). Errors in medication that occur in H1N1 cases are indicators of the recruitment of untrained healthcare workers in inappropriate departments that subsequently result in the failure of the healthcare worker to handle the emergency appropriately. Therefore, it is possible that he/she will make an error as compared to any trained healthcare worker. In addition, sometimes the unskilled healthcare workers are not able to recognize the actual cause of the disease, and this is very common in the case of H1N1, which is new for the healthcare workers, causing errors in medication and subsequently, terrible damages to the patients (Selgelid, 2009). For instance, reports indicated that drugs such as zanamivir and oseltamivir put H1N1 patients at risk during the earlier stage of the H1N1 spread that was unknown by the healthcare workers, which resulted in various complexities; however, these same drugs were efficient in treating H1N1 patients during the later stages of the H1N1 influenza (Selgelid, 2009). In addition, recent researches have indicated that this issue poses great threat due to its occurrences during different flu pandemic cases globally. For instance, in the Tamiflu outbreak, it was an observation that prescribing in milliliters was a usual habit of healthcare providers in the United States (FDA, 2009). However, during the Tamiflu outbreak, its dosage was in milligrams that resulted in a number of reports related to errors on medication, and similar reports were observed in a few H1N1 cases as well (FDA, 2009). Another research indicated that during the H1N1 influenza outbreak, the CDC allowed healthcare providers to use peramivir for specific usage only, as it is an unapproved drug. However, due to lack of awareness related to this peramivir drug, and even despite of its effective outcomes on the H1N1 patients, there were many cases regarding errors on medication related to doses of peramivir that were given without measuring weight and other factors of the patients. In the result, due to lack of awareness regarding this unapproved drug, CDC had to take back its step of allowing healthcare providers to use peramivir for H1N1 patients that causes inefficient results. Proof of Causes 1. Lack of Awareness/Training The majority of healthcare workers do not get special training for H1N1 cases, and authorities expect them to handle H1N1 patients with similar expertise. This results in one of the major causes of occurrences involving errors in medication (JCR, 2006). For instance, reports have indicated that although healthcare workers are aware of giving antiviral drugs to H1N1 patients, the major problem relates with the amount of dosage of such drugs (JCR, 2008). This situation requires special training sessions that typically does not occur otherwise, and as a result, healthcare workers have to deal with making their own decisions during these dreadful circumstances (JCR, 2008). Such training also does not allow healthcare workers to understand differences and complexities associated with different age groups and patients with previous medical history that can cause errors during medical practices. For example, oseltamivir is an efficient drug for treating H1N1 influenza; however, it is very important for healthcare workers to specify concentrations in ml or mg, but ignorance of such detailed medication causes errors (Selgelid, 2009). 2. Inappropriate Facilities In specific, H1N1 related reports indicated that healthcare workers who were working in clinical departments in different hospitals confronted greater troubles. In the case of H1N1, there were a few times where even the shortage of H1N1 vaccines resulted in various healthcare workers to experience ethical problems (Kalman, 2009). One of these ethical problems included the confusion to decide whether to inform patients about the unavailability of H1N1 vaccines, and such circumstances ultimately inclined them to give false medication to the patients in panic (Kalman, 2009). According to a survey that was administered, in such particular situations, healthcare workers felt a violation of patients’ trust, cancellation of their moral values, and dishonesty towards their sanctified profession. For instance, there was a report, which indicated that a lack of H1N1 vaccine supply often enforced healthcare workers to give inadequate medicines, such as that for fever, or pain, which resulted in an increase of immunity in such patients for wrong medications and helped to spread the H1N1 influenza further more rapidly (Slonim, 2009). In this regard, various H1N1 cases in the United States (FDA, 2009) reported occurrences of errors on medication due to lack of measuring device that would have allowed healthcare providers to measure the dose before putting it in the dosing dispenser. This indicates the significance of inappropriate facilities regarding the issue of errors on medication. 3. Mismanagement Lastly, specific issues occur around error in medication due to unprofessional conduct and the absence of ethical values in the healthcare and nursing environment (Thompson, 2005). In this regard, experts have indicated that the effectiveness and efforts of healthcare workers and practitioners are directly associated with the ethical environment of the whole hospital. For instance, if healthcare workers do not have a protected, contented, and safe environment at their job, and especially during H1N1 specific emergencies, it is more likely that they will cause a mess and make an error during one or more of their tasks. As a result, rather than focusing on their H1N1 influenza patients and their derails, healthcare workers will be diverting their focus to their own selves, primarily due to inadequate and unfavorable settings. Surveys have indicated that healthcare workers, especially in H1N1 emergencies, are able to handle the patients more effectively if they get a comfortable environment where they can perform their work appropriately and efficiently (JCR, 2008). The majority of the healthcare workers accepted that mismanagement, specifically behavior of the management with the workers, often frustrated them, which caused them to make errors in panic (JCR, 2008). Action Plan Long Term: In order to reduce and ultimately eliminate ‘medication on error’ issues confronted by healthcare professionals, there is an urgent need for the development of an effective action plan. In this regard, the foremost step will be a creation of a task force that will be responsible for preparedness of healthcare workers for the H1N1 influenza (Slonim, 2009). This will be very efficient in controlling errors on medication and elimination of other similar issues. Although state governments have created such task force teams in the past, it is imperative that governments carry out such actions on a federal and national level. Centralization of processes will allow healthcare workers to continue their practices anywhere in the country, due to its existence as a major factor in causing errors in medication due to a diverse set of practices that are currently present nationwide (Webber, 2005). In specific, such task forces should be responsible for training and monitoring healthcare workers in situations concerning the H1N1 influenza virus. Training must include a provision of comprehensive awareness about outcomes of wrongful medications for the patients (Edmunds, 2009). If this provision is acted upon immediately, it can be very helpful and motivating for the healthcare workers to work towards not making errors during medication in the future. Besides training, ‘medication reconciliation’ will be a very significant component of the action plan, which will include comparisons of different medications with H1N1 medications for different diseases. Such comparisons and evaluations of different medications will prevent healthcare workers in making further errors, or giving any medication that may duplicate the H1N1 influenza’s medicine (Frech, 2004). However, the most important factor in this long-term plan will be financial perspective that will need considerable attention, as it is observation that lack of financial planning often results in inefficient results despite of innovative and feasible ideas. In the United States, various funding sources exist that can ensure funding of the abovementioned action plan, and taxes will be the best sources. For this purpose, the Federal Government will have to allocate a specific budget for this action plan that must not exceed $900,000 annually. An efficient way will be to welcome bids from healthcare institutions and organizations for the implementation of above long-term plan that will ensure cost-effective implementation of the action plan. Short Term: Furthermore, creation of a drug database will be an efficient way to prevent errors in medication during the treatment of the H1N1 influenza. With the availability of such a database, healthcare workers will be able to check for any side effects/adverse effects of a specific drug for H1N1 patients nationally and globally (Barron, 2009). This will ultimately enable them to decide adequate medication for the H1N1 patients, which will be very effective in eliminating the identified problem statement for the H1N1 influenza (Barron, 2009). Last, but not the least, the most important part of the action plan will be continuous and frequent updates of the healthcare workers regarding the complexities, issues, and advancements related to the H1N1 influenza virus, which will facilitate them to deal with the situations more efficiently. In addition, it will be very important to create a team that will be counseling healthcare workers in terms of identifying and resolving their issues individually, as well as collectively. In this regard, it will be noteworthy in eliminating the problem of ‘medication on error’, as well as other issues that healthcare workers can confront during critical circumstances, such as the H1N1 influenza spread. This short-term action plan will require no significant funding due to its low-cost nature, and thus, healthcare organizations can implement this plan locally, regionally, and nationally along with collaboration of corporate companies. This partnership venture will be a significant way of acquiring funding for these short-term healthcare projects that will facilitate the government in minimizing the errors on medication that occurred in the past, as well as during the outbreak of H1N1. Conclusion Conclusively, the essay has discussed some of the significant aspects of the problem statement involving errors in medication and healthcare workers, specifically in the context of H1N1. The essay has identified and analyzed different studies related to the topic; however, it is anticipation that further research in this regard will allow for a more comprehensive and updated understanding of the immediate and gradual impacts of ‘medications on error’ during the H1N1 influenza epidemic. References Acosta, Meileen, Louie, Janice K., Winter, Kathleen; et al. (2009). Factors Associated with Death or Hospitalization Due to Pandemic 2009 Influenza A (H1N1).The Journal of the American Medical Association, 2009: 302(17): 1896-1902. Retrieved from http://jama.ama-assn.org/cgi/content/full/302/17/1896. Allegra, E. P. (2008). “Infection Control for Influenza in Healthcare Settings.” Avian Influenza Research Progress. Nova Publishers. Retrieved 2010 February 2. Barron H., Dear Healthcare Professional Letter: Important Prescribing Information. September 23, 2009. Retrieved from http://www.fda.gov/downloads/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/UCM183752.pdf. Edmunds, M. W. (2009). Introduction to Clinical Pharmacology. 3rd. Edition. Elsevier. FDA. (2009). FDA Public Health Alert. Retrieved on February 02, 2010: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm183649.htm Frech, Sarah A., Glenn, Gregory M., Kenney, Richard T., Muenz, Larry R., Villar, Christina P. (2004). Dose Sparing with Intradermal Injection of Influenza A (H1N1) Vaccine. The New England Journal of Medicine, November 25, 2004, 351;22. Retrieved from http://content.nejm.org.proxygw.wrlc.org/cgi/reprint/351/22/2295.pdf. Huber, D. (2006). Leadership and Nursing Care Management. Elsevier Health Sciences. Retrieved 2010 February 3. JCR. (2006). Understanding Medication Management in Your Healthcare Organization. Joint Commission Resources. Retrieved 2010 February 4. JCR. (2008). Medication Use. Joint Commission Resources. Retrieved 2010 February 3. Kalman, Bobbie. (2009). Preparing for Disasters. Crabtree Publishing Company. Retrieved 2010 February 2. Kramer, J. S., Durham, C., Schroeder, T., Garrelts, J. C. (2006). Effectiveness of Half-Dose Versus Full-Dose Influenza Vaccine in Healthcare Workers. American Journal of Health-System Pharmacy, 2006. 63:2111-2115. Retrieved from http://www.ajhp.org/cgi/content/63/21/2111. Peters, G. A. (2007). Medical Error and Patient Safety. CRC Press. Retrieved from http://www.emeraldinsight.com/10.1108/14777270910933442. Selgelid, M. J. (2009). Ethical and Philosophical Consideration of the Dual-use Dilemma in The Biological Sciences. Springer. Shetty, N. (2009). Infectious Disease. John Wiley and Sons. Retrieved 2010 February 4. Slonim, A. D. (2009). Avoiding Common Nursing Errors. Lippincott Williams & Wilkins. Thompson, K. K. (2005). Medication Safety. American Society of Health-System Pharmacists. September 2005, 62: 1871. Retrieved from http://www.ajhp.org/cgi/62/18/1871. Webber, R. (2005). Communicable Disease Epidemiology and Control. CABI. 1. The action plan did not include any information as to how to fund these various activities. The ideas are good ones, but they must be feasible and I needed a bit more on the financing of it all. I need finance information for the short-term activity and the long-term activity. In short, the “How?, Where?, and with What Money?” Read More