Reasons For Medication Errors And Ways For Their Prevention - Research Paper Example

 Reasons For Medication Errors And Ways For Their Prevention High Risk Incident High risk incidents compromise patient safety. Errors in administration of medication pose a high risk to patients. This high risk derives from the consequences to the error in terms of patient safety. Errors in administration of medication have the possibility of leading to serious consequences for the patient both in terms of outcomes as well as in economic considerations. Economic considerations arise from drug administration errors resulting in extended stay in the hospitals, thereby impacting on the cost of hospital stay and the earning potential of the individual. It is estimated that in the United States of America alone, medication administration errors that lead to increased costs of stay in the hospital and litigations are responsible for costs of approximately $ 2 billion annually. Errors in the administration of medication lead to poorer outcomes of increased pain and disability and in extreme cases even death (Maricle, Whitehead & Rhodes, 2007). According to Tang, Sheu, Yu, Wei & Chen, 2007, physicians, pharmacists and nurses make up the chain of healthcare professionals involved in the use of medications for therapeutic reasons. Physicians are responsible for prescribing the medications to be used on an individual. Medication errors can stem from the side of the physician, when poor attention is paid to prescribing the right drug, the right strength, the right dosage, the right route and the possibility of interaction with medications already being used by the patient. The pharmacist is responsible for dispensing the medication prescribed by the physician. Errors on the part pharmacist occur from dispensing the wrong drug, wrong strength and not notifying the physician of any discrepancy that the pharmacist feels is present in the prescription of the medication. Nursing professionals are responsible for the administration of the medication and errors from nursing professionals stem from wrong drug, wrong dose, wrong patient, wrong regimen (frequency of administration, timing of administration and duration), wrong route of administration, failure to give appropriate education to the patient or care giver on the medication , failure to follow appropriate drug administration policies and failure to follow instructions specific to the drug administered (Hughes and Ortiz, 2005). In addition to these errors is the issue of the adverse reaction of the drug itself on the patient, impacting on the safety on the patient (Wallis, 2009). Administration of medication is necessary in the treatment of various conditions and diseases of patients and cannot be avoided. Human errors are bound to occur in the administration of these medications, but policies and procedures implemented in health care institutions in the administration of medications can reduce the frequency with which these high risk incidents occur (Mayer & Cronin, 2008). Literature Review Medication errors occur frequently, wherein the healthcare professionals responsible for the administration of the medication and the health care institution are responsible for the occurrence of these incidents of high risk to patient safety. Estimates emanating from studies show that in the United States of America incidents of medication happen at the rate of one in five doses in a typical hospital environment. Ian addition prescription drug errors occur and 815 drug prescription errors were found to happen over a two year period (Woman Dies from Medication Error in California Nursing Home). There are many reasons why medication errors occur and a primary cause is the staffing issue in the health care institution. Shortage of nursing staff to fulfill all the care responsibilities of patients puts a strain on the nursing professional and contributes to the rising rate of medication errors. The growing shortage of nurses and the challenges that this poses to staffing, has a significant bearing on medication errors and patient safety (Ashley, 2008). The environment in which the nurses operate does contribute to the nursing drug administration errors. Protocols and medication administration schedules are put in place with little heed paid to the ability of the nurses to cope with them. As nursing professionals attempt to cope with these medication administration schedules they are often hurried in their preparation and administration, and also distracted and interrupted during the more crucial steps in the medication administration steps. Within the clinical environment multi-tasking is common among nursing professionals. An example of this is handling phone calls while preparing medications for their patients. There is a limit to which the cognitive functioning proceeds in a stressful environment, after which there is a likelihood of the process breakdown. Too much of a stressful environment can have a negative impact on an individuals capacity to perform tasks that require precision, attention, retrieval of knowledge and use of skills (Pape et al, 2005). Yet it is not just the stressful environment and heavy workload alone that has a role to play in nursing drug administration errors. Factors of lack of dosage calculation skills and neglect on the part of the nursing staff also have role to play (Tang, Sheu, Yu, Wei & Chen, 2007). In addition to medication errors there is the added risk of adverse reactions to the drugs themselves that pose a risk to the safety of the patient. Fifty thousand prescription errors stem from errors on the part of junior medical professionals annually. Every year nearly 250,000 individuals find themselves hospitalized as a result of adverse drug reactions (Wallis, 2009). In the United Kingdom there is growing awareness that drug administration errors is a major cause of avoidable morbidity and mortality, which leads to high financial costs to the patients, the healthcare system at large and the society as a whole. This has led to the establishment of the of the National Patient Safety Agency (NPSA), with the objective of reporting patient safety adverse events and using that data bring about the means to increased patient safety within the healthcare delivery system (Fenn, et al, 2004). A yellow card scheme has been introduced in the United Kingdom for reporting of adverse drug reaction incidents. These cards can be used by healthcare professionals and the general public as well. This scheme provides an opportunity of reporting of drugs marked with a black triangle in prescribing formularies and also other drugs and vaccines (Wallis, 2009). Patient Safety Action Plan The Canadian Nurses Association (CNA) has put into place a plan to improve patient safety. The basis of this plan is for awareness to be created among all the health care providers, patients and families about adverse high risk incidents through the sharing of information and discussing these adverse high risk incidents, so that these adverse high risk incidents come to the forefront and also solutions to reduce these incidents emerge (Ashley, 2008). Such a plan removes the accountability of the adverse events from an individual to the healthcare system on the whole, with the possibility of inculcating a culture of safety in the among all the stake holders of the health care sector (Mayer & Cronin, 2008). For this plan to succeed however there is the need to create better awareness among all the health care professionals and the other stake holders in health care sector of the seriousness of the issues of high risk adverse incidents in the healthcare sector and the need for a more safety conscious culture in the health acre sector. Commitment towards this goal from the healthcare professionals and the healthcare institutions is necessary for the plan to succeed. Literary References Ashley, L. (2008). Giving nurses a voice in patient safety. Canadian Nurse. November 2008, 24-25. Fenn, P., Gray, A., Rivero-Arias, O., Trevethick, G., Trevethick, K., Davy, C., Walshe, K., Esmail, A. & Vincent, C. (2004). The epidemiology of error: an analysis of databases of clinical negligence litigation. University of Oxford: Oxford, Pp. 1-55. Hughes, R. G. & Ortiz, E. (2005). Medication Errors: Why they happen, and how they can be prevented. AJN, pp. 14-24 Retrieved March 28, 2009 Available at: http://www.nursingcenter.com. Maricle, K., Whitehead, L. & Rhodes, M. (2007). Examining Medication Errors in a Tertiary Hospital. Journal of Nursing Care Quality, 22(1), 20-27. Mayer, C. M. & Cronin, D. (2008). Organizational Accountability In a Just Culture. Urologic Nursing, 28(6), 427-430. Pape, T. M., Guerra, D. M., Muzquiz, M., Bryant, J. B., Ingram, M., Schranner, B., Alcala, A., Sharp, J., Bishop, D., Carreno, E. & Welker, J. (2005). Innovative Approaches to Reducing Nurses’ Distraction During Medication Administration. The Journal of Continuing Education in Nursing, 36(3), 108-116. Tang, F., Sheu, S, Yu, S., Wei, I. & Chen, C. (2007). Nurses relate the contributing factors involved in medication errors. Journal of Clinical Nursing, 16, 447-457. Wallis, L. 2009, Adverse Reaction. Nursing Standard, 23(20), 18-19. Woman Dies from Medication Error in California Nursing Home. 2002. Retrieved March 28, 2009, from, Brayton Purcell LLP Available at: http://www.highriskincident.mh.htm Read More