Medication Safety Clinical Audit - Term Paper Example

Safety Clinic Audit By Student’s Name Course + Code Class Institution Date Introduction A clinical audit is a systematic care review and implementation of change seeking to improve care and outcome of patients. It ensures what is supposed to be done in the health systems is correctly done. However, improvement frameworks are made to system failure using auditing technique (Pain et al, 2017, p.23). Auditing in clinical assessment ensures quality life to patients reducing their death rates. This is done through proper selection and implementation of ways to handle patients in healthcare. It focuses on the incompetent health policies and how they are practiced. This paper seeks to investigate errors done in clinical wards and better ways to improve this sector. For better performance of a clinical audit, there are several strategies to be accounted. It follows spiral interconnected stages for its systematic development which include; best practice establishment, comparing the criteria taken, taking care improvement action and immediate monitoring for sustainable improvement (Dean et al, 2017, p. 5). Notably, each cycle is made to foster quality care to patients. The five steps used in auditing include; selection of the audit topic, setting criteria and standards of theme selection, data collection, data analysis and finally implementation of reinforcements and changes to be made to the existing practices. Proper checking is done to maintain the best-formulated practices. Many medical workers are prone to making mistakes during their service delivery. This is a deadly practice keeping in mind that they are dealing with lives of many patients. Poor services being offered to patients in wards are harmful because many of them die and others become disabled. We should ensure that the patients' health standards are prioritized and immediate responses are taken once the patient enters a given word. More so, the environment in the wards should be equipped with all the required equipment for better healthcare (Robinson et al, 2016, p. 46). Proper planning and management is key in handling patients’ health issues. Regarding this assessment. I will drive my focus on medical care audit in patient wards. This is done to oversee how patients in these wards suffer and coming up with better ways to remedy the matter. I will capitalize on a medication safety audit tool for my auditing strategy. Different organizations utilize different auditing tools but my organization uses a medication safety audit tool. In my organization, I work with Medication Safety Group in wards. I devise and pass relevant information regarding safety measures to be taken during medication delivery. The key aim is to improve the patient's care in these wards in order to reduce high death from patients taken to this department. I will then review and critique the audit cycle done by this paper using 10 patients in my ward as drawn in appendix A. Critique of clinical assessment tool There are several techniques that are used to monitor adverse events in an organization. They include; event monitoring, evaluating claims, reporting, and reviewing patients charts. Thereafter, errors derived from medication process are noted (Dean et al, 2017 p. 4). The medical policies of the hospital demands for annual reports and monthly reviews done by a patient's safety group in this unit and data collected documented properly. Results are compared with other same units in order to detect poor patient medication in the ward. The immediate remedy is enhanced to reduce the rate of patient care malpractices. There are 13 safety domains that are checked frequently from ten medication charts selected randomly from the used audit tool (McKenzie 2017, p.31) as outlined in Appendix A. These makes an assumption that the factors considered in administering medication to patients are relevant for effective auditing. It has better domain based descriptions with total assumptions regarded in ten random medication charts in a given unit. All the criteria and standards utilized in the clinical audit tool are considered are very vital during safe medication audit. They detail how crucial parts in medication charts are completed (McKenzie, 2017, p.31). The efficiency of this tool yields its effective utilization by the staff. This captivates professionalism in health care delivery. This is effected by counter-signature ensuing that the medications given to ward patients were correctly checked. Close monitoring is done in order to minimize occurrences of medication errors in wards. Data analysis The audit shown in the Appendix A was completed in the year 2016. The audit complied with the right of patients’ privacy where the names of the patients were not included (Wilson et al, 2016, p.649). 10 patients were utilized in collection and analysis of data from a given ward. This tool was completed by looking at the findings obtained by professional groups of medical experts, I being included. Aftermath, we were allowed to interpreted the audit effectively with very accurate data. Basing on the fact that a group of qualified experts can handle the same audit topic in order to provide higher quality reviewable data. From Appendix A, it is evident that most errors occur in the transcribing stage (Ravi 2017, p. 18). The alteration of prescription changes are not identified in the medication charts. The alterations done are not signed, dated nor alteration time given according to the organizational policies. Medical workers in wards were mandated to offer medication following the patients' charts given. Afterwards, a clear picture of poor prescriptions and medication delivery done by the pharmacist’s and nurses in the wards. The errors found in the audit done were associated with inadequate written communication. More so, the ward pharmacists offer poor services to the patients, an element that increases the rate of ill patients and deaths in our wards. Notably, variation in clinical setting in different areas as well captivate medication errors. Findings From the data collected and analyzed, the following are the findings derived from the audit: a) Lack of enough knowledge. The medical attendants like nurses and pharmacists lack enough knowledge and skills in their field. Some medical officers in wards are unable to interconnect the patient's illness with the type of drug to give out (wrong drug delivery). This has revealed that more than 18% of ward workers in Australia lack knowledge and skills in patients care, leading to high rate deaths in wards. Research done in 2000 show that the curricula do not cover some medical topics like pharmacology (McKenzie 2017, p.31). This proved lack of enough knowledge and skills in this area. There is the need for this unit to foster the skills of medical attendants to foster safety healthcare services. b) Poor communication. It is evident that poor communication between the doctors and nurses leads improper dosage to patients. For better healthcare, a complex communication process should be included hence effective communication is key, particularly in therapy. For instance, in directing nurses on how to give medication, the doctors do not indicate the time and the exact dose to be given to patients. On the other hand, the nurses’ fear asking relevant questions regarding the instructions given hence increasing the chances of making errors. The Appendix A shows how medical attendance in one of the wards gave out wrong medication without doctors' description and signatory. He was unable to seek clarification before delivery of the medicine. More so, anxiety and not believing in themselves reduces the effectiveness of some new nurses in wards. This is observed in the first two months of operation where they fear the doctors and they cannot communicate effectively to the patients. c) Unclear abbreviations. Both the qualified and new medical assistants in wards get problems with abbreviation interpretation. 60% of the nurses make alterations to the prescriptions given. There are different abbreviations used in medicine like, AAA, AP, C& S, amp, AP. They confuse many doctors and patients hence poor drug allocations. Abbreviations like C for Celsius and c for capsule confuse many medical officers. Doctors who uses abbreviations to describe patients’ body like AK-Above Knee confuse with Above Kidney (Gribble et al 2017. P. 16). This is dangerous as they' end up giving wrong medicine to patients. Quality improvement Provision of effective communication pathways in the medical systems are key for effective medical care. The audit results should be reinforced through annual meetings and email notices (Gribble et al 2017. P. 16). More so, step-wise learning through close assessment should be done for effective delivery of services to patients in the wards. This can be reinforced by availing reference materials for easy learning of abbreviations and drug allocation and dosage. It is fundamental for the new ward attendants to be supervised in the first month of their fieldwork as communicated by the graduate coordinator in Australia (Ravi 2017, p. 18). This will give chance for asking questions where possible to affect their communication skills and competence. This reduces errors caused by this staff hence proper patient care. This department formulated that supervision of nurses is weak hence being a source of errors in patient care in wards and other departments. The Australian healthcare has adopted national inpatient medication charts to reduce prescription errors. These charts are important for new nurses as they help them allocate drugs properly. This chart will create a faster environment for patients. For these changes to achieve the improvements needed, re-auditing in this department should be done. More changes may be needed hence the need for further re-auditing. Conclusion Many medication errors were realized in this audit. As such, it is important to do clinical auditing in order to detect the errors caused. The errors were irrational since the tick sheet used was unable to give clear discussions. More so, the best mechanisms are formulated to act remedy mechanisms. Clear communication, improper knowledge, and unfamiliar abbreviations are among the problems identified (Jackson 2016, p. 1333). There are several remedy strategies outlined which include; introduction of inpatient medication chart, education, and strict supervision will reduce errors associated with improper dosage and poor injections. It is prudent to note that this cannot be realized with the steadfast support from the all the healthcare workers, and the committees’ concerned. There is also need for continued auditing in order to formulate better ways of patient care regarding medicine administration. APPENDICES The table below summarizes the audit results for the 10 Audits done in the 13 audit tools. Clinical audit tool Percentage Patient identification 100% Medication allergy chart procedures followed 75% Prescriptions 70% Omission errors 60% Alteration/ PRN policy 60% Conducting weight and height measures 43% Documentation of medication history 80% Generic names and abbreviations 99% Medication reconciliations 90% Written patient information 70% Patient confirmation using a label 54% interview line labeling 65% VTS risk assessment 75% Appendix A References Dean, S., Foureur, M., Zaslawski, C., Newton-John, T., Yu, N. and Pappas, E., 2017. The effects of a structured mindfulness program on the development of empathy in healthcare students. NursingPlus Open, 3, pp.1-5. Gribble, C., Rahimi, M. and Blackmore, J., 2017. International Students and Post-study Employment: The Impact of University and Host Community Engagement on the Employment Outcomes of International Students in Australia. In International Student Connectedness and Identity (pp. 15-39). Springer Singapore. Jackson, D., 2016. Skill mastery and the formation of graduate identity in Bachelor graduates: evidence from Australia. Studies in Higher Education, 41(7), pp.1313-1332. McKenzie, L., 2017. A Precarious Passion: Gendered and Age-Based Insecurity Among Aspiring Academics in Australia. In Being an Early Career Feminist Academic (pp. 31-49). Palgrave Macmillan UK. Mikaelian, B. and Stanley, D., 2016. Incivility in nursing: from roots to repair. Journal of nursing management, 24(7), pp.962-969. Pain, T., Kingston, G., Askern, J., Smith, R., Phillips, S. and Bell, L., 2017. How are allied health notes used for inpatient care and clinical decision-making? A qualitative exploration of the views of doctors, nurses and allied health professionals. Health Information Management Journal, 46(1), pp.23-31. Ravi, A., Prine, L., deFiebre, G. and Rubin, S.E., 2017. Beyond the Surface: Care Seeking Among Patients Initiating Contraceptive Implant in an Urban Federally Qualified Health Center Network. Journal of Primary Care & Community Health, 8(1), pp.20-25. Robinson, M.E., Byrne, M. and McKenzie, R., 2016. Isqua16-2493care In The Ether-Developing A Robust Clinical Review Method For Telehealth. International Journal for Quality in Health Care, 28(suppl_1), pp.46-46. Spittal, M.J., Studdert, D.M., Paterson, R. and Bismark, M.M., 2016. Outcomes of notifications to health practitioner boards: a retrospective cohort study. BMC medicine, 14(1), p.198. Wilson, A.J., Palmer, L., Levett-Jones, T., Gilligan, C. and Outram, S., 2016. Interprofessional collaborative practice for medication safety: Nursing, pharmacy, and medical graduates’ experiences and perspectives. Journal of Interprofessional Care, 30(5), pp.649-654. Read More