Defining Medication Error
Question:
Discuss about the Medication Error In Nursing Profession.
Medication error is considered as one of the biggest concern of the present day healthcare system. Due to its varied negative effects, the government of healthcare is trying its best to mitigate the problem in different ways. Medication error is the preventable event that has the potential to cause inappropriate medication administration by healthcare professionals. This results in harm to the patients to an extent that may threaten their lives as well as result in their suffering to large degree (Cloete, 2015). Therefore, most of the organizations are trying their best to adopt strategies that help them to overcome the issues. The thesis statement is that “medication error has potential negative effects on both nursing profession and safety of patients and therefore strategies need to be taken to prevent the occurrence of such issues in the future.”This assignment will mainly help to shed light on the issue along with its impacts on both patients and professionals. Strategies to mitigate the issues will also be discussed.
Medication error can be defined as the failure in the treatment failure procedure conducted by healthcare professionals that has the potential to cause harm in patients. Although medicines are mainly products that prevent or care various kinds of disorders, they also have the potential to cause harmful reactions if not used correctly. Different types of medication errors may take place where the most common form of error reported by FDA is improper dose of medicine (Hayes et al., 2015). This form of error is common in 41% of the total reported medication error cases. Moreover, giving the wrong drug or using an improper route of administration is also other causes of medication errors that accounts for about 16% of the errors (Lan et al., 2014). Several other causes of medication error may result from inaccurate recording and transcribing orders and due to unclear and erroneous labelling of drugs. Besides, misidentification of the client by the healthcare professionals or incomplete deliveries of drugs are also of the other types of medication errors. Moreover, verification errors, having inaccurate knowledge base and even time and performance pressure are also of the other reasons. They have severe negative health outcomes of patients resulting in very poor quality of lives (Elliot et al., 2016).
Researchers are of the opinion that healthcare is always conducted under stressful situations in a high consequence system where there is an increased potential for the occurrence of error. The level of professional as well as personal responsibilities of the healthcare professional for patient care along with the expectations surrounding these responsibilities also carry a certain weight and burden. Therefore, medication errors are incomplete conflicts with the goals of alleviating the suffering of service users (Hayes et al., 2015). Interviews conducted of experienced nurses have revealed that in most healthcare centres, there is a culture of blame and silence that is related to error. The main consequence of this care is culture results in under-reporting of such error events to the authority that often accompanies severe self-blame among the healthcare professionals (Lane et al., 2014). This culture has also been seen to hinder different types of improvements in practices as well as systems. Severe other emotional impacts are also seen to be associated with such form medication error events. They suffer from various forms of doubt and self blame themselves that make them not only anxious but also depressed. Nurses have also stated to suffer from loss of sleep for consecutive number of days after the occurrence of such events (Harris et al., 2014). Moreover, many of the nurses are also seen to lack confidence in their job that affect their practices in various ways. They tend to lack the confidence in their approach towards their patients and this lack of confidence is reflected in their body language (Vaisamoradi et al., 2014). This affects the therapeutic relationship between the patients and the nurses. Moreover feeling of anxiety, guilt and remorse are also feelings that remain associated with them. On the other hand, providers are seen to suffer from various types of legal obligations as well. Many of the organisations expose the nursing professionals to legal obligations. In many cases, the patients and their families also take such actions. All these actions have a huge impact on the career of the nurses. Either they tend to leave the job out of shame or are even their license gets cancelled where sever impacts take place on the patents (Karavasiliadou & Athanouski, 2014). Researchers conducted with nursing professionals had stated that guilt and shame are the most common feelings that they go through when such mistakes are made by them. About twenty percent of the professionals who have conducted the disorder had stated that they had gone through phases when they cannot gain back their self-confidence of practicing healthcare and were seen to question their own skills and professional competence (Ulas et al., 2015). Another important feeling that was also marked was that the nursing professionals felt angered towards their team as a whole. However, eighty percent of the interviewees had clearly stated that the adverse events had stayed back in their memories as a fixed event. Nurses have stated that “heart racing, dry mouth, tunnel vision as you look again at the vial in your hand and realization kicks in – you’ve just pushed 5mg of Midazolam IV instead of Metoclopromide” (Lan et al., 2014). Many of the nurses do not report these incidents out of fear stating that their career may be destroyed. They also state that too harsh punishments are given for medication errors for which the culture of non-reporting by the other nurses have come up (Alsweed et al., 2014). Therefore, healthcare organizations should be encouraged to be accountable for their actions and take initiatives to report their activities so that better healthcare culture can be developed.
Causes of Medication Error
A huge number of negative consequences result from the medication error by the professionals that result in poor quality lives of the patients. Often many of the research papers had stated that some of the effects of medication error are long stays of the patients at hospitals. Medical complications may also take place that result in huge suffering of the patients making them lead poor quality lives (Vaisamoradi et al., 2014). Medication errors conducted by the professional may have temporary as well as permanent effects on the body causing impairment in body structures as well as functions. These may include different mental, sensory, physical complication that may or may not accompany pain. Researchers have grouped a number of negative effects under the category of physical implications (Ulas et al., 2015). They have stated that medication error may range from no notable effect of the health of the patient to that of even unavoidable deaths in the healthcare canters. In the former result, although the patient is not at the risk of losing life but wring medication or low dose medication may extend the period of treatment or may fail to reduce the pain and suffering of the patients. This, in a way, results to improper care service delivery resulting in extending their stay at the hospital and increased suffering (Karavasiliadou & Athanouski, 2014). Other physical impairments that associate with medication errors include occurrence of new conditions and adverse symptoms that may be temporary and permanent. Patient reported symptoms include ringing in the ears, hypotension, skin disfigurement, itching, tingling and many others. This could include mild as well as different types of serious issues (Wright & Khatri, 2015). This may be explained by an example. When a nursing professional provides improper dose of penicillin, it may undergo reaction resulting in the formation of rash as well as anaphylactic shock. Another professional who provides a wrong dose of heparin may expose the person to even deaths as well. Apart from various implications of medication errors like pain, nausea, vomiting and many others, emotional implications of medication errors can also be noted (Alsweed et al., 2014). Patients become stressed and depressed as they become concerned with the fate of the treatment or whether they would be able to come back to normal lives. Many of the patients also feel angered and betrayal as they feel that the healthcare professionals are not performing their duties respectfully and behaving unprofessionally making their lives vulnerable to threats (Kerstenetzky et al., 2018). Many of the patients are also seen to suffer from self-doubts as well as self-blame as many of the patients have been seen to state “maybe it’s because I’m old, maybe it’s my fault” and many others. Such incidences are also seen to develop fear of taking future medicines after incidences of medication errors occur with them that make them go through near death experiences (Wright & Khatri, 2015). Financially as well, they are seen to suffer massively as long hospital stays make them expose to spending of huge number of resources and finance. This financial drain not only affects the patients but even family members to large extent (Harris et al., 2014). Insurance co-pays, lost wages, disability costs and other childcare costs all remain associated with medication errors of the students. On a personal front, the patients are seen to be demoralized from the extended length of stay. They also tend to develop altered belief in the benefits of the medication (Nanji et al., 2016). They are even seen to lose confidence on the healthcare professionals as well as on the healthcare service of the organization. Therefore, they either develop apathy to comply with the healthcare professionals or are seen to develop fear-getting service from the professionals or the healthcare organizations.
Negative Effects of Medication Error
A number of strategies can be incorporated to reduce medication errors in the organisations. One of the most important is development of a culture in the healthcare workplace where communication flows in all directions. Effective sharing of information, improvement of handwriting of the healthcare professionals, avoiding problematic abbreviations should be inculcated as important behaviours for medication error prevention (Kerstenetzky et al., 2018). Similar drug names should be taken care of especially during communication, advising other professionals or even during own practices so that errors can be avoided (Nienman et al., 2015). Using of electronic system should be promoted which can eliminate illegible handwriting and prevent automate screening for allergies, duplication of therapy and other drug-drug interactions. Another important strategy that should be also taken is responsible labelling and storage of drugs. This would include learning of proper handling of medications by separating drugs with lookalike names, separating high alert medications from other medicines and many others (Harris et al., 2014). The storage area should also be well organised so that medication errors do not take place. Proper control of accessing to medications should be done where healthcare professionals should be able to lock and secure his or her practice medication storage area after use. Strict procedures of logging, storing as well as monitoring samples of drugs should be followed. Medications dispensed to patients should be well maintained by mentioning the name of the medication, dose, strength, frequency, purpose, expiration date, quantity of medication along with name of the patients, dispensing and prescribing information (Harris et al., 2014). This helps in making in reducing the chances of medication. Moreover, the organisation should train their staffs to use the devices properly like the correct use of right syringes and others (Nienman et al., 2015). The organisation should also take initiatives where the performance of the practice of the nursing professionals should be assed. The nursing professionals should be able to reflect upon their own performance, on the errors, that they have made or were about to make and thereby adapt practices that will help them to prevent errors (Nanji et al., 2016).
Conclusion:
From the entire discussion above, it becomes quite clear that medication errors have a number of negative effects on the patient but also on the professionals. The safest of the patient is affected as they suffer from physical, emotional, financial and personal implications. This affects their quality lives making them stay for long in the hospitals, hospital readmission or even unavoidable deaths. The professionals also go through emotional turmoil resulting in loss of confidence, guilt, and shame and even disruptive career growth. Therefore, proper strategies need to be applied by which the healthcare professionals as well as the organizations can ensure practices that prevents medication errors.
Strategies to Reduce Medication Error
References:
Alsweed, F., Alshaikh, A., Ahmed, A., Yunus, F., & Househ, M. (2014). Impact of computerised provider order entry system on nursing workflow, patient safety, and medication errors: perspectives from the front line. International journal of electronic healthcare, 7(4), 287-300.
Cloete, L. (2015). Reducing medication errors in nursing practice. Nursing Standard (2014+), 29(20), 50.
Elliott, R. A., Lee, C. Y., Beanland, C., Vakil, K., & Goeman, D. (2016). Medicines management, medication errors and adverse medication events in older people referred to a community nursing service: a retrospective observational study. Drugs-real world outcomes, 3(1), 13-24.
Harris, M. A., Pittiglio, L., Newton, S. E., & Moore, G. (2014). Using simulation to improve the medication administration skills of undergraduate nursing students. Nursing Education Perspectives, 35(1), 26-29.
Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration. Journal of clinical nursing, 24(21-22), 3063-3076.
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).
Kerstenetzky, L., Birschbach, M. J., Beach, K. F., Hager, D. R., & Kennelty, K. A. (2018). Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework. Research in Social and Administrative Pharmacy, 14(2), 138-145.
Lan, Y. H., Wang, K. W. K., Yu, S., Chen, I. J., Wu, H. F., & Tang, F. I. (2014). Medication errors in pediatric nursing: Assessment of nurses’ knowledge and analysis of the consequences of errors. Nurse education today, 34(5), 821-828.
Lane, S. J., Troyer, J. L., Dienemann, J. A., Laditka, S. B., & Blanchette, C. M. (2014). Effects of skilled nursing facility structure and process factors on medication errors during nursing home admission. Health care management review, 39(4), 340-351.
Nanji, K. C., Patel, A., Shaikh, S., Seger, D. L., & Bates, D. W. (2016). Evaluation of perioperative medication errors and adverse drug events. Anesthesiology: The Journal of the American Society of Anesthesiologists, 124(1), 25-34.
Niemann, D., Bertsche, A., Meyrath, D., Koepf, E. D., Traiser, C., Seebald, K., … & Bertsche, T. (2015). A prospective three?step intervention study to prevent medication errors in drug handling in paediatric care. Journal of clinical nursing, 24(1-2), 101-114.
Ulas, A., Silay, K., Akinci, S., Dede, D. S., Akinci, M. B., Sendur, M. A. N., … & Ozdemir, N. (2015). Medication errors in chemotherapy preparation and administration: a survey conducted among oncology nurses in Turkey. Asian Pac J Cancer Prev, 16(5), 1699-705.
Vaismoradi, M., Jordan, S., Turunen, H., & Bondas, T. (2014). Nursing students’ perspectives of the cause of medication errors. Nurse education today, 34(3), 434-440.
Wright, W., & Khatri, N. (2015). Bullying among nursing staff: Relationship with psychological/behavioral responses of nurses and medical errors. Health care management review, 40(2), 139-147.
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