Lesson 7 Small-Group Discussion. Patient Safety Step 1 In a report by the Institute of Medicine (2006), Titled, Preventing Medication Errors, “The committee concludes that there are at least 1.5 million preventable adverse drug events (ADE’s) that occur in the United States each year.” These numbers are astonishing given the number of adults that are taking prescription medications daily. Most of the errors occur during the prescribing and administering steps and during an average hospital stay, a patient can expect to have one medication error occur every day (Institute of Medicine, 2006). Medication errors are preventable adverse events and costly to patients, insurance companies and health care organizations (Institute of Medicine, 2006). It is estimated that for every adverse drug event that occurs in a hospital, adds over 8,000 to the hospital stay (Institute of Medicine, 2006). One of the essential components in reducing medication error is a collaborative partnership with the patient and healthcare providers to facilitate communication. Patient education regarding risks, side effects, drug interactions and contraindications must be thoroughly reviewed with the patient (Institute of Medicine, 2006). The use of technology for prescribing, dispensing and to obtain detailed information regarding …show more content…
The first element identified for the safety goal is staff and patient education on surgical site infection. Staff at my facility must undergo mandatory training upon hire and yearly regarding policies, procedures and protocols that need to be strictly adhered to in the prevention of surgical site infection. Patient’s are educated prior to surgery during the preoperative phone call and asked to bathe the morning of the surgery or the night before using antibacterial soap. For total joint procedures there are additional steps in the
Six months after the introduction of medication aides, error rates were as follows: RN (2.75%), LPN (7.25%) and medication aides (6.06%) with a mean error rate of 6.6%” Randolph & Scott-Calwiezell (2010) as cited in Budden (2011). While errors remain, the objective of reducing inaccuracies among primary nursing staff was achieved by
Preventable medical mistakes cause approximately 200,000 deaths around the United States each year. (1) More than 1,000,000 Americans are negatively impacted by medication errors each year caused by inadvertent mistakes in the prescription filling process. With 4 out of 5 adults taking at least 1 medication daily and 1 out of 4 adults taking 5 or more medications daily nationwide, errors like these cost healthcare industry billions of dollars per year. Health information technology were developed to transform healthcare services, the way they are provided and compensated. Electronic prescribing (e-prescribing) becomes an internal part of that transformation process, which can be confirmed from annual Surescripts’ National Progress Report.
The nursing staff needs to make sure they have more indicators towards practice nurse safety. Focusing on working patient safety down to zero with grade c medication ( Cockerham ,J.,Figueroa-Altmann,A., Foxen,C., Paffett,C., Sullivan,A.,&Wellner,J.,2014). The nurses making sure patient safety is first when administrating medication .The hospital would like to limit risk and increase reliability when taking care of patients. The purposed of this peer review article is to have the quality nursing and ample amount of nursing staff.
ADEs associated with medication discrepancies can prolong hospital stays and, in the post-discharge period, may lead to emergency room visits, hospital readmissions, and utilization of other health care resources. Preventable adverse drug events (PADE) are associated with 1 of 5 injuries or deaths and a result of poorly designed systems, which often lack independent redundancies. Preventable ADEs at transition points of care account for 46-56% of all medication errors. One strategy to reduce PADEs and ADEs is to reconcile the medication orders between the two transition points. The Institute for Healthcare Improvement (IHI) defines medication reconciliation as a formal process to compile a list of all the medications a patient is taking before admission, and comparing it with the doctor’s admission, transfer and discharge orders.
One significant barrier is the potential detrimental impact on physician and staff workflow. Computer-based systems that allow clinicians to prescribe drugs electronically are designed to automatically warn of potential medication errors, but a new study reveals clinicians often override the alerts and rely instead on their own judgment. A study, at Dana-Farber Cancer Institute showed that most clinicians find the current medication alerts a task of annoyance rather than a valuable tool for patient safety. Although the e-prescribing alert with improve medication safety, we the society will not see its benefit until there is a system to help clinicians better manage medication safety alerts. This study shed a light on the real value of e-prescribing alerts in the eyes of our clinicians.
Technology is a massive part of our society today and it is continuously changing. It can help solve issues and increase sufficiency. One safety issue that technology can help improve is medication administration errors that occur in hospitals and other health care settings. A medication administration error is defined as any preventable event that could possibly result in unsuitable medication use or harm to the patient while the health care professional is in control of the medication. The most common type of medical error is medication errors.
Preventatives for Medication Errors Administration of medications has become more complex and the process more exacting. About 15% of adverse events occurring in hospitals are related to medication. An estimated 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors (Tzeng, Yin & Schneider, 2013). About 700,000 emergency department visits and 120,000 hospitalizations are due to ADEs annually ("Medication safety basics," August ). These errors occur commonly when the nurse becomes easily distracted and loses focus on the task at hand.
When I read this guideline I realize my hospital don’t even have a Standing Operating Procedure (SOP) on administration of medication. I strongly believe this is one major contributing factor why the medication error took place in my practice area. A key point that I notice in this guideline is that, the nurse who is administrating medication should have knowledge especial the risk involved in this group of drugs and must have had read the guidelines on Medications
Through the learning from week 1 and week 2, I have learnt that the most frequent adverse event in health-care delivery is health care-associated infections. It is essential for us to follow the infection control practices that both patients and us are at a risk of being infected. Standard Precautions involve the use of safe work practices and protective barriers, for example, the use of personal protective equipment(PPE). At first, I think Standard Precautions are very easy. Everyone knows PPE can protect us from infections and hand hygiene is important throughout the process.
Medication Errors in Healthcare The nursing profession entails many responsibilities that range from providing emotional support to administering medications that could result in death for those receiving care. Approximately 40% of a nurse's day consists of passing medication, a duty that sets their level of liability above many other healthcare professions (McCuistion, Vuljoin-DiMaggio, Winton, Yeager, & Kee, 2018). Despite today's advances in technology and nursing education, the frequency of medication errors is still staggering. To ensure that the benefits of nursing outweigh the risks, nurses look to the Quality and Safety Education for Nurses (QSEN) six core competencies for guidance.
Medication errors is any correctable event that could lead to inappropriate
Medication use is potentially dangerous. Polypharmacy is increasing, and makes it harder to keep track of side effects and interactions and of potentially inappropriate drug combinations. “The risk of serious consequences, hospitalization, and death due to medication errors increases with patients’ age and number of medications (Scand J Prim Health Care, 2012)”. For example, the GP is supposed to monitor the patient's regular medication, but does not always do so. Lack of monitoring and keeping track of patients’ medication use is a main cause when a patient is given inappropriate drugs.
A Medication error is defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is under the control of the health care professional, patient, or consume. Therefore, any form of error that arrives within the healthcare system is deemed unacceptable. Now by understanding what a medication error entails, nurses are better able to place emphasis on how to prevent medication errors. It is important to prevent as many errors as possible when administering medications. Hospitals that accommodate high numbers of medication errors receive less funding and support by fellow agencies.
Safe medication administration is a big aspect of nursing care, because if medications aren’t given safely, then it can lead to some serious adverse effects to the patients. There are many things that can go wrong, and that’s why nurses have to be very careful when handling and giving medications. Nurses can make mistakes, and give the wrong med, give it to the wrong person, or even give too much or too little of the drug. Careful medication administration can lead to not making big mistakes that can lead to hurting others. “Medication Administration is a complex multistep process that encompasses prescribing, transcribing, dispensing, and administering drugs and monitoring patient response.”
This resulted in 7% of the respondents reporting involvement in a medication error during that past year. Good interpersonal skills and effective communication ensures that concerns regarding patient safety can be brought up without seemingly challenging the knowledge of the other healthcare