NUR 2407 Pharmacology Module 4 Assignment Safety Risks

NUR 2407 Pharmacology Module 4 Assignment Safety Risks

 

Provide your answers to the following questions in a 2-page paper. Use APA Editorial Format for all citations and references used.

What should the “culture and environment of safety” look like when preparing and administering medications?

Discuss a common breach of medication administration.

Identify three (3) factors that lead to errors in documentation related to medication administration.

What can I do to prevent medication errors?

Medication errors have been a key target for improving safety since Bates and colleagues’ reports in the 1990s characterized the frequency of adverse drug events (ADEs) and the relationship between medication errors and ADEs in hospitalized patients. As described in related primers on medication errors and adverse drug events and on the pharmacist’s role in medication safety, the medication-use process is highly complex with many steps and risk points for error. This primer will focus on nurse-related medication administration errors.

 

Medication administration errors are typically thought of as a failure in one of the five “rights” of medication administration (right patient, medication, time, dose, and route). These five “rights” have been historically incorporated into the nursing curriculum as the standard processes to ensure safe medication administration. Recent literature, however, has emphasized that medication administration is part of a complex medication use process, in which a multidisciplinary care team works together to ensure patient-centered care delivery. As such, it has been emphasized that the five “rights” do not ensure administration safety as a standalone process. Therefore, four additional “rights” were proposed to include right documentation, action/reason, form, and response.¹ As modern healthcare delivery systems continue to evolve, emphasis on system design (i.e. technology & clinical workflows) has become a priority to complement the medication administration process. System-related causes of medication administration errors may include inadequate training, distractors, convoluted processes, and system misconfiguration.²

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Despite error reduction efforts through implementing new technologies and streamlining processes, medication administration errors remain prevalent. In a review of 91 direct observation studies of medication errors in hospitals and long-term care facilities, investigators estimated median error rates of 8%–25% during medication administration. Intravenous administration had a higher error rate, with an estimated median rate (including timing errors) ranging from 48%–53%.

 

A substantial proportion of medication administration errors occur in hospitalized children. This is largely due to the complexity of weight-based pediatric dosing, which encompasses medication doses based on calculations from weight and sometimes height. Variability of weights used for calculation can increase medication dose errors.⁶ Given this variability, dose preparation is uniquely challenging in pediatric populations, which increases risk for wrong dose administration.

 

Outside of the hospital setting, patients and caregivers are also at high risk for making errors. Errors in the home are reported to occur at rates between 2-33%. Wrong dose, missing doses, and wrong medication are the most commonly reported administration errors. Contributing factors to patient and caregiver error include low health literacy, poor provider–patient communication, absence of health literacy, and universal precautions in the outpatient clinic.