Which situation is most likely to result in the nurse making a medication error?
Healthcare workers face more challenges today than ever before. Doctors are seeing more patients every hour of every day, and all healthcare staff, including doctors, nurses, and administrators, must adapt to the demands of new technology in healthcare, such as electronic health records (EHR) systems and Computerized Provider (Physician) Order Entry (CPOE) systems. Show
Overwork and systemic issues can and do lead to medical errors-thousands, in fact, every year, according to a 1999 report by the Institute of Medicine. At the time of the report, between 44,000 and 98,000 deaths occurred each year as a result of medical mistakes.1 Today the numbers are even more alarming; according to Medcom Trainex.2 Consider the following:
Medical errors are not only monetarily costly, but costly in terms of loss of trust in the healthcare system by patients, reduced patient satisfaction, and degraded morale among healthcare professionals, who often feel helpless to change the situation. It’s important to note that one of the main conclusions of the Institute’s report is that the majority of medical errors occur not as a result of incompetence or recklessness on the part of nurses and other healthcare workers, but rather as a result of faulty systems, fragmented processes, and working conditions (e.g., nurses exhausted from working double shifts). Deaths resulting from medical errors are tragic not only for patients and their families, but for the healthcare professionals who are responsible, as an article painfully highlighted about one nurse’s tragic mistake a few years ago. There are many types of medical errors, and they can occur anywhere in the healthcare system-from hospitals, to nursing homes, to pharmacies. The focus of this article is on medication errors in nursing. We’ll examine different types of medication errors, how they occur, and prevention measures for reducing these errors. FRAGMENTATION AND DECENTRALIZATION: KEY PROBLEMS IN HEALTHCAREThe fragmented nature of our healthcare system has contributed to an epidemic of medication and other medical errors today. When patients see multiple healthcare providers in different settings-whether by choice or otherwise-the result is often fragmentation of information. One doctor may not have access to the same patient information as another-one of the primary causes of medication errors. Medication Error Statistics Seventy percent of individuals in the U.S. take at least one medication per day, and more than half of all Americans take two.3 Every day at least one death in the U.S. happens a result of a medication error, and approximately1.3 million people annually are injured due to medication errors. 4 TYPES OF MEDICATION ERRORSMedication errors can occur anywhere along the route, from the clinician who prescribes the medication to the healthcare professional who administers the medication. The different types of medication errors include (but are not necessarily limited to):
These are just some of the many possible medication errors that can occur. CAUSES OF MEDICATION ERRORS
PREVENTING MEDICATION ERRORSNurses may not have the authority to make infrastructural changes, but they do have the power to suggest needed changes and take precautions to prevent medication errors, including the following: KNOW THE PATIENTThis includes the patient’s name, age, date of birth, weight, vital signs, allergies, diagnosis, and current lab results. If patients have a barcode armband-use it. The added administration times of using arm band systems have led some nurses to create potentially dangerous “workarounds” to avoid scanning barcodes. Don’t make this potentially dangerous mistake- use all of the information at your disposal to ensure patient safety, and avoid shortcuts. KNOW THE DRUGNurses need access to accurate, current, readily available drug information, whether the information comes from computerized drug information systems, order sets, text references, or patient profiles. If you have any questions or concerns about a drug, don’t ignore your instincts-ask. Remember that you are still culpable, even if the physician prescribed the wrong medication, the wrong dose, the wrong frequency, etc. KEEP LINES OF COMMUNICATION OPENBreakdowns in communication among physicians, nurses, pharmacists, and others in the healthcare system can lead to medication errors. The “SBAR” method can help alleviate miscommunications. SBAR (Situation, Background, Assessment, Recommendation) works like this:
Communication is vitally important, as it is the root cause of many sentinel events, according to the Joint Commission (TJC).5 DOUBLE CHECK HIGH ALERT MEDICINESHigh-alert medicines such as heparin can have devastating consequences if not administered properly. A tragic case involving the death of three infant patients after receiving massive heparin overdoses happened as a result of misleading packaging. Since this incident, the drug manufacturer now uses larger font sizes, tear-off cautionary labels, and different colors to distinguish drug doses.6 Medications often look alike and sound alike-this can be a source of errors. Double check high alert medications with another nurse to prevent accidental overdoses and other medication errors. DOCUMENT EACH DRUG ADMINISTEREDAccurate documentation is essential and should include accurate recording of the drug information, the name of the drug, the dose, route, time, patient response, and any refusal of the drug by the patient. TAKE AN ACTIVE ROLE IN CORRECTING ISSUES YOU IDENTIFYIf you see that look-alike or sound-alike medications are stored next to each other, ask your supervisor to correct the problem, emphasizing the increased risk of medication errors. Request that medications be reconciled (i.e., that the names, dosages, and administration routes of all medications are compared to identify conflicts). Request that a bar coding system be implemented that allows for the verification of the six medication rights (right individual, right medication, right dose, right time, right route, right documentation). INFORM THE PATIENT OF THE DRUGS THEY ARE RECEIVINGMake sure your patients know the names of the medications they are taking, what they look like, what they are for, how to take them or how they will be administered, the dosage, and the potential side effects and interactions. ASK FOR CONTINUING EDUCATIONAsk for mandatory training sessions about medications that are introduced to your facility. Training should include medication-related policies, procedures, and protocols. Updates like these, along with comprehensive nurse CE programs that include healthcare videos, empower nurses and can help prevent medication errors. Nurse educators and continuing education providers should include all of these prevention tips, and more, in nurse education programs to help nurses avoid medication errors that could have detrimental or even deadly consequences for patients, and significant consequences for nurses, including disciplinary action, job dismissal, criminal charges, and mental anguish. What are the causes of medication errors by nurses?Common causes of medication error include incorrect diagnosis, prescribing errors, dose miscalculations, poor drug distribution practices, drug and drug device related problems, incorrect drug administration, failed communication and lack of patient education.
What are the most common medication errors in nursing?Types of Medication Errors. Prescribing.. Omission.. Wrong time.. Unauthorized drug.. Improper dose.. Wrong dose prescription/wrong dose preparation.. Administration errors include the incorrect route of administration, giving the drug to the wrong patient, extra dose, or wrong rate.. What is the most common cause of medication errors in hospitals?Communication breakdowns are the most common causes of medical errors. Whether verbal or written, these issues can arise in a medical practice or a healthcare system and can occur between a physician, nurse, healthcare team member, or patient. Poor communication often results in medical errors.
Which situation is an example of a medication error?Wrong dose errors , wherein the correct dosage was prescribed, but the wrong dose was administered. Improper administration technique errors , such as administering a medication intravenously instead of orally.
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