Running head: ASSESSMENT 4 1
ASSESSMENT 4 2
Assessment 4: Improvement Plan Tool Kit
Rody Zapata
School of Nursing and Health Sciences, Capella University
NURS-FPX4020: Improving Quality of Care and Patient Safety
Dr Sandy Arnold
09/20/2021
The medication administration errors refer to the existence of variations between what the patient is receiving, or what the patient is supposed to receive, and what the provider is intending to give in the original order. The medication errors are linked to the wrong or missing doses, the wrong medication, wrong patients, and wrong route of administration. The factors the leads to the patient and caregiver errors are low health literacy, the poor communication process between the provider and the caregiver, and the non-application of universal precautions in the outpatient clinics.
Medication errors are the key challenges that threaten the safety of the patients, and this interferes with the quality of the healthcare services that are delivered to the patients. The medication errors can expose patients to health complications, and even deaths. It leads to extended period of hospitalization of the patients, thus, raising the healthcare costs for the services that the patients never intended to be treated for. Based on these alarming and concerning impacts, the Joint Commission, the healthcare facilities, and the regulatory institution involved have reassessed the strategies and policies for patients safety within healthcare facilities. The recommendations have been proposed to help in ensuring that the safety of the patients is improved by reducing the rates of medication errors.
Based on the need to prioritize safety of patients by zero incidences of medication errors, several interventions have been proposed to assists in the reduction of the problem. Some of these interventions have proven to be effective in some healthcare facilities. Some of the interventions that have been adopted involved the contemporaneous use of technology, for example, the use of the Barcode Medication Administration System. The intervention was designed to help in the prevention of the inadequate administration of medications, and to enhance safety and quality of patients care. The focus of this paper is, therefore, to provide a discussion on the effectiveness of the barcode intervention using some of the literature studies.
The adverse effects of medication errors are recognized by many healthcare professionals and healthcare facilities; however, little attention is given to the approaches that can be adopted to help in ensuring that those issues are addressed. Bifftu et al (2016), aimed at assessing the incidences of the medication administration error reporting behaviors and the related factors amongst nurses. The author adopted the institution-based quantitative cross-sectional study amongst 282 nurses. The authors used a semi-structured, semi-administered questionnaire. Based on the outcome of this study, error reporting is associated with the incidences of medication errors (Bifftu et al., 2016). The findings of this study reveal that the behavior or habit of error reporting is associated with the education status, the organizational definition of error, and the administrative reasoning, as well as fear.
The article is significant for the discussion since it shows that the successful implementation of the intervention requires commitment of the healthcare providers to ensure that other factors that influence the prevention of medication errors are addressed. One of these factors is the culture of error reporting and the clear understanding among the organizational members on the meaning of the medication error. The article reveals that is important for the hospital management to work collaboratively in reducing the incidences of medication errors and encouraging the approach of reporting the medication error to know whether the intervention implemented is working or not.
The article is important in the reduction of the patient safety risk since it ensures that there is a joint effort from both the management and the healthcare providers in reducing the medication errors. The adoption of the culture of reporting is helping nurses to work without any form of fear and this is essential in the reduction of the incidences of medication errors. Nurses are playing important role in the successful process of administering medication since they can either act as the source of error, the contributor, and the observer. Nurses are professionally, legally, and ethical required to recognize the medication errors and reporting those (Bifftu et al., 2016). Therefore, the reduction of the risks to medication errors requires a clear explanation on the meaning of the reportable errors and improvement of the nurses educational status.
The article is relevant for the implementation of quality and safety improvement. The research work reveal that adoption of the BMCA is a helps in the reduction of the issue by helping the nurses to ensure that there is a process of checking the five rights of the medication, i.e., the right dose, the right patient, right route, right drug, and the right time (Marcias et al., 2018). This is important in helping the nurses to ensure that nurses increase the time they are spending in the performance of the patient care activities.
The article is important in the reduction of the patient safety risk to the medication administration errors. BMCA is important in the reduction of the incidences of medication administration errors. The intervention considers the aspect of the rights during the prescription of medication (Marcias et al., 2018). It ensures that the medication is prescribed to the right patients and patients follow the medication schedule to prevent any complications during the treatment of the patients.
The implementation of the Bar-Code medication administration is important in the reduction of patient harm. Thompson et al. (2018) while focusing on the assessment of the effects of the implementation of the BCMA. Technology on the rate of medication administration errors in the inpatient setting reveal that the consistent utilization of the BCMA is helping in the improvement in the safety of the patient by reducing the number of risks of harm as a result of the errors that occur during administration (Thompson et al., 2018). This was a rollout study focused on the approaches that can be adopted in implementing the BCMA within four or five units at the time within the eleven separate waves.
The result of this study shows that following the introduction of the BCMA technology, there was a decrease by 43.5 percent in the errors that occurs during the provision or prescription of medication. BCMA is helping in the reduction of the incidences of harm caused by the administration errors from 0.65 for every 100,000 medications pre-intervention, to about 0.29 in every 100,000 medications post-interventions. This led to a reduction by 55.4 percent in the actual patient harm events (Thompson et al., 2018). No errors recorded at category E or greater were associated with the BCMA factors.
This study is important and plays an essential role in the implementation of quality and safety improvement in terms of the medication administration process. According to this article, the utilization of the BCMA technology can be relied on to ensure that there is improvement in the safety of the patient. The technology is important in the improvement of the safety of the patients during medication administration (Thompson et al., 2018). The BCMA assists in reducing the harm that occur to the patients as a result of medication administration errors.
The article is also important in the reduction of the patient safety risk associated with medication administration errors. The article reveals the role of the BCMA in making sure that patients especially in the inpatient units are safer from medication errors. Patient in the inpatient units requires effective healthcare delivery to help in making sure that they are free from the nosocomial infection that increases the number of days they spent while in the facility. The risk of being diagnosed with nosocomial diseases or complications associated with medication errors is reduced when nurses can adopt and implement the BCMA technology within the facility (Thompson et al., 2018). The successful implementation of the BCMA in the hospital helps in the reduction of the risk of the patients exposure to the potential harms while receiving healthcare services in the inpatient facilities.
Healthcare facilities have made an effort to ensure that there is a reduction in adverse drug events (ADEs) through investing the new technologies. However, there is a lack of data concerning the effectiveness of these technologies. Truitt et al. (2016) focused on evaluating the effects of the implementation of the barcode medication administration (BCMA) and the electronic medication administration record (eMAR) technology on the profile of ADEs within healthcare facilities. The authors carried out a before and after study to examine the impacts of the implementation of the BCMA, and the eMAR technology on the profile of the ADE at the medical facility that has about four hundred beds. The reported ADEs were compared for both pre- and post- implementation periods of five months to find out whether there was an incidence of reduction in the rates of the ADEs in the medication use stages, for example, the processing and administration among others.
The outcome of the study reveals a significant reduction in the ADEs from 0.26 percent to 0.20 percent following the implementation of the BCMA. The results also reveal a reduction in the transcription errors from 0.089 percent to 0.036 percent and this was associated with the reduction in the wrong time errors. The study is important in the implementation of patient safety while preventing or reducing medication errors (Truitt et al., 2016). The article shows that eMAR and BCMA technology can be relied on to improve the safety of the patients. This is achieved by reducing the overall rates of ADEs and the rates of transcription errors.
The article is also significant in the implementation of the approaches aimed at reducing the risk to patient safety as a result of the potential medication administration errors. The study confirms the importance of adopting both eMAR and BCMA in the reduction of the harmful effects of administration errors. Therefore, the potentials harm such as injuries or health complications that usually occur as a result of medication administration errors can be addressed through BCMA (Truitt et al., 2016). The BCMA together with the eMAR is helpful in the reduction of the risk to the adverse drug events associated with the medication errors.
Many medication errors can be prevented and the health information technologies like the bar code medication administration (BMCA) systems are increasingly regarded as the best solution to this issue. Shah et al. (2016) performed a literature review studies using the articles from 1992 to 2015, using the search of reliable databases such as MEDLINE, Pubmed, and EMBASE databases (Shah et al., 2016). The outcome of this literature review shows that BCMA is effective in the reduction of non-timing-related administration errors. The utilization of the BCMA helped in the reduction of incorrect patient, doses, medications, and the wrong route errors. The outcome of the article shows that dosing errors were the predominant type of errors that were reduced by the BCMA (Shah et al., 2016).
The study is relevant to the implementation of the approaches aimed at reducing medication errors. The safety of the patients is affected when the patient is provided with incorrect medication, poor dosages, and the wrong route. The study, therefore, helps in the improvement of patient safety by ensuring that the medication prescription to the patients involves the considerations of the aspects of the five rights (Shah et al., 2016). In this case, healthcare providers are required to make sure that there is electronic verification of the five rights, those are: the right patient, the right dose, the right drug, the right time, and the right route.
The article is important in the implementation of the process of reducing the risk of patients to medication errors. The study offers an approach that can be used to ensure that the right procedure in the administration of the drug is fully adopted and implemented by the providers and facilities (Shah et al., 2016). The reduction in the risks of medication errors is attained by considering the aspects of the five rights. The article helps in ensuring that nurses can implement the barcode medication administration by scanning the bar code that is found in the identification badge, the patient wristband, and the medication to be received by the patient.
References
Bifftu, B. B., Dachew, B. A., Tiruneh, B. T., & Beshad, D. T. (2016). Medication administration error reporting and associated factors among nurses working at the University of Gondar referral hospital, Northwest Ethiopia. BMC Nurs, 15(1), 43.
Jain, M., & Rani, U. (2017). Auto Documentation to Hospital Information System Using Bar-Coded Medication Administration. Asian Journal of Pharmaceutical and Clinical Research. doi:http://dx.doi.org/10.22159/ajpcr.2017.v10s1.124
Macias, M., Bernabeu-Andreu, F. A., Arribas, I., Navarro, F., & Baldominos, G. (2018). Impact of a Barcode Medication Administration System on Patient Safety. Oncology Nursing Forum, 45(1), E1-E13. doi:10.1188/18.ONF.E1-E13
Shah, K., Lo, C., Babich, M., Taso, N. W., & Bansback, N. J. (2016). Bar Code Medication Administration Technology: A Systematic Review of Impact on Patient Safety When Used with Computerized Prescriber Order Entry and Automated Dispensing Devices. The Canadian Journal of Hospital Pharmacy, 69(5), 394-402. doi:10.4212/cjhp.v69i5.1594
Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russel, J. J., Wermers, R. A., . . . Nassens, J. M. (2018). Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clinic Proceedings: Innovations, Quality, & Outcomes, 2(4), 342-351. doi:10.1016/j.mayocpiqo.2018.09.001
Truitt, E., Thompson, R., Blazey-Martin, D., NiSai, D., & Salem, D. (2016). Effect of the Implementation of Barcode Technology and an Electronic Medication Administration Record on Adverse Drug Events. Hospital Pharmacy, 51(6), 474-483. doi:10.1310/hpj5106-474
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