Assignment Medication Errors
Added on 2020-04-21
18 Pages4875 Words83 Views
Running head: MEDICATION ERRORSCase Study of Medication error in the operation theatreName of the StudentName of the UniversityAuthor Note
MEDICATION ERRORS1Executive summaryThis assignment will report a case study that involved adverse medication error related to wrongadministration of drugs, which created adverse health effects on the patients. There are severalfactors that contribute to the occurrence of medication errors in a hospital setting. The primaryfactors that need to be addressed in order to decrease or prevent the occurrence of suchmedication errors involve improvement of the adherence shown by healthcare staff towards thenational and local guidelines and polices that enable safe preparation and administration ofmedications upon patients. A through awareness and training of healthcare staff is required inorder to make them show compliance to the rules proposed by the hospital administrations.Moreover, there is also a need to promote effective communication between healthcare workersand encourage collaboration between them in healthcare field to facilitate easy delivery of drugsthat improve patient outcomes. This also reduces chances of errors. Thus, awareness of staff onanaesthesia is fundamental to maintenance of health status. This report will therefore analyse theevents that might have contributed to the incident.
MEDICATION ERRORS2Table of ContentsIntroduction..........................................................................................................................3Analysis of the incident.......................................................................................................3Quality improvement...........................................................................................................5Discussion on improving patient safety...............................................................................8Conclusion.........................................................................................................................10References..........................................................................................................................12
MEDICATION ERRORS3IntroductionThe process of medication refers to the treatment procedure using drugs to preventoccurrence of disease or adverse symptoms in a person. On the other hand, medication errors aredefined as any preventable events, which may lead to patient harm or inappropriate medicationuse under the control of healthcare professionals. Professional practice, procedures, health careproducts, and systems that include drug prescribing, communication, labeling, packaging andnomenclature of drugs, their dispensing, and distribution can lead to such errors (Alsulami,Conroy and Choonara 2012). This assignment will focus on a medication error event thatoccurred in the operation theatre while performing cholecystectomy.Analysis of the incidentFour years ago, during morning duty there was a need to perform a surgery for acutecholecystitis on a female patient. She was 27 years of age and had been admitted to the hospitaldue to severe inflammation of the gall bladder. On analysis of her medical records it was foundthat she did not have any previous medical issues. In the operation theatre, before drugs wereadministered for anaesthesia, the anaesthetist consultant had asked the practitioner to prepare 20mg of Primperan (metoclopramide). It was used to reduce the symptoms of nausea, vomiting andheartburn. Two 2 ml amber coloured ampoules were prepared by the practitioner that contained10 mg Primperan. However, the practitioner did not label it specifically, before placing it in theshelf. Furthermore, the practitioner had kept an ampoule of 1mg/ml adrenaline in an ambercoloured glass ampoule in the shelves. This was not to be done as the shelves contained onlyantiemetic drugs that were effective against nausea and vomiting. Therefore, on reaching the
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