Decreased Medication Administration Errors in Healthcare Units

Decreased medication
administration errors

Contents
ABSTRACT.....................................................................................................................................1
BACKGROUND.............................................................................................................................1
LITERATURE REVIEW................................................................................................................3
THE PROPOSAL............................................................................................................................1
AIM..................................................................................................................................................2
KEY STAKEHOLDERS.................................................................................................................4
METHOD........................................................................................................................................4
ESTABLISHING MEASURES......................................................................................................5
GOVERNANCE & ETHICS...........................................................................................................6
REFERENCES................................................................................................................................8

ABSTRACT
Medication administration errors is commonly defined as the reported administration of
wrong dose, missing dose and wrong medication. Some of the factors that widely contribute to
medication administration error are low health literacy, poor patient-provider communication,
and universal precautions. A substantial amount of medication administration errors occur in
children who are hospitalized. This literature highlighted the importance of decreasing
medication administration errors in a healthcare unit. There are a wide variety of factors that
contribute to this issue through poor health literacy rate. However, the main issue is that the
healthcare units are complex and managed, therefore, errors are bound to happen.
BACKGROUND
Medication administration errors, according to Ginger Schroers and et. al., 2021, is
considered a critical issue regarding patient safety. The healthcare providers responsible for
administration of medications to patients are Nurses (Nurses’ Perceived Causes of Medication
Administration Errors: A Qualitative Systematic Review, 2021). The role of a nurse is crucial in
interpretation of prescription accurately and observation of response produced by patient in a
healthcare setting during hospitalization. Nurses are bound to remain professional and follow
drug protocols for the treatment of the patient. The role of nurses as a healthcare providers is
crucial as they are directly involved in the care of patients. The healthcare assessment along with
close monitoring of drug is done by nurses who are in close contact with the patient and their
families. Medication error is defined as the “the difference between what the patient received
compared to what the patient was supposed to receive in the original order” (Montgomery and et.
al., 2021). This decrease in medication effectiveness can be caused due to human errors.
However, there are a variety of factors that contribute to this cause such as patients following
medication non adherence, interference of diet with medication, co-morbid conditions etc. The
onset of medication errors has a serious impact on the safety of the patient. These errors may
arise during any stage such as ordering, reading prescription, dispensing of medications or
administration. The rectification and elimination of these errors is important to encourage a safe
culture in healthcare settings.
This particular issue of medication administration errors was raised by the Joint
Commission (2017) that gave an insight about the poor outcomes obtained as a result of
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administration errors. The reason behind medication administration errors during the
hospitalization of the patient include failure to collaborate with other members of the healthcare
team, unresolved interdisciplinary orders, not complying by evidence based guidelines and
sometimes under-skilled staff (Hada and Coyer, 2021). The inability to delivery proper
medication administration leads to a variety of outcomes for the patient such as delayed
diagnosis, delay in treatment, increased tenure of hospital stay and an increased risk of hospital
admissions. According to the National Institute for Health Research, it was suggested that there
are several risk associated with the delivery of wrong medications. The Joint Commission states
that about 90% of the adverse effects in patients are observed due to administration of the wrong
medication by nurses. Therefore, it is necessary to execute appropriate strategies for the
intervention of poor patient outcomes. The perception of causes of medication errors to patients
can be improved by the development of intervention techniques, the main goal of which is to
mitigate the occurrence of these errors. Nurses have a huge responsibility of protecting the rights
of public health by carrying out their responsibilities in an effective and safe manner.
Considering another perspective delivered by Montgomery and et. al., 2021, due to high
volumes of patients in healthcare settings, nurses have reported suffering from high levels of
burnouts which leads to impairment of patient safety which is categorized under medication
safety. The causes of these high levels of burnouts can range from Personal to client related. This
study put forward by Montgomery and et. al., 2021, showcase that burnout levels are a crucial
factor in determining the onset of medication administration errors in hospitalized patients
(Härkänen, Turunen and Vehviläinen-Julkunen, 2020). Self perceived causes of errors by nurses
where commonly knowledge based, personal and other factors. The basic factor for the lack of
medication knowledge, this can include the inability and inaccuracy to read prescriptions. High
levels of burnout comes under contextual factors which includes heavy workloads causing
fatigue and incompetency. Moreover, lack of awareness was observed in nurses regarding lack of
knowledge about nursing principles and guidelines. There are several other barriers that caused
errors in medication administration. Some of them were language barriers, cultural barriers and
personal barriers. Language barriers affects the quality of in-house training and various other
ethnic aspects. Lastly, language barriers and unhealthy attitudes of nurses leads to decreased
quality of care which is inadequate for the overall well being of the patients residing in hospitals.
Other common causes of medication errors include incorrect diagnosis, wrong prescription of
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drugs and miscalculations of drugs which can poorly affect drug distribution practice in hospital
settings. There is a high likelihood of incorrect drug administration and failed communication
among nurses which increases the possibility of medication administration of errors (Craig and
et. al., 2021).
Additional factors such as, environmental and behavioural, have a direct impact on
interpersonal interactions which causes complexities in the nursing output of surgical wards. The
nurses are not aware about the expiration dates of medicines and sometimes give incorrect
dosage to patients which can negatively impact the health of patients leading to adverse drug
reactions. The most common cause of occurrence of medical error is breakdown of
communication, both verbal and written, which can occur between a nurse, doctor, patient and
physician. The delivery of poor communication leads to error of medicine administration. For the
delivery of appropriate care it is crucial to ensure that nursing staff is well equipped with
knowledge and all the relevant information. According to a study conducted by NHS, it was
reported that most of the medication errors occur during the delivery of medications due to lack
of medical knowledge. However, in the United Kingdom, the overload of work and
miscommunication between healthcare workers is one sole reason of medication administration
errors (Kuo and et. al., 2020). Some of the observed problems included misplacement of medical
prescription or medications for the valuable information. Therefore, as a result of this, it is
crucial to safeguard the safety of patients and carry out appropriate procedures for monitoring
and reviewing of medication administration system performed by nurses in a hospital settings.
LITERATURE REVIEW
The different databases used for this particular literature proposal are CINAHIL,
PubMed, Cochrane library, Embase, Medline, Ovid and Royal College of Nursing websites. The
selection of these articles was based on the peer-reviewed research system. The used keywords
for this literature review are medication administration, medication errors, proper
communication, patient safety, delivery of excellent patient care, quality improvement, reliability
of healthcare produced by nursing administration (Benjamin and et. al., 2018). The conclusion of
the search revealed that evidence based literature review is crucial to acknowledge during the
delivery of health care practices. The authors drew attention towards the complex interactions
that were involved in the administration of medications by nurses to the patients. According to a
systematic search study conducted by Kelly Gonzales, (2010), she revealed that there are a
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