Strategies to Minimize Medication Errors

The importance of minimizing medication errors cannot be overstated, as they can have severe consequences for patients and the healthcare system. To prevent or mitigate these errors, various strategies can be employed. These include using computerized provider-order entry systems to limit human error in communication and dispensing phases, implementing automated dispensing cabinets and bar-coding systems, establishing proper medication reconciliation policies, standardizing medication-use processes, and ensuring correct documentation. Additionally, education on medication safety and proper communication is crucial for the entire healthcare team. By adopting these strategies, healthcare institutions can reduce the incidence of medication errors and improve patient outcomes.

Medication Safety 1
MEDICATION SAFETY AS A PROFESSIONAL ISSUE IN NURSING
Student Name:
Course:
Professor:
University:
Date:

Medication Safety 2
Introduction
Medication safety refers to the practice of giving patients the right medication, in the
right doses, and at the right times (Cima and Clarke 2012). It is an important professional issue
for nurses since they are the healthcare workers who do actual drug administration. The
physicians mainly prescribe medication while the pharmacists receive, store, and dispense
medications. Medication safety becomes an issue in nursing when it is done in the wrong way
thus constituting medical error. Agyemang and While (2010) define medical error as any
avoidable events that may lead to inappropriate use of medication with or without resultant harm
to the patient while the medication process is in the control of the patient, a consumer, or a
healthcare professional. Medication error can occur at any point in the healthcare chain including
prescription, order communication, labeling, packaging, dispensing, administration, monitoring,
and use. As for nurses, special focus is on administration. However, nurses are also involved in
prescription, order communication, and monitoring. The importance of drug medication errors to
patients, healthcare personnel, health institutions, and the economy cannot be understated. This
paper is an in-depth discussion of medication safety and medication errors; it also recommends
various ways in which nurses can enhance medication safety and avoid medication errors.
Significance of Medication Safety to Nursing
McBride-Henry and Foureur (2005) state that nurses are the healthcare personnel who
take most responsibility for medication errors and their impacts. Nurses are involved in the
majority of the activities that constitute the medication chain (Bull et al. 2017). Nurses are often
involved in process of prescription either directly by prescribing drugs like analgesics in the
absence of physicians or indirectly by helping the physician to decide the medication given to a

Medication Safety 3
patient. Moreover, nurses are heavily involved in the communication and drug dispensing
processes that follow. Nurses are also the chief drug administrators. Although systemic factors
play a great role, nurses are certainly the most important cadre of healthcare professionals when
one thinks of medication safety (Brady et al. 2009). It is for this reason that medication safety is
an important issue for the nursing profession.
Lounsbury (2009) reports that the greatest percentage of medication errors occur at the
level of nursing activities. The author states that 39% of all medication errors are committed by
physicians. However, nurses have an opportunity to identify and correct these errors at the levels
of medication dispensation and administration (Lounsbury 2009). Additionally, nurses are the
healthcare personnel who are closest to patients. As such, the nurses can identify the
consequences of medication error on patients earlier and report them appropriately. These tend to
increase the responsibilities of nursing in preventing and limiting the consequences of
medication error.
Furthermore, as the primary preventers of medication error, it is the role of nurses to
report confirmed or suspected cases of the same (Lounsbury 2009). Although all healthcare
workers should be involved in proactive identification and management of medical errors, the
greatest responsibility is upon nurses hence the significance of medication safety as a
professional issue in nursing. Actually, monitoring patients for response or reactions to drugs is
part of holistic patient care and is thus a direct responsibility of nurses.
In a review of relevant literature, Durham (2015) also found out that nurses have more
responsibility when it comes to medication safety compared to any other cadre of healthcare
workers. She says that individual factors leading to medication error are unpredictable and
unintentional. She also enumerates various causes of medication error among nurses. These

Medication Safety 4
include recognition and perceptual factors both for drugs and patients; reporting errors; and
inadequate utilization of pharmacology knowledge.
The incidence of medication errors also affects individual nurses adversely and has major
implications for the nursing profession. Individual nurses involved in the medication error often
experience emotional plight as they have to put up with a feeling of shame, guilt,
disappointment, and self-doubt (Schelbred and Nord 2007). Ethically, the nurses might find it
difficult to report an error committed by themselves or their close associates; they also have
difficulties in explaining this to the patients. Additionally, these nurses stand a risk of facing
litigation or revocation of their licenses. Such incidences also derail the nurse’s professional
development and their effectiveness at their work; in fact, some may be forced to seek a break to
deal with the resultant emotional instability (Schelbred and Nord 2007).
The health institution and the entire nursing profession are also affected adversely. The
health institutions might have to incur significant costs in either settling damages or paying for
legal counsel on behalf of their employees (Hughes, 2008). In addition, the incidence of medical
errors often leads to unethical practices by many members of the profession in an attempt to
cover up. These unethical practices and the resultant plight of the patient often lead to a loss of a
health institution’s good reputation hence a decrease in their competitive edge. Moreover, the
cumulative effects of medication errors can cost a health institution their accreditation. The nurse
leadership in the affected health institution also ends up spending a lot of time considering the
case, conducting the investigation, and instilling disciplinary measures for the affected
individuals at the expense of patient care.

Medication Safety 5
Significance of Medication Safety on Patient Safety
McBride-Henry and Foureur (2005) assert that medication error occurs in one out of
every five cases. This is a relatively high incidence rate considering the fact that medication
errors can cause significant harm to the patients, their families, the society and the economy.
Glavin (2010) states that in the USA alone, approximately 7000 deaths every year can be
attributed to medication errors. Moreover, Glavin (2010) reveals that medication errors cost a
teaching hospital in the USA approximately $5.6 million every year; half of these deaths and
costs are preventable. Medication safety is one of the major aspects of patient safety.
Medication errors are a breach of patient safety and are a known cause of significant
morbidity and mortality (Cima and Clarke 2012). Depending on the nature of the error and its
magnitude, some patients can escape unscathed, though. Medication errors could worsen a
patient’s current illness, cause another illness or cause temporary discomfort, for example
ringing ears, nausea, headache, dizziness, or abdominal pains to the patient (Cima and Clarke
2012). Emotionally, the knowledge of medication error and its consequences to the patient often
causes a feeling of depression, anger, and betrayal (Cima and Clarke 2012). Such emotions can
cause physically stable patients to be aggressive and launch either verbal or even physical attack
to the staff that is thought to have made the error or any other staff around them. Some patients,
especially the elderly ones, may resort to blaming themselves for their role in facilitating the
error. Even worse, the incident could make patients have a fear for future medication, which can
be detrimental to their health outcomes in future. Depending on their insurance status, some
patients may have to incur extra costs to fund the medical bills increased by the effects of the
medication error. Moreover, even patients with excellent insurance cover might have to undergo
extra indirect costs such as childcare and disability costs (Cima and Clarke 2012). Personally,

Medication Safety 6
many patients are demoralized by having to stay in the hospital for a longer time for something
that is neither their mistake nor that of the nature of their bodies. Additionally, many patients
lose faith in the healthcare system and the desirable effects of drugs. These could impact
adversely on their future health-seeking behaviors and hence their future health outcomes.
The families of affected patients are also often affected adversely. Most family members
suffer sadness and despondency to witness the additional and avoidable suffering of their loved
one (Cima and Clarke 2012). Further, they may develop a fear of the safety of the patient and
mistrust in the healthcare providers. In some cases, these members might feel angry and betrayed
and resort to physical or verbal aggressiveness; in fact, patients’ family members are the most
important group of people who are known to physically assault healthcare workers (Hughes
2008). The families also suffer financially as due to the lost wages of the affected member.
Moreover, the family might have to incur extra costs, which could be medical or indirect costs
such as parking fee and childcare (Cima and Clarke 2012). In future, the family members may
also develop the fear for medication, which may affect negatively on their health seeking
behavior and health outcomes. In addition, some of the family members might have to act as
advocates for the patient in the investigations of the error; this is distressing and can be
depressing for the family member doing it.
The society and the economy are also affected by medication error. Expenditure of huge
sums of money on avoidable medical errors causes suffering for the economy (Glavin, 2010).
Moreover, health insurance companies have to sort out the health bills that result from medical
error. The litigation processes and costs incurred also hurt the economy. Generally, the increased
morbidity leads to loss of many workdays as the victim stays in the hospital while all or part of
their family has to spend time by their side. On the side of the society, formation of bad attitudes

Medication Safety 7
of the healthcare system hence decreases the effectiveness of the system. The cumulative effects
of the errors might also lead to legislations and formation of movements for reform.
Strategies to Minimize the Incidence and Impact of Medication Error
Medication errors are common and dangerous occurrences, which need prevention. Even
where prevention is difficult, there should be strategies to limit the impact of medication errors
when they occur. This section of the paper discusses the various steps, which can be taken to
either prevent medication error to limit its negative impacts. These steps focus mainly on the
nursing profession and look to limit both systemic and individual causes of error.
First, as a way to limit human error in the communication and dispensing phases,
computerized provider-order entry systems, can help (Weant et al. 2014). In such as system, the
pharmacist is notified through a computerized mechanism whenever a physician prescribes a
particular medication and only dispenses the prescribed dose. Moreover, these computerized
systems can have drug guides, which will automatically correct incorrect dosages in the
physician’s prescription. At the point of administration, the nurses should also counter-check the
prescribed and dispensed dosages and drug forms with a drug guide; in other words, drug guides
should always be available.
Secondly, health institutions should look to use automated dispensing cabinets and bar-
coding systems (Weant et al. 2014). These can help to alleviate all probable errors in the
dispensation phase. The automated dispensing cabinets will ensure that only the correct
medication is kept in the correct cabinets as a result limiting the chance of unintentionally
dispensing wrong medication. Additionally, automation will only allow dispensation at the
required time and in the required doses.

Medication Safety 8
Third, every institution should have proper medication reconciliation policies (Weant et
al. 2014). Most cases of medication error happen to patients who are either new in an institution
or in a department. Medication reconciliation involves an in-depth review of the medications
administered to the patient. In this review, the previous administration of these medications is
confirmed and the doses, dosage frequency, dosage form, and even the medications themselves
corrected accordingly.
Fourth, standardization of medication-use processes can limit both individual and
systemic factors in the causation of medication error (Weant et al. 2014). There should also be
policies to ensure that these processes are followed to the latter (Greenall et al. 2004). These
processes can include mandatory counter-checking with a fellow nurse or physician and strict
observation of the five ‘rights’ before administering medication. These five ‘rights’ include the
right patient, the right medication, the right dose, the right time, and the right dosage form. The
use of name alerts can be used in critical-care departments to correctly identify patients.
Finally, correct documentation will be important in preventing medication errors (Weant
et al. 2014). Important documents such as prescriptions should be legible to prevent human error.
Placement of 0 before decimal points can also aid in preventing dosage mistakes. Medications
should be labeled properly and records updated after drug administration.
Although nurses are heavily implicated in medication safety and medication errors, it is
the role of every member of the healthcare team to prevent these errors and their impacts (Brady
et al. 2009). As such, communication and coordination among nurses and among the entire
healthcare team is the most powerful tool to help in this. Institutions should create a culture and
an environment that enhances communication. Moreover, education on medication safety and

Medication Safety 9
proper communication is also important (Weant et al. 2014; Greenall et al. 2004; Bull et al.
2017).

Medication Safety 10
Bibliography
Agyemang, R.E.O. and While, A., 2010. Medication errors: types, causes, and impact on nursing
practice. British Journal of Nursing, 19(6).
Brady, A., Malone, A. and Fleming, S., 2009. A literature review of the individual and systems
factors that contribute to medication errors in nursing practice. Journal of nursing management,
17(6), pp.679-697.
Bull, E.R., Mason, C., Junior, F.D., Santos, L.V., Scott, A., Ademokun, D., Simião, Z., Oliver,
W.M., Joaquim, F.F. and Cavanagh, S.M., 2017. Developing nurse medication safety training in
a health partnership in Mozambique using behavioral science. Globalization and health, 13(1),
p.45.
Cima, L., Clarke, S., & Joint Commission Resources, Inc. (2012). The nurse's role in medication
safety. Oakbrook Terrace, Ill: Joint Commission Resources.
Durham, B., 2015. The nurse's role in medication safety. Nursing2017, 45(4), pp.1-4.
Glavin, R.J., 2010. Drug errors: consequences, mechanisms, and avoidance. British journal of
anesthesia, 105(1), pp.76-82.
Greenall, J., Hyland, S., Colquhoun, M. and Jelincic, V., 2004. Medication safety alerts. The
Canadian Journal of Hospital Pharmacy, 57(2).
Hughes, R. (2008). Patient safety and quality: an evidence-based handbook for nurses.
Rockville, MD, Agency for Healthcare Research and Quality.
Lounsbury, K.S., 2009. Improving Medication Safety by Implementing a Just Culture. DNP
Dissertation. University of San Francisco.
McBride-Henry, K. and Foureur, M., 2006. Medication administration errors: understanding the
issues. Australian Journal of Advanced Nursing, The, 23(3), p.33.

Medication Safety 11
Schelbred, A.B. and Nord, R., 2007. Nurses’ experiences of drug administration errors. Journal
of advanced nursing, 60(3), pp.317-324.
Weant, K.A., Bailey, A.M. and Baker, S.N., 2014. Strategies for reducing medication errors in
the emergency department. Open access emergency medicine: OAEM, 6, p.45.