Medication Errors in Nursing: Roles, Practices, and Guidelines

This report delves into the critical issue of medication errors within the nursing context, using the case of Mrs. Melissa Mendez to illustrate key concepts. It explores the roles and responsibilities of registered nurses in medication management, highlighting the importance of the 'five rights' of medication administration and the need for continuous vigilance. The report identifies various nursing practices that contribute to medication errors, such as issues with drug distribution systems, deviations from established procedures, and the quality of prescriptions. It emphasizes the significance of nurses' knowledge, mathematical skills, and reporting mechanisms in preventing errors. Furthermore, the report outlines relevant medication policies and guidelines, including the Registered Nurses Standards for Practice, the National Medicines Policy, and the Medication Safety Standard. The conclusion underscores the multifaceted nature of medication errors and their impact on patients, healthcare professionals, and institutions, reinforcing the importance of understanding and addressing these issues to ensure patient safety and improve healthcare outcomes.

MEDICATION ERRORS 1
Nursing foundations for the
Australian Context
Student Details:

MEDICATION ERRORS 2
Contents
Introduction......................................................................................................................................3
Roles and duties of a registered nurse in terms of medicine error...................................................3
Registered nursing practices contributing medication errors..........................................................4
Drug distribution systems............................................................................................................4
Deviation from procedures..........................................................................................................5
Quality of prescriptions...............................................................................................................5
Knowledge and Medication errors...............................................................................................5
Mathematical skills......................................................................................................................6
Reporting medicine faults............................................................................................................6
Medication policies and guidelines.................................................................................................6
Registered Nurses Standard.........................................................................................................6
Policy and guidelines...................................................................................................................6
National medicine policy.........................................................................................................7
Medication Safety....................................................................................................................7
Medicines and prescribing: Policies and Guidelines...............................................................7
Conclusion.......................................................................................................................................9
Bibliography..................................................................................................................................10

MEDICATION ERRORS 3
Introduction
Medicine faults are recognized to “documentation issues, comprising illegible
handwriting, misunderstanding abbreviations, misplaced decimal point”. Ecological issues like
disruptions and disturbances though managing the medication are also credited to possible
mistakes. This project is based on the 72-year old women (Mrs. Melissa Mendez) who is in the
medical ward for 3 days after few syndromes related to urine frequency. This report highlights
the characters and duties of registered nurse while making a medication error, practices
contributing to medication errors and medication error policies and guidelines in Australia.
Roles and duties of a registered nurse in terms of medicine error
The procedure of transporting medicines to patients includes a total of stages
necessitating teamwork among “medical practitioners, registered nurses and pharmacists”; it is
the chief accountability of nurses to safeguard the harmless management of medicine. Nurses are
independently answerable for their personal movements and have the accountability to defend
patients from damage increasing from medicine blunders. Similar duties are also owed by
nursing students; however, there are many differences in terms of their role as well. Basically,
registered nurses have been skilled to run through the “five rights of medication administration,
namely the, right medication, right dose, right route, right time and right patient”. Although, the
privileges are normally observed as a “basic standard for safe medication practices”, nurse
creates numerous management mistakes notwithstanding partaking confirmed. Registered nurses
requisite to measure their capability to securely and efficiently carry out their parts and
accountabilities for medicine management in their medical situation (M Smeulers, 2014).
Nurses are accountable for the organization of enduring organization and as such, it is
indispensable that they have contribution into project and application of any novel medication
management scheme. Registered nurses should have the information about “dilution and diluting
agents, the quantity and expiry of diluted medication and the possibility of precipitation”.
Additionally, nurse should know the usage of procedures in medicine management which can
overwhelmed medicine information shortfalls and elevation of operative conclusion building by
the incorporation of information into repetition. While comparing with nursing students, the
number of responsibilities reduced; however, they have to follow these procedures as well to
succeed in their academic career. Nurses who are not self-assured in their exact aptitudes should
authorize any medication calculations by requesting a peer of the realm to dual check the
scheming, confirming the precise amount with the drugstore, or referring a drug manuscript to
authenticate a safe dose assortment (CA Smith-Miller, 2014).
In comparison with registered nurses, student nurses involve the information about
medicine security and high risk medicine. Student nurse’s takes part in medication management
and senior nurse who have shown capability may be allowable to act as the senior individual

MEDICATION ERRORS 4
giving medications (nursingmidwiferyboard.gov, 2015). Scholar nurses actions in relation to
medication management will be lawfully enclosed by the commissioning specialist when the
rules are trailed. Additionally, student nurses take part in order to improve knowledge in relative
to medicine to the patient’s disorder. Student nurses have to detect the usage of rules, values and
strategies for medication management during scientific assignment and to create an
understanding (Nurse Key, 2016).
Registered nursing practices contributing medication errors
In the case of Mrs. Melissa Mendez, medicine error happened in the hospice as the doctor
arranged Trimethoprim 200 mg twice a day to the enduring for UTI and the enduring is
previously on methotrexate of 20mg weekly for “rheumatoid arthritis” which is a high-risk pill
and these medications are tremendously stern and life intimidating mixture. The medication
interaction instigated hematological toxicity, which is an unadorned contamination that is why
Mrs. Melissa had depreciated and disordered after the medication interaction. But the nurse did
not understand since of nonexistence of evidence concerning medication collaboration and high
risk pill. Several perform by registered nurses which lead to medicine errors are listed below:
Drug distribution systems
Medicine error is also more likely with unsuitable dependence or physical certification or
material schemes that do not interconnect with one alternative. The procedure of getting
medicine from the drugstore can underwrite to mistakes like “late deliveries, loss of orders and
inadequate 24 hour cover can all contribute to errors”. The drug management system can
possibly control susceptible opinions at which medicine error can happen (Cloete, 2015).
Deviation from procedures
Disappointment to shadow events and the attendance of interruption has been established
to contribute to medicine mistakes. Interruptions in managing venous medications have been
originated to be produced by absence of indwelling. Medicine mistake creating circumstances
also encompassed project of skill, announcement, capability, and enduring connected issues.
Quality of prescriptions
Unproductive transcribed and spoken statement in relative to treatments underwrites to
medicine mistakes, predominantly between nurses and specialists. Nurses and doctors have a
responsibility not only to connect important vicissitudes in relative to the medicines and
management of medicines but also to attend prudently to all info. Quantity oversight is usually as
a result of failure to connect prescriber variations after medicinal and medical refers (S
Karavasiliadou, 2014).
Knowledge and Medication errors
The medicine organization procedure includes intelligent action in adding to the somatic
act of medicine groundwork or management. “Constant vigilance” is obligatory as nurses

MEDICATION ERRORS 5
involve with specialized decision and dangerous thoughtful to detect patients, connect with all
stake frames, understand pertinent statistics and smear information and skills to exact patient
consequences.
Image Source: (AM Parry, 2015)
Mathematical skills
In order to achieve precise medication intentions, elementary accurate services to
estimate scientific glitches and the capability to abstract the scientific info obtainable and
quotation the pertinent evidence in command to verbalize a Math’s scheming to be resolved.
Precise ability and skill is a precondition to the presentation of medicine scheming. Medicine
mistakes subsequent from poor control skills are a global issue (R Adhikari, 2014).
Reporting medicine faults
A quantity of barricades to nurtures and specialists broadcasting blunders has been
acknowledged. These contain terror of corrective exploit, not being capable to shot namelessly,
constrictions on time and also discerning that it was needless to report the mistakes because they
had no undesirable consequences (S Fleming, 2014).

MEDICATION ERRORS 6
Medication policies and guidelines
Since then a amount of inventiveness in enduring security have been assumed at both the
state and national levels, and numerous hospices have strengthened their labors at stopping
patient damages, predominantly those due to medicine mistakes (Nursing and Midwifery Board
of Australia, 2019).
Registered Nurses Standard
The registered nurse values for preparation contain of the resulting seven values:
1. Deliberates censoriously and examines nursing training.
2. Involves in beneficial and specialized associations.
3. Preserves the competence for preparation.
4. Lengthily behaviors impost.
5. Progresses a proposal for treatment preparation.
6. Delivers harmless, suitable and receptive quality nursing rehearsal.
7. Appraises consequences to update nursing exercise.
Policy and guidelines
The “Nursing and midwifery board of Australia” delivers leadership to nurses and
midwives by broadcasting a variety of strategies, programs and strategies.
National medicine policy (NMP)
Propelled in December 1999, NMP is well recognized permitted outline based in
companies between “Governments health educators, health practitioners, and other healthcare
providers and suppliers, the medicines industry”. The NMP goals to recover optimistic fitness
consequences for all Australians through their admission to and prudent use of medications
(Health, 2019).
The NMP has four dominant objects founded on vigorous and deferential companies, taking
into justification rudiments of social and economic strategy. The objectives are:
a. Opportune admission to the drugs that Australians requires.
b. Medications gathering suitable values of worth, security and effectiveness.
c. Eminence use of medications.
d. Upholding an accountable and feasible tablets manufacturing.
Medication Safety
The “Medication Safety Standard” necessitates health service governments to appliance
schemes that decrease the incidence of medicine events and recover the care and excellence of
medication usage. The meaning of the regular is to safeguard that capable clinicians securely
recommend, distribute and manage suitable tablets to knowledgeable patients and observe the
belongings (Safety and Quality, 2019).

MEDICATION ERRORS 7
 “Criteria involved achieving the Medication Safety Standard”
 “Governance and systems for medication safety”
 “Documentation of patient information”
 “Medication management processes”
 “Continuity of medication management”
 “Communicating with patients and carers”
Medicines and prescribing: Policies and Guidelines
Rules, directions and evidence assets formed and recognized by SA heath to endorse the safe
and eminence use of medications and increase enduring care counting (SA Health, 2019):
 Medication administration
 Recommending strategies
 Drug requirement treatment sequencers
The purpose of these policies is to:
 Safeguard a homogeneous and dependable tactic to the harmless use of from top to
bottom risk medications, counting unvarying danger assessment and achievement to
address risks, in agreement with national values.
 Provision the medical labor force in the safe organization and use of high risk
medications.
 Outline separate and wellbeing provision tasks in relative to in height danger medications
administration.
 “Assist hospitals and services meet the Australian Commission on Safety and Quality in
Health Care (ACSQHC) National Safety and Quality Health Service Standards in
particular”.
Application of strategy safeguards indication of management and supremacy around
applying, nursing and appraising an approach to securely manage high dangers of medications.

MEDICATION ERRORS 8
Conclusion
An irresistible body of works on medicine mistakes has documented the recurrent,
multilayered issues of such mistakes and their influence on “patients, health professionals, and
hospitals at large”. This report engrossed on parts and duties of registered fosters in rapports of
medicine mistakes, subsidizing issues related to medicine mistakes and policies, standards and
guidelines related to medication errors in Australia.

MEDICATION ERRORS 9
Bibliography
CA Smith-Miller, J. S.-K. (2014). An integrative review: fatigue among nurses in acute care
settings. JONA: The Journal of Nursing Administration, (44), 487-494.
Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice,
14(1).
E Metsälä, U. V. (2014). Medication errors in elderly acute care–a systematic review.
Scandinavian journal of caring sciences, 28(1), 12-28.
Health, T. D. (2019, 04 29). National Medicines Policy. Retrieved from The Department of
Health:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/National+Medicines+P
olicy-1
M Smeulers, A. O. (2014). Nurses' experiences and perspectives on medication safety practices:
an explorative qualitative study. Journal of Nursing Management, 22(3), 276-285.
M Vaismoradi, S. J. (2014). Nursing students' perspectives of the cause of medication errors.
Nurse Education Today, 34(3), 434-440.
Nurse Key. (2016, 10 6). The role of nurses in drug administration. Retrieved from Nurse Key:
https://nursekey.com/the-role-of-nurses-in-drug-administration/
Nursing and Midwifery Board of Australia. (2019). Registered nurse standards for practice.
Retrieved from Nursing and Midwifery Board of Australia;:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx
nursingmidwiferyboard.gov. (2015, 08 11). Professional Codes & Guidelines. Retrieved from
nursingmidwiferyboard.gov;: https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements.aspx
R Adhikari, J. T. (2014). A multi-disciplinary approach to medication safety and the implication
for nursing education and practice. Nurse education, 34(2), 185-190.
S Fleming, A. B. (2014). An evaluation of the drug calculation skills of registered nurses. Nurse
Education in Practice, 14(1), 55-61.
S Karavasiliadou, E. A. (2014). An inside look into the factors contributing to medication errors
in the clinical nursing practice. Health Science Journal, 8(1), 247-255.

MEDICATION ERRORS 10
SA Health. (2019, 06 24). Medicines and prescribing: Policies and guidelines. Retrieved from
SA Health;:
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
clinical+resources/clinical+topics/medicines+and+drugs/
medicines+and+prescribing+policies+and+guidelines
Safety and Quality. (2019). Standard 4: Medication Safety. Retrieved from Safety and Quality;:
https://www.safetyandquality.gov.au/sites/default/files/migrated/Standard4_Oct_2012_W
EB.pdf