Strategies to Reduce Medication Administration Errors in Healthcare

This report addresses the critical issue of medication administration errors within the nursing profession. It begins by highlighting the significant role of nurses in medication administration and the potential for errors to lead to adverse patient outcomes. The report focuses on the challenges faced by new graduate nurses, including their lack of experience and self-management skills, which can contribute to errors. It then explores the use of the PICO framework to formulate a research question about interventions to improve medication administration outcomes. The literature review synthesizes findings from several studies, emphasizing the effectiveness of electronic systems, checklists, and supervision in reducing medication errors. The discussion section synthesizes the findings, and the conclusion reiterates the importance of electronic reminders, feedback, documentation, and senior supervision in preventing medication administration errors. The report underscores the need for comprehensive strategies to enhance patient safety in clinical settings.

Running head: MEDICAL LITERATURE
MEDICAL LITERATURE
Name of Student
Name of University
Author note

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MEDICAL LITERATURE
INTRODUCTION
Medication administration error is a critical process that leads to the development of
more severe clinical complications that affect the lives and prognosis of the patient at a very
severe rate 1. Nursing discipline play a huge role in the process of medication administration
and it is actually highly important that the nurses are trained and supervised properly in order
to perform the medication administration process in a very crucial and critical manner. It is
highly important to understand the new graduate nurses play a huge role in the development
of these psychosocial and clinical problems related to medication administration errors2. The
problem lies with the professional and self-management skills of the new graduate nurses
who lack the required mindset, personal skills and the clinical experience that affects the
perception of the new graduate nurses in formation of negative attitudes about the medication
administration process and the procedure. In the high paced acute care and in the critical care
department – where the patient has to be given various medications at a or rather a timely
basis complicates the procedures and processes related to the technique of medications (and
in addition to the given requirement of route of administration which might be different for
different drug) also play a very critical role in the development of adverse drug reactions
event resulting from medication administration error 3. Adverse drug event are severe drug
related clinical outcomes of the patient resulted due to the administration of the wrong or
incorrect drug at the wrong time which has resulted in a clinical accident situation, causing
the patient to go through an anaphylaxis or hypersensitivity or drug allergies that can prove
fatal and deadly for the patient of any age and gender. It has been seen that the workplace
where the nurses work in a clinical scenario, are the sources of stress and anxiety and it is the
very lack of psychological safety that affect the lives and the quality of practice by the nurses,
especially by the new graduate nurses as compared to the old and the experienced nurses who

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knows how to work under the immense clinical pressure of patient servicing. In the medical
literature, the causes of adverse drug reactions or adverse drug events has been attributed to
the lack of positive perception of the new graduate nurses, lack of the right attitude of the
new graduate nurses, lack of supervision by the senior nurses and lack of communication and
knowledge of the new, inexperienced nurses that has resulted in the development and
presentation of situations where the nurse has committed a medication administration error
and it is to be noted very closely and considered very well that an adverse drug event
resulting from the medication administration error can prove fatal for the subject as well.
However, the there is a gap in the understanding that how and what factors actually impact
the wrong decision making of the nurses with the medication admiration process and what
measures can be taken to correct the nursing error.
Using the PICO format, the research question can be formulated as:-
Population Intervention Comparison Outcome
Young graduate
nurses
Audits,
documentation and
electronic guiding
tools
Supervision by senior
nurses
more clarity with the
medication
administration
process in each
medical cases
Does the use and incorporation of audits and electronic reminders in the clinical supervision
process improve the outcomes of the nursing involved with medication administration error?

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MEDICAL LITERATURE
LITERATURE REVIEW
A search across the electronic databases such as PubMed, Cinahal, Embase was
performed in order to find the articles that are analyzed with respect to the problem of the
research.
Inclusion criteria:
a) Articles published in the peer reviewed journals will be chosen
b) Articles that are in English language.
c) articles not more than 5 years old
Exclusion criteria:
a) Articles not published in the peer reviewed journals will be chosen
b) Articles that are not in English language.
c) Articles more than 5 years old
Article name Author name Year of
publication
Methodology Findings
4 "Intravenous
smart pump drug
library
compliance: a
descriptive study
of 44 hospitals."
Giuliano, Karen
K., Wan-Ting Su,
Daniel D.
Degnan, Kristy
Fitzgerald,
Richard J. Zink,
and Poching
DeLaurentis
2018 Descriptive
Study
According to
the study, the
use of drug
library is a
bioinformatics
based system
that is critical
to the

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knowledge and
access of the
nurses which
would prevent
them from the
committing of
the drug
administration
errors and it is
highly
important that
the intravenous
pumps that are
used in
medication
delivery are
used in
synchronization
with the
bioinformatics
based drug
library to
prevent the
medication
administration

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errors related
adverse drug
event. Training
and education
of nurses with
the use of drug
library is
critical.
5. "Nurse
compliance with
a protocol for
safe injectable
medication
administration:
comparison of
two multicentre
observational
studies."
Schutijser,
Bernadette,
Joanna Ewa
Klopotowska,
Irene Jongerden,
Peter
Spreeuwenberg,
Cordula Wagner,
and Martine de
Bruijne.
2018 prospective
observational
study
with Multilevel
logistic
regression
analyses
This research
identifies a
second check
by a supervisor
nurses whether
the nurse is
using the right
electronically
guided
procedures and
reminders to
better his or her
skills with the
entire process
of drug or
medication
administration

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and also with
hand hygiene.
The researchers
of this study
recommend the
use of the
electronic and
digital systems
along with
human
supervision
process in order
to better the
nursing
outcomes in a
an effective
manner.
6. "Increasing
compliance of
safe medication
administration in
pediatric
anesthesia by use
of a standardized
checklist."
Kanjia, Megha
Karkera, Adam
C. Adler, David
Buck, and Anna
M. Varughese.
2019 Failure mode
effects analysis.
Statistical and
control chart
methods were
used.
The researchers
of this study
emphasizes on
the severe and
the most
harmful effects
on the
outcomes of the

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pediatric
patients under
the effect of
anesthesia and
being
administered
with the wrong
medications by
the nurse. The
use of paper
checklist and
the use of the
right
documentation
procedure is
critical to the
correct
medication
administration
in a clinical
scenario and it
is highly
important that
the same
standardized

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checklist is
used by all the
nurses in the
hospital in
order to comply
with guidelines
of the same
best evidence
based practice.
7. "Electronic
Audit and
Feedback With
Positive Rewards
Improve
Anesthesia
Provider
Compliance
With a Barcode-
Based Drug
Safety System."
Bowdle, T.
Andrew, Srdjan
Jelacic, Bala Nair,
Frank Zucker,
Logan S. Bussey,
Kei Togashi, Jen-
Ting Yang, and
John Lang.
2019 Anesthesia
Information
Management
System and
Smart Anesthesia
Manager
software
Was used to
quantify drug
administration by
syringe without
and with bar
code scanning.
It is highly
important to
understand that
the nurses and
the registered
nurse
anesthetist play
a huge role in
the drug
delivery
process to the
patients who
are
anesthetized.
According to
the researchers

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of the study, a
reward based
appraisal
system and gift
packages for
the top
performing
nurses are the
critical areas of
motivation for
the correct drug
administration
practices.
Electronic
audits, in
addition to a
feedback
intervention are
critical to the
process of best
compliance by
the nurses.
8. "A Multi-
hospital Before–
After
Schnock, Kumiko
O., Patricia C.
Dykes, Jennifer
2018 A before–after
observational
study with a
The researchers
of the study
uses a point

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MEDICAL LITERATURE
Observational
Study Using a
Point-Prevalence
Approach with
an Infusion
Safety
Intervention
Bundle to
Reduce
Intravenous
Medication
Administration
Errors."
Albert, Deborah
Ariosto, Caitlin
Cameron, Diane
L. Carroll,
Moreen Donahue
et al.
prospective
point-prevalence
approach
prevalence
method in the
understanding
of how safety
bundle helps in
prevention of
medication
administration
errors and finds
out positive
outcomes in the
high paced
nursing and
medical clinical
scenario.
DISCUSSION
It is to be noted that the various aspects of the medication administration errors are
attributed to lack of guidance or support system being given to the new nurses in a high
functioning clinical or rather a medical care scenario. It is to be analyzed and understood that
the health information systems in addition to the electronic medical records play a huge role
in the development of best and evidence based practices in the nurses working in the acute
care departments and the studies that are used for systematic review in this has identified the
use and application of the electronic technologies in order to guide and aid the nurse with
medication administration procedures in relation to multiple medications. The studies that has

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been used to explore the best compliance methods of nurses to check the medication
administration errors identifies the supervision by a second nurse, by a senior nurse and by
the nursing managers in the same department in order to comply with best practice guidelines
in an effective manner. Compassionate and professional support from the senior in addition to
the peer support has been highlighted by all these research articles to be an important and
effective method of reducing the medication administration errors. Electronic audits and
electronics mediated feedback taking are identified as the crucial tools in the correction of the
medication administration errors. This is highly important that the documentation procedures
and the paper audits as well as the standardized paper documentation procedures play a huge
role in the prevention and management of the medication administration errors in a clinical
scenario.
Conclusion
Hence it can be concluded saying that although the clinical problem lies with the self-
management skills and lack of professional practical skills in the new graduate nurses who
lack the required mindset, intrapersonal skills along with clinical experience and
interpersonal skills that affects the perception of the new graduate nurses, leading to
medication administration errors. Electronic reminders, feedbacks, documentation and the use
of safety bundles in addition to senior supervision can be the useful tools in the prevention of
medication administration errors in a clinical scenario.