Professional Nursing Practice: Reducing Medical Errors and Safe Care

This essay addresses the critical issue of medical errors within nursing practice, using a case study involving a nurse's actions that led to a patient's death. It delves into the consequences of such errors for both patients and healthcare professionals, highlighting the importance of safe nursing practices and adherence to established nursing standards. The essay explores the development of a safe nursing plan, emphasizing the need for adequate knowledge, critical thinking, and communication with supervisors. It references the Nursing and Midwifery Board of Australia's standards and the NSQHS medication safety standards. The essay includes a reflective component, analyzing the incident using the 'What? So what? Now what?' model, and concludes with recommendations for preventing future errors through education and risk management. The essay emphasizes the significance of reflective practice and adherence to nursing codes of conduct to ensure patient safety and improve the quality of care.

Running head: APPROACHES TO PROFESSIONAL NURSING PRACTICE
APPROACHES TO PROFESSIONAL NURSING PRACTICE
Name of the Student
Name of the University
Author Note

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Introduction
Medical errors is a major problem in health care sectors which hampers the safety of
patients. This essay describes about a medical errors caused by Ms. Mavis Lopes, a nurse
from St. George Hospital. Nymphea Anderson was a 97 year old women who was admitted
in the hospital with heart attack. Her chances of living was low. Ms Lopes administered a
drug without any recommendation from the physicians. This essay focuses on the safe
nursing practice to reduce medical errors. It also described about the consequences of
malpractice, along with importance of safe nursing practice and implementation of the safe
nursing plan in critical situations. The discussion is supported by different published
literature collected from Google Scholar and PubMed and nursing standards.
Background
The incident occurred in St George Hospital, where Mrs Anderson was admitted with
vomiting nausea urinary tract infection, dehydration and angina. She had a medical history of
hypertension and different heart diseases. The condition of Mrs Anderson was critical and
chances of survival was low. However, later her health condition got improved but she was
having difficulty in swallowing. In that moment, Ms Lopes injected a mixture of three
different drugs without the recommendation of the doctors. This leads to death of Mrs.
Anderson. The trail is going on in the court where Ms Lopes accepted that she did a
malfunction.
Consequences
Medical errors can affect both the health professionals and patient in different ways.
The medical errors can be broadly categories in two types which are major errors and minor
errors (Bari, Khan & Rathore, 2016). Minor errors are characterized as those errors which can

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harm the patient to some extent but also preventable (eg. Adverse drug effect). On the other
hand, major mistakes refers to those which can damage the condition of a patient severely
(Bari, Khan & Rathore, 2016). Several studies highlighted the consequences which can occur
due to medical errors. It can affect both the health professional and the patient. Moreover, it
has a negative impact on the hospital where the incident occurred. Several studies reported
that, consequences of medical errors can lead to death of the patient and it psychologically
affects the family members by hampering their psychological wellbeing (Makary, & Daniel,
2016). In case of nurses, the consequences of the medical error can also induce physiological
conditions such as self-doubt, stress, guilt and depression. In case of Ms Lopes, the court
procedure can affect her career and she can lose her job. This can also affect the quality of the
hospital (Makary, & Daniel, 2016).
Nursing plan and Safe practice
Nursing and Midwifery board of Australia (2019), describes several standard for
nursing practice, among those one of the important standard is development of a plan for
nursing practice. The first step to develop a nursing plan is to understand about the goal
(Hayes, Jackson, Davidson & Power, 2015). In this case, the goal is to reduce the chances of
the medical errors in nursing practice. Several published literatures reported different causes
of medical errors in nursing such as inadequate knowledge, stress, memory lapses,
incomplete patient information etc. (Parry, Barriball & While, 2015). Ms Lopes injected the
drug without any recommendation of a physician. It is understood that she did not have
adequate knowledge about the health condition of the patient. NSQHS medication safety
standards (2019), describes to record the medical history of the patient. Ms Lopes was most
probably unaware of the medical history of Mrs Anderson which is a vital aspect of this
medical error. Therefore, to provide a safe nursing care plan it is important to have adequate
knowledge of the situation and the nurses need to perform critical thinking and also need to

3APPROACHES TO PROFESSIONAL NURSING PRACTICE
discuss about the plan with the supervisor to understand all the perspective (Brasaite,
Kaunonen & Suominen, 2015). According to the code of conduct for nurses (2019), it is the
responsibility of the nurse to face the consequences of a decision which is made by the nurse.
Therefore, decision making is an important part of nursing (Zuriguel Perez et al., 2015).
Critical thinking and detail oriented observational skills are important for nurses to make
clinical decisions. Apart from that, risk management is also important to reduce the medical
errors. The NHQHS patient safety standards (2019) highlighted the important measures to
manage the risk related to the patients and nurses need to follow those steps to develop a
nursing plan. According to several reported studies, educational sessions regarding policies,
protocols and consequences is useful for nurses to reduce the medical errors.
Reflection
What?
This event help me to understand that medical errors are connected in healthcare
services. I feel it is important to address the problem so that it can be solved. The number of
deaths in Australia due to medical error was reported as 12000 (Cloete, 2015). I feel it is
important to take proper measure to reduce the problem.
So What?
According to me, the action of Ms Lopes was not correct. She did not maintain the
patient safety standards and nursing practice standards, which lead to the error. According to
the code of conduct for nursing (2019), it is important to take second opinion before making
any decision. In critical conditions it is important to communicate with other health
professionals to take decision rather than using medications as per the symptoms (Parry,
Barriball & While, 2015). I believe, Ms Lopes, uses the drugs only to reduce the symptoms,

4APPROACHES TO PROFESSIONAL NURSING PRACTICE
however, she was not aware of the medical history of Mrs Anderson. Therefore, the medical
error occurs.
Now what?
NSQHS standards are important for safe nursing practice where it is mentioned that
risk management is necessary to ensure the safety of a patient. I believe, Ms Lopes did not
aware of the risks related to the condition of Mrs Anderson. Several study reported that,
adequate risk management can reduce the medical errors significantly.
Conclusion
To conclude, it is visible in the case study that Ms. Lopes made a wrong decision in
case of Mrs Andersen. She did not follow the rules and regulations of nursing standards
during that time. According to the mentioned data, medical errors can be reduced by
implementing the nursing standards adequately. Therefore it is important to provide the
information regarding nursing polices to the nurses by educational sessions so that
reoccurrence of this kind of incident can be avoided.

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References
Bari, A., Khan, R. A., & Rathore, A. W. (2016). Medical errors; causes, consequences,
emotional response and resulting behavioral change. Pakistan journal of medical
sciences, 32(3), 523. 10.12669/pjms.323.9701
Brasaite, I., Kaunonen, M., & Suominen, T. (2015). Healthcare professionals' knowledge,
attitudes and skills regarding patient safety: a systematic literature review.
Scandinavian journal of caring sciences, 29(1), 30-50.
https://doi.org/10.1111/scs.12136
Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice,
14(1). doi: 10.7748/cnp.14.1.29.e1148
Code of conduct for nurses. (2019). Retrieved on: August 13 2019. Retrieved from:
https://www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=2ahUKEwi11Ze
Ay__jAhVDMo8KHUt9CAUQFjACegQIBxAC&url=http%3A%2F
%2Fwww.nursingmidwiferyboard.gov.au%2Fdocuments%2Fdefault.aspx%3Frecord
%3DW
D17%252F23850%26dbid%3DAP%26chksum%3DL8j874hp3DTlC1Sj4klHag%253D
%253D&usg=AOvVaw2_EwvXELm1PrjH5t5kPGZh
Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals:
a literature review of disruptions to nursing practice during medication administration.
Journal of clinical nursing, 24(21-22), 3063-3076. https://doi.org/10.1111/jocn.12944
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the
US. Bmj, 353, i2139. https://doi.org/10.1136/bmj.i2139

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National Safety and Quality Health Service. (2019). Retrieved on: August 13 2019. Retrieved
from: https://www.safetyandquality.gov.au/standards/nsqhs-standards
Nursing and Midwifery Board of Australia. (2019). Retrived on: August 13 2019. Retrieved
from: https://www.nursingmidwiferyboard.gov.au/
Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered
Nurse medication administration error: A narrative review. International journal of
nursing studies, 52(1), 403-420. https://doi.org/10.1016/j.ijnurstu.2014.07.003
Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing-E-Book:
Diagnosis and Management. Elsevier Health Sciences. Retrieved from:
https://books.google.co.in/books?
hl=en&lr=&id=VIglDgAAQBAJ&oi=fnd&pg=PP1&dq=risk+management+in+nursi
ng&ots=jQwdPdbuNd&sig=_RDczn5Z2LabpjF1orDCN0qfC7Q#v=onepage&q=risk
%20management%20in%20nursing&f=false
Zuriguel Perez, E., Lluch Canut, M. T., Falco Pegueroles, A., Puig Llobet, M., Moreno
Arroyo, C., & Roldan Merino, J. (2015). Critical thinking in nursing: Scoping review
of the literature. International journal of nursing practice, 21(6), 820-830.
https://doi.org/10.1111/ijn.12347

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