Reflective Journal: Medication Error, Consequences, and Prevention

This reflective journal entry details a nursing student's experience with a medication error during their first medical/surgical clinical experience. The journal explores the factors contributing to the error, including lack of experience, distractions, and fatigue. It delves into the student's feelings during the situation, emphasizing guilt and a decline in self-esteem. The entry outlines the nurse's roles and responsibilities during medication administration, highlighting the importance of competence, safety, and adherence to the five rights of medication administration. The physical and psychological consequences of medication errors for patients are discussed, including potential for physical harm and emotional distress. The student identifies their communication skills as a strength in preventing future errors, emphasizing effective communication with the inter-professional team and patients. The journal references relevant literature to support the analysis and recommendations.

Running head: REFLECTION
Reflection
Name of the student:
Name of the University:
Author’s note

1REFLECTION
Factors contributing to medication error:
During my first medical/surgical experience, I made a medication error. I was assigned
the duty to take care of a 54 year old patient post surgery and he had received opioids via
epidural catheter. Upon return to the ward, the patient was found to have a very low respiratory
rate. According to physician’s order, I had to give IV dose of Narcan to maintain vital signs of
patient. After I had injected medication in the port in a hurry, I realized that I had injected entire
1 ml vial whereas as the desired label was 1 mg per ml. In horror, the immediate action that I
took was to immediately inform this to the senior nurse and the physician. Hence, in my case, the
factors that contributed to the medication error included lack of education and experience in
medication administration and environmental factors like distractions, rush and fatigue during
medication preparation for patient. Dumo (2012) gives the evidence that amount of nursing
education and years of experience are factors that are directly linked to medication errors.
Feelings during the situation:
When engaged in any incidence of medication errors, I would feel very terrified because
medication errors might increase health risk for patient. It may put them to unnecessary trauma
and even lead to death of patient. Hence, I would have developed feeling of guilt and low mood
because of this mistake during nursing practice. I will also have low confidence and feelings of
poor self-esteem by being involved in medication error.
Role and responsibility during medication administration
Medication errors mostly occur during the time medication preparation or during
administration of medication. The key responsibility and responsibility of a nurse during
medication administration include maintaining competence and safety during medication

2REFLECTION
administration related task (College of Nurses of Ontario, 2019). To demonstrate competence
during medication administration, it will be necessary to ensure appropriateness of medication
practice by proper assessment of client and considering the medication and the environment.
Another responsibility is to ensure that nurse do not engage in any practice which is outside their
limit or scope of practice. In addition, to promote safety culture during medication administration
practice, the key responsibilities for nurse includes fulfilling the five rights of medication
administration including right patient, right drug, right dose, right time and right route (Cloete,
2015). Efficiently completing these five steps is likely to ensure that right patient is receiving the
drug and ensure that nurse have right understanding regarding the rationale for the drug. Other
the role and responsibility in relation to drug safety includes collaborating with patient, reducing
harm to patient from dosage error or misuse of medication and ensuring proper storage, dosage
and disposal of drug (College of Nurses of Ontario, 2019).
Physical consequences of a medication error for the patient:
The occurrence of a medication error is associated with many adverse physical
consequences for the patient. It can lead to severe physical injury for patients such as changes in
vital signs, increase in clinical deterioration of symptoms, physical pain and deteriorating health
status. Because of this effect of medication error on health status, the patients are likely to be
involved in longer hospital stay (Choi et al., 2016). A study by Van Cott (2018) gives the
evidence that patient may also sustain ambulatory dysfunction, acute abnormalities and even
death due to medication errors. Hence, it can be concluded medication error had direct influence
on patient and it is associated with patient harm and adverse physical health consequences for
patient.

3REFLECTION
Psychological consequences of a medication error:
Medication error has disastrous impact on patient because due to clinical deterioration
and changes in health status, they suffer from intense distress and poor emotional state. Negative
events due to medication also leaves them traumatized. Patients have reported about negative
emotions due to atypical presentation and procedural complications occurring during medication
error (Bari, Khan & Rathore, 2016). Hence, emotional distress is high for patients affected by
medication error due to adverse signs and symptoms and increase in cost associated with care.
The event of a medication error can increase psychological trauma for the nurses as well as the
patient. The nurse involved in a medication error might feel terrified and very upset by this
mistake. They can also experience a lack of confidence in their clinical expertise. Due to strong
emotional response, they may also develop the thought of leaving the practice (Chan et al.,
2017). Hence, feelings of low self-esteem and poor mood may dominate when nurses engage in a
medication error.
Current strengths in respect to preventing medication errors:
Based on review of roles and responsibilities during medication practice and factors
contributing to medication errors, I believe that my communication skill is my strength which
will help me to prevent medication errors even if I do not have adequate experience in
medication administration. This is said because much medication error related events also occur
because of miscommunication or poor communication between nurse, physician and the
pharmacist (Peddie et al., 2016). Hence, my communication skill will ensure effective
documentation of the process and engaging in timely communication with inter-professional
team members in case of any confusion or receiving a medication order that is inappropriate. I

4REFLECTION
would be able to consult with the prescriber to understand the right course of action to promote
safety of patient during medication practices. Shitu et al. (2018) gives the evidence that
medication errors can be prevented through effective communication process. This is beneficial
in not only improving communication with inter-professional team but also in improving
communication with patient so that patients are also aware about the rationale for using the drug.
Patients will feel motivate to adhere to medication order once they are adequately educated about
it. The significance of active communication with patient is that it will aid in engaging in
effective dialogue with the patient to detected problem associated with medicine use, drug-drug
treatment and effects of treatment. Hence, my communication skill is likely to reduce the
possibility of medication errors and promote safety for patients.

5REFLECTION
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. doi: http://dx.doi.org/10.12669/pjms.323.9701
Chan, S. T., Khong, P. C. B., & Wang, W. (2017). Psychological responses, coping and
supporting needs of healthcare professionals as second victims. International nursing
review, 64(2), 242-262. https://doi.org/10.1111/inr.12317
Choi, I., Lee, S. M., Flynn, L., Kim, C. M., Lee, S., Kim, N. K., & Suh, D. C. (2016). Incidence
and treatment costs attributable to medication errors in hospitalized patients. Research in
Social and Administrative Pharmacy, 12(3), 428-437.
https://doi.org/10.1016/j.sapharm.2015.08.006
Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing
Practice, 14(1). Retrieved from:
https://www.researchgate.net/profile/Linda_Cloete/publication/270966132_Reducing_me
dication_errors_in_nursing_practice/links/56ea225e08ae25ede8310132/Reducing-
medication-errors-in-nursing-practice.pdf
College of Nurses of Ontario (2019). Practice standard: medication. Retrieved from:
https://www.cno.org/globalassets/docs/prac/41007_medication.pdf
Dumo, A. M. B. (2012). Factors affecting medication errors among staff nurses: basis in the
formulation of medication information guide. IAMURE International Journal Of Health
Education, 1(1), 88-149. DOI: 10.7718/iamure.ijhe.v1i1.210

6REFLECTION
Peddie, D., Small, S. S., Badke, K., Wickham, M. E., Bailey, C., Chruscicki, A., ... & Hohl, C.
M. (2016). Designing an adverse drug event reporting system to prevent unintentional
reexposures to harmful drugs: study protocol for a multiple methods design. JMIR
research protocols, 5(3), e169. doi:10.2196/resprot.5967
Shitu, Z., Hassan, I., Aung, M. M. T., Kamaruzaman, T. H. T., & Musa, R. M. (2018). Avoiding
medication errors through effective communication in a healthcare
environment. Malaysian Journal of Movement, Health & Exercise, 7(1). 15-128.
http://dx.doi.org/10.15282/mohe.v7i1.202
Van Cott, H. (2018). Human errors: Their causes and reduction. In Human error in medicine (pp.
53-65). CRC Press. Retrieved from:
https://www.taylorfrancis.com/books/e/9780203751725/chapters/10.1201/978020375172
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