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Medication Error Impact on Healthcare Quality

Introduction

Medication errors are issues that exist in everyday medical practices. The presentation makes it possible to show the impact medication errors have on the economy and the number of people at risk annually, and this phenomenon is considered a failure in practice. Several initiatives are put in place, and through them, possibly this failure will be dealt with to minimize the harm caused.

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Overview

In the United States, there are approximately 6,800 prescription medications alongside countless drugs available over-the-counter. By 2019, the Food and Drug Administration in the U.S. showed that medication errors had been recorded in over 100,000 people reporting complaints associated with suspected medication errors on an annual basis (FDA. 2019, n.p.). As of 2016, the harm attributed to medication error in the country accounted for a cost of $3.5 billion, on the lower side, with an estimated 1.5 million individuals being on the receiving end (da Silva and Krishnamurthy, 2016, 24). Errors in medication administration are typically considered failures when viewed in the medication administration rights’ perspective, which constitutes of dose, medication, right patient, route, and time (Patient Safety Network. 2021, n.p.). The rights entrenched within the nursing curriculum show an element of failure in the standardized procedure by which the safety of medication administration should be.

How Medication error impacts nurse’s needs to use high level clinical judgment

According to clinical judgment, nurses can manage appropriate medication use through interprofessional care and consultation. The medical errors cannot undermine the role of nurses in health care promotion and provision since they are mandated with advising patients on the appropriate way to use medicines (Ritcher, Garvare, & Nystrom, 2017, 344). Moreover, nurses must ensure preventions are made, and reports are taken concerning side effects and medication complications. However, with this mandate, sometimes, nurses find it challenging to adhere to the standardized practices on medication because of time insufficiency. Courtesy of data interpretation, nurses, are responsible for processing information, thinking, reflecting on an issue, and coming up with a conclusion. The process outcomes are decision-making in the clinical practice followed by diagnosis (Ritcher et al., 2017, 344). Sometimes it becomes challenging to follow through with the process because of various factors, which causes the conclusion in medication prescription as inappropriate.

Time plays a vital role in how nurses make judgments about medical practices. However, in insufficient time, the ability to analyze medical orders related to limited informational cues renders nurses prone to ignoring medical orders. Therefore, making the appropriate decisions becomes a challenge to nurses (Seidi, ALhani, & Ardalan, 2017, 6064). Clinical judgment development might be impacted by task difficulty, pressure on time, and experience. Further, because of routine or judgment-based orientations, nurses encounter another challenge that makes them incapable of making the right decisions. In the presence of factors like workload and stress, it also becomes difficult for nurses to effectively make the right decisions (Seidi, ALhani, & Ardalan, 2017, 6064). When the mentioned factors are combined, nurses find themselves having a hard time making appropriate judgments and relying on their personal experiences regardless of evidence, guidelines, and instructions.

Current Health Initiatives

To address the challenge of a medication error, FDA has ensured three initiatives are implemented. They have first given the right patient the right drug through which the government has made it a rule that biological and specific drugs have to be labeled based on their required barcodes (FDA. 2019, n.p.). To make these effective, tablets, alongside every other oral dosage, must have legible and distinct imprint codes. Oral syringes alongside every other device co-packaged with liquid oral dosage form must be appropriately measured. The package designs must safeguard the customer against any incorrect drug usage. Second, prescription and over-the-counter drug labeling should match the content within the package (FDA. 2019, n.p.). Lastly, consumers themselves have a significant role in minimizing medication errors, and therefore, they have to inquire about the drug they purchase.

Emerging Issues

Tubing misconnection, as an emerging medication error, is an issue that requires education of both support staff and clinical staff to correct the misplacements associated with dialysis, feeding tubes, and IV catheters, among others. Another emerging issue with medication errors is equipment and device errors. Health professionals work with the faith that improvements in technology will enhance efficiency in service delivery (da Silva and Krishnamurthy, 2016, 32). However, with technological advances come the common pitfalls that sometimes result in inadequacy in maintenance. Similarly, with the advances in technology comes another potential challenge to service delivery, improper infusion. Reliance on technology on inputs at times makes it difficult to give proper medication (da Silva and Krishnamurthy, 2016, 32). Misdiagnosis is often associated with almost the same medication names, an issue that emerges every time new drugs are introduced.

Common Issues

Among the common medication errors comprise of incorrect timing where within both institutional and home settings, the challenge of accuracy interferes with scheduled dosages. The absorption of some medications becomes significantly influenced when taken with or without water (Seidi, ALhani, & Ardalan, 2017, 6066). The error is linked to the wrong dosage associated with aspects like extra, under, or overdosage. Incorrect dosage takes place when different or inappropriate medication is taken. Improper patient action results from the patient inappropriately taking a particular medicine. The only remedy by which that can solve this is through patient education. For its part, wrong preparation is an error with some other preparation type that happens immediately before a final medication administration (Seidiet al., 2017, 6068). An incorrect dosage form is an error where a patient receives a record of dosage that is not prescribed, which is exemplified by an extended release rather than an immediate release.

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A different angle to illustrate common medication errors is the perspective established concerning pharmacists. Such errors are mainly mechanical or judgmental, where pharmacists cannot detect drug interactions due to critical errors (Gillani et al., 2020, 65). The mistake of wrong strength occurs when potentially, somewhere in the medication procedure, a human error attributed to the same syringes or bottles results in incorrect packaging. Wrong rate, on the other hand associated with an error where medications are offered as infusions of IV pushes. The danger with this error is that drugs may potentially result in insignificant adverse reactions. The mistake of an expired product happens when there is confusion in improper preparation storage, whose outcome is dead product use or deterioration (Gillani et al., 2020, 65). The error of incorrect duration is associated with the reception of medication for a shorter or longer time than the prescribed time frame.

Workplace Communication Issues

Establishing and maintaining effective communication in the health care setting is significant in ensuring errors associated with communication are minimized. Ineffective communication at the workplace triggers poor or misunderstanding s, which result in lack of follow-ups by either doctors or nurses (Seidiet al., 2017, 6070). While follow-ups are essential, it becomes challenging to give patients the support they need without good communication. Often this results in medication errors. Further, with poor communications at workplaces, patients cannot comprehend the process to undertake to go in and out. The outcomes of such misunderstanding might result in fewer recommendations or treatments for patients. With poor communication, staffs fast become frustrated, leading to two possible issues (Seidiet al., 2017, 6071). First, frustrations might lead to employee burnout, and second, the clinical environment is impacted.

Conclusion

The presentation has shown medication errors are a failure in the field of health care practice. The impact of the loss has not only interfered with people’s lives but also harmed the economy. To counter the effects on the economy, the government has implemented some interventions to minimize the errors’ impact. However, every individual has a role to play in ensuring the mistakes are minimized.

References

da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: a patient case and review of Pennsylvania and National data. Journal of community hospital internal medicine perspectives, 6(4), 31758. Web.

Food and Drug Administration. (2019). Working to Reduce Medication Errors. Web.

Gillani SW, Gulam SM, Thomas D, Gebreigziabher FB, Al-Salloum J, Assadi RA, Sam KG. (2020).Role and Services of Pharmacist in the Prevention of Medication Errors: A Systematic Review. Curr Drug Saf.

Patient Safety Netwrok. (2021). Medication Administration Errors. Web.

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Richter Sundberg L, Garvare R, Nystrom ME. Reaching beyond the review of research evidence: a qualitative study of decision making during the development of clinical practice guidelines for disease prevention in healthcare. BMC health services research. 2017;17(1):344.

Seidi, J., Alhani, F., & Ardalan, F. (2017). Exploring nurses’ experience about facilitating factors in medication administration based on clinical judgment of nurses: A content analysis. Electronic physician, 9(12), 6063–6071. Web.

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