Analyzing the Issue of Medication Error, Essay Example

Pharmacotherapy is a fundamental resource in offering care to patients within the health system background. However, it can cause a significant risk to a patient, including mortality, if not correctly administered. Medication signifies any preventable incidence that may cause improper use of drugs and patient harm by the healthcare professional. Worldwide, mistakes in drug administration continue to happen regularly, representing one of the primary sources of mortality and morbidity in the hospital setting. Generally, errors in drug administration happen during ordering, recording, and dispensing. Medication errors comprise patient safety, which is regarded as a crucial determinant of healthcare quality. Therefore, ensuring that nurses administer correct medication is vital towards achieving the best feasible outcome in the patient’s care.

Elements of the Problem/ Issue

The process of providing medications to patients in a healthcare setting should be accorded more attention to minimize the possibility of causing redundant harm. The errors in drug administration are the most common form of medical error occurring in most hospitals across the globe. In the US alone, between 7000 and 9000 individuals lose their lives due to medication errors (Tariq, Vashisht & Scherbak, 2020). The error occurs when the clinician prescribes and administers a wrong drug at any point in the treatment process. Medication mistakes result in undesirable outcomes on patients, including an extended period of hospitalization, high cost of care, and, at worst, loss of lives.

The primary source of medication mistakes is a distraction, with approximately 75% of the errors associated with this cause (Tariq et al., 2020). Medical practitioners have many roles in the hospital, which can cause a lapse of judgment when writing drug prescriptions. In addition, unscheduled incidents such as answering telephone calls, attending meetings, communicating with the patient’s family, and speaking to the insurance representatives can disrupt the patient’s care. However, most clinicians do not recognize that these interruptions are a challenge and can cause drug errors. Another cause of medication error is the lack of pharmacological knowledge. According to Salar, Kiani, and Rezaee (2020), inadequate knowledge of pharmacological information, poor clinical performance, and not adhering to the drug administration process can lead to wrong medication. Thus, healthcare practitioners require recognizing factors leading to medical errors to establish solutions and thus improve the patient’s outcome.

A significant number of medication errors occur due to an increased workload by the healthcare providers.  Research by Gorgich et al. (2015) revealed that fatigue due to a high workload is among the leading causes of medication inaccuracies. Most healthcare institutions have a low number of qualified practitioners to offer care to patients, which can be overwhelming. Long working hours by the nurses engenders emotional stress, which regularly prevents them from making correct prescriptions. Distortions and illegible writing can also be a source of medication error. According to Tariq, Vashisht, and Scherbak (2020), this form of distortion can generate serious errors because nurses and pharmacists should not take the role of drug prescription.  A more significant part of distortion results from poor writing, misconstrued symbols, and incorrect translation. Usually, when providers have reservations concerning the drug, they regularly request the nurse to substitute the drug for a related medication.

Analysis

Nurses are immediate providers of care and thus have a crucial role in supporting patient’s safety. The crucial role that they play during drug administration cannot be overemphasized, given that it is a fundamental aspect of their daily practice. As a nurse, it is essential to be aware of the issues leading to medication errors to support safer practices in healthcare settings for a positive outcome (Escrivá, Serrano &Garrido, 2019). Nurses require being more knowledgeable about the drugs they use to curb the increasing number of medication mistakes.  Accordingly, this can lead to improved patient safety, which is the primary determinant of quality healthcare.

Young children under the age of 3 are one of the populations at risk of medication error. Bravo, Cochran, and Barrett (2016) note that medication errors are the most frequent adverse incidents that children in inpatient care experience. Usually, most drugs do not include pediatric instructions and dosage guidelines requiring the providers to use weight-based dosage, which engenders more prospects for medication error. According to Escrivá, Serrano, and Garrido (2019) Scihub, patients in the intensive care unit are particularly at risk of drug administration errors. Critically sick individuals admitted in the ICU constitutes the most significant number of patients experiencing potentially life-threatening mistake during their stay in the hospital. Patients in ICU are more susceptible to medication error due to their critical condition, broad and complex medications that clinicians use to manage their condition. Increased care burdens and regular changing of the caregivers exacerbated by the urgent nature of practice carried out in these units increase the chances for medication errors. Lack of adequate training and experience by nurses working with patients in ICU creates risks for medication error.

Proposed Solution

Considering the main aspects leading to mistakes in medication administration enables nurses and the entire healthcare system to eradicate such incidences. Nursing supervisors require developing an enabling atmosphere that allows cases of drug inaccuracies to be reported to instigate actions to prevent their occurrences in the future rather than punishing healthcare providers involved in such errors (Ayorinde &Alabi, 2019). The approach will advance and promote a safe environment for patients in the hospital. A crucial emphasis was made on increased workload and lack of adequate knowledge of the use of drugs that providers use when providing care. In this case, the administration requires to deal with the understaffing by recruiting more nurses and reinforce the education of care providers through in-service training initiatives on safe drug administration.

Besides recruiting more qualified nurses, the management needs to establish in-service training to educate care providers regarding vital aspects of pharmacology. The training would facilitate nurses to execute an appropriate protocol for drug administration by ensuring they are dealing with the right patient, medication, dosage, route, and time. In addition, the training will involve educating nurses concerning the correct recording of drugs. Nurse leaders should caution care providers against documenting the dosage before the drug is administered to ensure that patients received the medication when it was recorded (Ayorinde &Alabi, 2019). Through the in-service training, nurses should also be educated regarding electronic health records (EHR) to minimize incidences of medication errors. The use of EHR is valuable in detecting possible medication interactions and adverse reactions. The EHR technology database assists care providers to research the adverse impacts and contraindication of any medication quickly. Such technologies offer guidelines on the approved dosage and administration of all medications, thus preventing medication mistakes.

Medical institutions should implement incorporated, collaborative, and inter-professional in-service training to educate caregivers on drug pharmacology and safe drug administration. Such a system would instill nurses with the required knowledge of the causes of drug errors and how to deal with such incidences when they occur to avoid loss of lives. The process will also involve establishing retraining programs on pharmacology based on the caregivers’ needs and periodical evaluation of their knowledge of drug administration (Salar, Kiani & Rezaee, 2020). In addition, care providers should advance their pharmacologic knowledge and be up-to-date with the new medications by maintaining ongoing drug competency. Such continuing training updates clinicians regarding the safe administration of new medications, including indications, dosage, mode of action, possible adverse effects, and contraindications. Thus, the training efforts will make nurses more competent in drug administration, thereby reducing medication errors.

Ethical Implication

If safe drug administration practice is to be implemented in the hospital, it would be necessary to adhere to ethical principles to attain a successful result. In the medical context, the principles of autonomy, justice, nonmaleficence, and beneficence guide the practices of caregivers. Justice signifies dealing with all patients without discrimination, while autonomy refers to respecting patient’s decisions. Non-maleficence indicates no harm, while beneficence is working for the patient’s best interest (Kadivar et al., 2017). Nurses should respect the independence and autonomy of the patients when administering medications. The workers have to enlighten the patient regarding the ongoing care plan and when a medication error occurs. The principles of beneficence and nonmaleficence may engender moral inconsistency for clinicians regarding balancing expected benefits with potential risks for patients (Kadivar et al., 2017). Healthcare givers should take crucial steps to minimize the occurrence of drug mistakes. However, when the error occurs, they should report it to patients to obtain an intervention to offset possible harm.

Conclusion

Nurses are the frontline professionals who spend much of their time administering drugs. An occurrence of medication error can lead to an increased length of hospital stay, morbidity, or even death. Factors such as fatigue due to increased workload, distraction, and lack of sufficient training on drug administration are some of the causes contributing to medication errors. For caregivers, making a drug mistake is a psychologically traumatic incident that compromises their self-esteem and assurance to function in the medical setting. Increasing the staffing ratio and implanting in-service training to enlighten nurses on pharmacology and drug administration can reduce medical errors. However, this requires integrated and collaborative working by all professions involved in offering care to the patients.

References

Ayorinde, M.O., &Alabi, PI (2019). Perception and contributing factors to medication  Administration errors among nurses in Nigeria. International Journal of Africa Nursing Sciences, 11, 100153. doi:10.1016/j.ijans.2019.100153 Retrieved from https://www.sciencedirect.com/science/article/pii/S2214139118301604/pdfft?isDTMRedir=true download=true

Bravo, K., Cochran, G., & Barrett, R. (2016). Nursing strategies to increase medication safety in inpatient settings. Journal of nursing care quality, 31(4), 335-341.Retrieved fromhttps://nursing.ceconnection.com/ovidfiles/00001786-201610000-00006.pdf

Escrivá Gracia, J., Serrano, R.B., & Garrido, J.F. (2019). Medication Errors and Drug Knowledge Gaps among Critical-Care Nurses: a Mixed Multi-Method Study. BMC- Medical Health Research Journal. https://doi.org/10.1186/s12913-019-4481-7

Gorgich, E.A., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2015). Investigating the Causes Of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint. Global Journal of Health Science, 8(8), 220. doi:10.5539/gjhs.v8n8p220 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016359/pdf/GJHS-8-220.pdf

Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., &Zarvani, A. (2017). Ethical and legal aspects of patient’s safety: a clinical case report. Journal of medical ethics and the history of medicine, 10.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150915/

Salar, A., Kiani, F., &Rezaee, N. (2020). Preventing medication errors in hospitals: A Qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. doi:10.1016/j.ijans.2020.100235 Retrieved from https://www.sciencedirect.com/science/article/pii/S2214139120301128/pdfft?isDTMRedir=true&download=true

Tariq, R. A., Vashisht, R., & Scherbak, Y. (2020). Medication errors. StatPearls [Internet].Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519065/