Medication Errors: What Is Their Impact? Essay Example

Medication errors and the associated adverse drug events (ADEs) are among the most common causes of injury or death in clinical settings, yet by their very nature are also avoidable. Medication errors arise for a variety of reasons, which can vary according to the specific clinical setting. Addressing the problem of medication errors and finding solutions to the problem has been an area of significant concern to researchers and practitioners in recent years, especially in light of new and adapting technologies that can be used to help facilitate, streamline, and serve as a check for the processes involved with the administration of medications. As evidence-based practices are applied to virtually every aspect of the health care system, it is becoming increasingly incumbent upon those who prescribe, handle, and administer medications to adopt and adhere to a practice of care intended to avoid medication errors and ADEs. This has significant implications for nurses, who often (or even typically) function at the nexus between those who prescribe and provide medications and those to whom medications are administered. As nurses are most often those tasked with administering medications in the clinical setting, they serve as the last line of defense protecting patients against error and adverse events.

Literature Review

Extant literature on medication errors and how such errors can be avoided dates back to the earliest days of the contemporary health care system, but a number of specific factors have contributed to draw greater attention to the issue of medication errors in the clinical setting. First among these is the evolution of the complex and intertwined set of organizations and individuals who function within the larger health care system, and the increasing risk for error such growth and complexity engenders. The next is the advent of information technology (IT) and the increasing use of electronic medical records (EMRs) and other computerized systems to store, transfer, and utilize information; the rapid and widespread adoption of such technology has made it necessary for nurses (and virtually everyone in the clinical setting) to learn how to properly use such technology in their day-to-day functions (Wittich et al, 2014). A third significant factor is that medication errors and their associated ADEs can often be traced to nurses, and with this in mind, much of the contemporary literature on medication errors focuses on the various causes and reasons why nurses may administer medications in error.

An examination of the extant literature on the issue also reveals that nurses are responsible for preventing nearly half of all medication errors by noticing potential problems and intervening before medications can be administered (Davoud et al, 2014). With this in mind, it is clear that nurses serve at a critical junction in the medication-delivery system, and practices aimed at preventing medication errors and ADEs must focus on the ways that such problems can be avoided.

Medication Errors: Contributing Factors

There are a number of factors that contribute to medication error, and these factors can generally be ascribed to several key players in the larger organizational system of health care. The administration of medications is the last event in a chain of events that typically begins with prescribers (i.e. physicians), and the most common errors at this stage include the prescribing of the wrong medications (Bates & Slight, 2014). The next stage involved in the administration of medications occurs with pharmacists who fill prescriptions, and mistakes can be made here when pharmacists misread prescriptions or fill prescriptions with the wrong medications (Bates & Slight). The third stage involves those who administer medications, and mistakes made at this stage include the selection of the wrong medications or the improper administration of those medications (Bates & Slight). This is, of course, a very cursory overview, and there are a number of other ways that medication errors can be made; for the purposes of much of the literature on nurse and medication errors, however, it is these areas that receive much of the attention.

Preventing Medication Errors

A recent study by Chircu et al (2013) on the issue of medication errors used a business process management (BPM) and accounting control theory (ACT) approach to analyzing medication errors, and found that many such errors occurred at the point of handoff; i.e.at the various steps in the process where one actor (such as a prescriber) “handed off” information to the next actor (such as a pharmacist.) Research of this nature has focused on the issue of information quality (IQ) and ways that the transmission of accurate information at the point of handoff can be assured. Across the spectrum of literature and research on medication errors, a consensus appears to have formed that computer-based technology and organizational standardization are among the most effective means of preventing medication errors (Zeng et al, 2013; Merry & Anderson, 2011). Computer-based automated systems can be used to help ensure proper labeling, storage, and administration of medications, while system-wide standardization can help ensure that all actors within the system are working in coordination.

One of the issues related to medication error that has made it difficult to understand and avoid is that of self-reporting. According to the research, nurses are often hesitant to report medication errors for fear of reprisal, and cite an organizational culture that transfers blame instead of addressing solutions (Mostafaei et al, 2014). A significant number of studies, such as that conducted by Redley and Botti (2013) have demonstrated that electronic medication management systems are an effective means by which medication errors can be reduced or avoided.

References

Bates, D., & Slight, S. (2014). Medication Errors: What Is Their Impact?. Mayo Clinic Proceedings, 89(8), 1027-1029. doi:10.1016/j.mayocp.2014.06.014

Chircu, A., Gogan, J., Boss, S., & Baxter, R. (2013). Medication errors, handoff processes and information quality. Business Process Mgmt Journal, 19(2), 201-216. doi:10.1108/14637151311308286

Merry, A., & Anderson, B. (2011). Medication errors – new approaches to prevention. Pediatric Anesthesia,21(7), 743-753. doi:10.1111/j.1460-9592.2011.03589.x

Mostafaei, D., BaratiMarnani, A., MosaviEsfahani, H., Estebsari, F., Shahzaidi, S., Jamshidi, E., &Aghamiri, S. (2014). Medication Errors of Nurses and Factors in Refusal to Report Medication Errors Among Nurses in a Teaching Medical Center of Iran in 2012. Iran Red Crescent Med J, 16(10). doi:10.5812/ircmj.16600

Redley, B., & Botti, M. (2012). Reported medication errors after introducing an electronic medication management system. J Clin Nurs, 22(3-4), 579-589. doi:10.1111/j.1365-2702.2012.04326.x

Tzeng, H. (2014). Medication error-related issues in nursing practice. Medsurg Nursing, 22(1).

Wittich, C., Burkle, C., & Lanier, W. (2014). Medication Errors: An Overview for Clinicians. Mayo Clinic Proceedings, 89(8), 1116-1125. doi:10.1016/j.mayocp.2014.05.007