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Assessment 1: Enhancing Quality and Safety
Desiree Johanne
Department of Nursing, Capella University
NURS-FPX4020 Improving Quality Care Patient Safety
Dr. Germika Brandon
February 26, 2023
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Assessment 1: Enhancing Quality and Safety
One of the main duties from any health professional, is to maintain their patients safe,
that is, free from harm. However, data from institutions such as the World Health Organization
(2019) shows that, in the last decade, nearly twenty percent of disability or death related injures
had to do with medication-related errors. The purpose of this paper is examining a safety quality
issue such as medication administration in healthcare settings, as well as some plausible
evidence-based and best-practice solutions that could address this problem. This paper will also
examine the nurses’ role and other stakeholders as part of the possible solution.
The impact of medication-related errors involves the adverse effects these can have on
patients (Khalil & Huang, 2020). However, it is also important to consider, that nursing staff
members are, most of the times, the people in charge of administering medications to patients,
therefore, they are able to prevent these adverse events (Khalil & Lee, 2018). Literature and
evidence-based practice offers a series of preventive methods of medication errors that can help
nurses and other healthcare professionals to maintain their patients’ safety (Alteren et al., 2018).
What are Medication Errors?
When patients suffer harm from incidents (that can be preventable) derived of
medications inappropriately used or controlled by professionals, these fall into the category of
medication errors (Aseeri et al., 2020). Chapuis et al. (2019) list different sources of origin of
these types of events, for instance professional practice (i. e. inadequate prescription) products
(wrong label or packaging), system (denomination, dispensing devises, distribution mechanisms)
and utilization. Some factors that cause these types of errors in commonly used medications with
similar name or packaging, which can lead to confusion from either the patient or the provider,
when acquiring, prescribing, administering or taking the medication (Escrivá García et al., 2019).
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Another factor involves rare or unusually prescribed medications, meaning the type of
medications that are uncommon in certain specific treatments or that lack of scientific validation
for those specific purposes but that can potentially help improving the patients’ condition, based
in criteria that it is either not reliable or that has not been tested enough to have empiric evidence
(Curie, 2018). Other factors are related with higher doses than those established for therapeutic
purpose of certain medications, leading to allergic reactions or intoxication (Currie, 2018).
Nurses’ Involvement Preventing Medication Errors and Improving Patient Safety
According to available literature, evidence-based practice (EBP) is an important resource
healthcare professionals can use to prevent medication errors (ME), either by using prevention
strategies or using adequate practices for medication administration (MA) so that the number of
adverse events is lower (Wolf & Hughes.,2 019). In addition, there are certain practices health
professionals can use to minimize the occurrence of medication errors, for instance: thoroughly
selecting the medications, their administration and monitoring the way this affect the patient’s
body functions, in order to make adjustments on the dosage, in case it is necessary.
Currie (2018) also notes that it is important to consider how different prescriptions and
administration routes and the physiological factors of each patient that make their mechanism of
action varies from one case to the other. This means that healthcare professionals must identify
and understand what are the conditions of the patient that might change (i. e. reduce or increase)
the action certain medication have on his/her body. The most common example, is to verify how
toxic a drug can be or what other adverse effects can have on the patients’ health. Chapuis et al.
(2019) use the example of overdoses to show how the cumulative effect medications have in a
human body. Therefore, it is important to establish what are the tolerable levels for its use (i. e.
achieving plasma levels or circulating in the human body before its excretion).
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Using evidence-based practice to determine a range of toxicity levels derived from
medication administration in a patient’s body, can orient nurses in determining the adequate
dosage patients need for treatment (Alteren et al., 2018). Considering that any medication can be
potentially toxic (depending of its levels of presence in the human body), knowing the side
effects of each medication, as well as signs and symptoms associated with intoxication, can help
nurses in being alert and anticipate potential cases in their facility (Chanielere et al., 2018).
How Can Stakeholders Participate?
Patients’ safety is a goal that not involves healthcare professionals. A stakeholder is
someone that is directly or indirectly affected by how positive (or negative) the outcomes of the
organization; they can also participate in many activities, either because they are administrators,
providers, suppliers or executives (Perdini & Ferri, 2019). This means that, stakeholders must
also strive for the patients’ safety improvement. Ways to do so include offering new ideas or
finding relevant information that the healthcare staff could use to mitigate the problem. Currie
(2018) notes that other ways stakeholders can address the issue of medication errors involves the
development of policies and compliance programs for that purpose. The latter includes safety
strategies, collecting data to improve the facility’s conditions, monitoring the staff members and
offering legal advice on the consequences of malpractice (Currie, 2018).
In order to have positive outcomes, stakeholders can rely in evidence-based practice
contained in literature, to improve the patient’s safety in the facility. Chaneliere et al. (2018)
state that there are multiple sources containing effective methods that detect practices and system
failures that contribute to the occurrence of medication errors. Other authors point out the
importance of analyzing the human factors in these events, leading to adopt control mechanisms
such as security rounds, monitoring as well as other preventive practices (Khalil & Lee, 2018).
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Another key resource stakeholders can use is technology. According to Wolf and Hughes
(2019) there are different ways technology can help in minimizing medication errors in a
healthcare facility. Some examples include surveillance devices, alert systems as well as other
tools that can help preventing medication errors, for instance, decision support systems (Wolf &
Hughes, 2019). The authors also recommend stakeholders invest in having a better integration of
their healthcare’ systematization by using electronic medical records that are constantly updated,
so that health professionals have access to accurate information online (Wolf & Hughes).
From a nurse’s perspective, administering medications to patients is one of the most
common activities in their routines, which is why it is important to improve their skills in this
practice, as well as acquiring new knowledge that gives them a better discernment of
medications and adequate administration of (Nkurunziza et al., 2019). In addition, emphasizing
on patient-centered care as part of their competencies can make nurses more competent when
taking care of them, particularly focusing on their safety when receiving medications.
Conclusion
Medication errors are, sadly, a recurring event in healthcare facilities, however, there are
plenty of resources that healthcare professionals, particularly nurses, can use to prevent this
phenomenon from happening. Evidence based care and practices is an important resource in
which nurses can learn how to administer medications appropriately, reducing the risk of errors
as much as possible. Likewise, there are technologies and practice guidelines that help health
professionals when administering medications, particularly to identify potential sources of risks
in this area. Finally, stakeholders must actively participate, not only in preserving the patients’
safety, but also in the provision of healthcare services that meet the standards of quality, that
includes the adoption of safety practices that prevent medication errors from happening.
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References
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