Medication Errors: Applying Research Skills
NHS FPX 4000 Assignment 2 Attempt 1 Applying Research Skills
Drug administration is an integral part of nursing. Medication errors can be pernicious to patients’ health. Medicines are prescribed by physicians and dispensed by pharmacists but the responsibility of correct administration rests within the scope of nurse practice. Each nurse is individually responsible for their practice. The result of medication errors varies from mild to deadly. But these errors can be widely preventable by strictly maintaining and following the five rights of drug administration- the right patient, the right drug, the right dose, the right route and the right time.
According to the National Coordinating council for medication error prevention and Analysis (NCC MERP), medication error is defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of a healthcare provider, patient, or consumer”.
As a professional registered nurse, it is my responsibility to keep my patients safe. When caring for patients at the long-term care facility, there might be shifts that you care for 18-22 patients and you are in charge of medication administration for those patients. Few months back I recalled an event when I was working as an evening shift nurse supervisor. I received a call from the floor nurse reporting an incident, a medication error. The floor nurse was preparing medication for the evening rounds but got distracted by a family member who was visiting their father. The nurse had to stop the medication preparation because of this distraction. After the conversion with the family member, the nurse resumed the medication preparation but this time was distracted by a phone call and at the same time the nursing assistant reported to the nurse that one of the resident’s was requesting his pain medication. The nurse while on the phone went to medication cart and pulled out medication what she thought it was for the right patient but instead it was another tablet which had similar packing. The nurse administered the drug without performing the five rights of drug administration. During the shift change, nurse noted a discrepancy in narcotics and then realized the medication was pulled from the wrong cabinet. The incident was reported in our safety portal and the patient was monitored for any adverse effects. This particular incident helped me to realize the importance of following the five rights of drug administration and to avoid any distraction such as phone calls, updating family with resident’s progress during medication rounds.
Identifying Academic Peer reviewed journal articles and Assessing credibility
When searching for the best articles for the topic that I chose, I used the search engine, called Summon which can be found in Capella University page under the library tab. For the specific topic, I searched for the articles by using the keywords like medication safety, medication error, packaging improvements and staff education. I filtered my search by selecting peer-reviewed, journal articles and publication date within five years. In addition to the Summon search engine, I have searched for articles using google scholar search engine but paid attention to avoid websites with unreputable sources.
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I chose journals that are well known and published with in the past five years. I read article thoroughly to asses if the data/ information is accepted by additional articles. Peer reviewed journals and articles are scholarly reliable source for information on a topic. It is a type of quality control.
Annotated Bibliography
Escriva Garcia, J; Aparisi Sanz, A., Brage Serrano, R., Fernandez, Garrido, J. (2020). Medication errors and risk area in a critical care unit. Journal of Advanced nursing,77(1),286-295.https://doi-org.library.capella.edu/10.1111. This article discussed mainly the medication errors, their causalities and the highest risk areas in critical care. The article discussed about the systematic analysis of the prescription, transcription and administration records of 2,634 dose unit of medication that were administrated to a total of 87 critically ill patients during 2018. For data collection, social demographic characteristics were also taken into consideration. The article points out that upon reviewing prescription and transcription records, they identified a total of 174 errors, approximately 71% occurred during the prescription of the script and the remaining 29% on the transcription time. In conclusion, nurse transcription behaves as an important filter in the pharmacotherapeutics process as it foresees and prevents many errors that may reach the patients.
Shao, S-C., Lai, E C-C., Owang, K.L., Chen, Ha-Y., Chan., Y-Y. (2018). Look-Article medication packages and patient safety. Journal of patient safety, e47-48.
This journal reiterates the need for constant attention needed by health care professionals, medical industry and regulatory authorities to avoid look alike medication package in the interest of medication safety. The Journal also emphasis that medication error prevention requires clinical vigilance. The journal presented a case study report of 66-year-old male patient who was taking Rosuvastatin 5mg tablets daily since 2014. This patient reported itching for 10 days after his last prescription refill in February 2017. After investigating the cause of recent symptoms, it can be found that the pharmacy dispensed wrong drug. This journal points out the strategies that the pharmacist developed after this incident to prevent future medication error and its follow up result. The authors concluded the journal by stating that package confusions are an important cause of medication errors.
NHS FPX 4000 Assignment 2 Attempt 1 Applying Research Skills
Huang, H-C., Wang, C-H., Chen, P-C., Lee, Y-D. (2019). Bibliometric Analysis of medication error and Adverse Drug Event Studies.
This journal emphasizes to map studies of medication error and adverse drug events and investigate the interrelationships among medication errors and adverse drug events. The data shows that the drug- related problem, in particular, medication errors and adverse drug events are associated with increased cause for treatment. The data-based result from the case study revealed 3343 medication errors and 3342 adverse drug event documents. The key themes on medication errors focused mainly in medication errors in adult inpatients, computerized physician order entry in medication error studies and medication errors in pediatric in patients. The key theme on adverse drug events focused on detection, analysis, effect and prevention from adult inpatients to pediatric inpatient settings and from hospitalized case to ambulatory case. In conclusion, mapping used in the study provides a valuable tool for researches and provides a clear evidence of close relationship between medication errors and adverse drug effects.
Tsegaye, D., Alen,G.,Tessema, Z., Alebachew,W. (2020). Medication administration errors and Associated factors among nurses. International Journal of General medicine,13, 1621- 1632.
This article, discusses the factors that could associated with medication errors. The study conducted on a randomly selected nurses with a minimum of six-month working experience and involved in direct patient care. Four hundred fourteen nurses participated in the study with 98.1% response rate. The data shows that’s 57.7% of nurse’s made medication error over twelve-month period and 30.4 % made it more than three times. The journal points that the factors such as nurse to patient ratio, lack of training, interruption during medication administration, failure to follow rights of medication administration are some element associated with medication errors. The study concluded by articulating that stakeholders like regional health bureau, hospital and nurse administration should collaborate and shared respective responsible to minimized the problem owing to medication error.
Learning from the Research
Medication error can potentially cause a dangerous outcome. Reading and analyzing multiple peer- reviewed articles provided me with factual and credible supportive statements for the research paper. From the peer reviewed articles that I selected, I have noticed the human factor is central in contributing and control of errors. The research article shows that the main factors associated with medication errors are transcription error, packages with look-alike medication, and other element such as interruption during medication administration and nurse to patient ratio to mention few. This research enhanced my knowledge and understanding about medication errors and reiterate me on the steps to prevent drug error. The annotated bibliography has help me to find article that is pertinent to the research topic that I selected.
NHS FPX 4000 Assignment 2 Attempt 1 Applying Research Skills
References
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Escrivá Garcia, J., Aparisi Sanz, Á., Brage Serrano, R., & Fernández Garrido, J. (2020). Medication errors and risk areas in a Critical Care Unit. Journal of Advanced Nursing, 77(1), 286–295. https://doi.org/10.1111.
Huang, H.-C., Wang, C.-H., Chen, P.-C., & Lee, Y.-D. (2019). Bibliometric analysis of medication errors and Adverse Drug Events Studies. Journal of Patient Safety, 15(2), 128–134. https://doi.org/10.1097.
NCC MERP. (2021, August 27). Types of medication errors. Retrieved April 21, 2022, from https://www.nccmerp.org/types-medication-errors.
Shao, S.-C., Lai, E. C.-C., Owang, K. L., Chen, H.-Y., & Chan, Y.-Y. (2018). Look-alike medication packages and patient safety. Journal of Patient Safety, 14(3). https://doi.org/10.1097.
Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, Volume 13, 1621–1632. https://doi.org/10.2147.
