NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

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Enhancing Quality and Safety in Medication

NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

Healthcare is solely based on medication and its administration. A single patient can be administered with several medications at the same time, there is always a risk associated with the administration and safety of the concerned stakeholders. Medication errors can be made while prescribing, storing, reconciling inventories and administering (Ross, 2019). These errors no matter how small can lead a patient into jeopardy while those responsible for the errors can also be held accountable for the mistakes. With the ever-increasing pressures on healthcare providers, errors are bound to happen at some point as the staff is only human and can crack under pressure. These supposedly unintentional errors also have effects on psychological and mental health of those making the errors which leads to depression, anxiety and fear. Some minor but noticeable errors that are recorded and accounted for are said to cost around $77 billion a year (Rodziewicz, et al., 2018). An astounding number of 400,000 patients that are hospitalized each year have experienced harm that is preventable. Almost 10,000 lives are lost each year which are all due to medical errors. (Nyongesa Simiyu, 2018).

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A Scenario of Medication Error

A 75-year-old woman was injected with an anesthetic instead of a sedative at a healthcare facility in Tennessee (Ross, 2019). The error led to a homicide charge against the nurse administering the dose to this woman. It was a blatant error made by the nurse as she could not find the prescribed medicine in the automatic dispensing cabinet and chose the first medicine after typing in the first two letters of the medicine’s name. The nurse was later found not guilty of the charge but she had to deal with a horrific incident that was caused by her own error. She had allegedly overridden the safety protocols that caused the error and resulted in the worst outcome that such errors could possibly have. This incident and the related hearings were covered by the press and were also published in the mainstream.

Elements and Initiatives of Quality Improvement

The effects and the amplitude of medication errors are alarming. These errors need broad investigations and conclusive steps need to be taken to ensure that such errors are reduced if not eliminated. Patient safety is of the utmost importance to any healthcare facility and is deemed as the focal point of the revenues of all related to the care provider field. Researchers need to highlight all factors that are the cause of concern in generating these errors (Chowdhury, 2020). Governments and bodies responsible for the well-being of humans need to actively participate in devising policies and strategies that would help in reducing errors that put the patient’s safety at risk. According to Chowdhury (2020), there are several factors need to be kept in view for addressing this issue. These elements range form:

  • Acceptance of issues that exist within the domains of nurses, physicians and pharmacists.
  • Effective communication with the focus on patient safety.
  • Identification and reporting of errors.
  • Accountability at individual and personal level.

NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

In light of the issues with regards to medication errors, an initiative aimed at the improvement of care quality and medication management was implemented at a teaching hospital’s Acute Care for Elders Program (ACE) (Chowdhury, et al., 2018).  The initiative involved the integration of a clinical pharmacist into the ACE program. The main objectives of the initiative were to curb the growing number of errors in the program. The target was to observe the instances of adjustments in dosage, therapy inappropriateness and the deterrence of adverse instances of erroneous medication. A total of 1243 was observed for 588 patients that were onboard in this initiative (Chowdhury, et al., 2018). The results from this initiative were surprising as the number of recommendations related to changes in medication saw a significant increase. As a result of this initiative, the stakeholders were able to suggest that the inclusion of a clinical pharmacist in care facilities was vital and would yield significant improvements in providing care to the elderly. Moreover, evidence-based study by Nyongesa Simiyu (2018) states that medication that is administered at an initial visit needs to be gauged and measured in terms of its effects on an individual, especially in the case of elderly patients. These initial prescriptions are changed in substantial numbers due to their effects on the elderly. Thus, a clinical pharmacist continuously observes changes in a patient’s symptoms and recommends changes to certain medications which are also accepted by most of the healthcare providers. Moreover, the study by Ross (2019) also describes specific standards or the evidence related to the safety risks. The author states that changing or discontinuing certain medications can effectively avoid adverse drug events and significantly reduce the need of readmission to a healthcare facility.

Factors Leading to Patient Safety Risks

Patient safety is the key element in healthcare at all levels. When this safety is compromised due to any factor, the patient’s life gets in danger which is the key factor in all healthcare practices and processes (“Examples of quality improvement”, n.d). There is a broad list of factors that can lead to patient safety being compromised. Some of the critical factors are listed here:

  • Erroneous administration of medicine
  • Error in diagnostics
  • Communication errors
  • Surgical errors
  • Healthcare associated infections

These are the defining factors in ensuring that a healthcare facility is providing a satisfactory patient care. There is a very thin line between satisfaction and dissatisfaction which can be compromised with a tiny error with huge repercussions. 

Patient Safety and Organizational Interventions

NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

Nurses have a critical role to play in providing decent healthcare to the patient’s they are dealing with. There are several elements that the nursing staff has to be aware of when working in a healthcare organization. These elements are a benchmark for patient satisfaction. Nurses have to always try to adhere with the basic policies and have to try to deliver their best in each of these areas to ensure satisfactory results. Nurses spend the most time with a patient which is why they are of pivotal importance in an organization’s quality improvement initiatives. Some of the most important nursing elements in the quality improvement of a healthcare organization are effectiveness, efficiency, respect, safety and timeliness. Nurses continuously keeping an eye out for improvement in these areas always bring changes to traditional ways that help an organization bring quality enhancements. Organizations should provide nurses with necessary education related to improvement initiatives and the latest technology which can bring improvement once they are aware of the risks and benefits associated with a change that would supposedly bring improvement. According to the American Nurses Association, the nurse at the center of a process is the best measure of the organization’s status of healthcare (School of Nursing, 2022). In terms of cost savings related to drugs administration issue, nurses can follow evidence-based strategies and involve number of pharmacist interventions. This can help to boost the pharmacist’s participation in the management of drug administration and will improve nurse’s coordination with them. Increasing collaboration between nurses and pharmacists will help nurses to gain valuable knowledge to boost their medication management and will reduce untimely human errors. With a reduction of such unwanted human errors as well as the cost of medications. This shows that clinical pharmacists will be able to play a pivotal role in the cost reduction and safety of the organization by coordinating with nurses on a daily basis.  

NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

Stakeholder Importance in Quality Improvement

Nurses although are the center of attention when it comes to improving the quality of a healthcare organization. However, there are other key players that are significant to the initiatives for improvement. The patients, clinicians, physicians, managers, nurse leaders, cashiers and financial and non-financial executives are all keys to improving the quality and reducing the costs of an organization (Ross, 2019). A simple process in a healthcare organization involves almost all of these stakeholders as they are all involved in the process at one stage or the other. Executives are the ones that define strategies that are the driving force behind improvement initiatives while the managers and leaders are responsible for ensuring these strategies and policies are adhered with in order to bring efficiency and reduce costs. With leaders and executives leading from the front, the clinicians, physicians and nurses are all responsible for carrying out the improvement initiatives. These three are the actual executors of the processes and strategies. These stakeholders are the ones that need to implement the changes required to bring about quality enhancement in a healthcare organization.

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Moreover, stakeholders play a crucial role in the improvement of healthcare quality and safety because their engagement approach helps them to define safety and quality goals and explore the feasibility of the initiatives. Determining particular stakeholders is important as they can develop a group’s identity and they can empower community members to improve and involve in QI initiatives as well as advance policy chances at an organizational level (Chowdhury et al., 2020).  

Conclusion

Medication errors are the leading cause of healthcare failures which result in dire circumstances. The healthcare providers are typically only responsible for diagnosing and prescribing medication should also follow-up with their patients in order to be aware of any adverse effects of the prescribed medication. Further the nursing staff and the clinical pharmacist are the key elements in making sure that the medication administration is accurate and error free. Healthcare organizations need to improve their quality by empowering their staff especially the nursing staff and also provide education to the stakeholders that are vital in quality improvement initiatives.

NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety

References

Ross, M. (2019, March). 6 Medication error stories that made headlines. Cureatr.com; Cureatr Inc. https://blog.cureatr.com/6-medication-error-stories-that-made-headlines

Nyongesa Simiyu, K. (2018). Nurses’ medication administration errors at medical surgical units. American Journal of Nursing Science7(3), 88. https://doi.org/10.11648/j.ajns.20180703.12

Europe PMC. (2019). Europe PMC. Europepmc.org. https://europepmc.org/article/nbk/nbk499956

Chowdhury, T. P., Starr, R., Brennan, M., Knee, A., Ehresman, M., Velayutham, L., Malanowski, A. J., Courtney, H.-A., & Stefan, M. S. (2020). A quality improvement initiative to improve medication management in an acute care for elders ‘program through integration of a clinical pharmacist. Journal of Pharmacy Practice33(1), 55–62. https://doi.org/10.1177/0897190018786618

Examples of quality improvement in nursing. (n.d.). Online.nursing.umich.edu. Retrieved June 24, 2022, from https://online.nursing.umich.edu/blog/quality-improvement-in-nursing/#:~:text=Quality%20improvement%20involves%20more%20than