NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

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Improvement Plan Tool Kit-Medication Error

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

An improvement plan tool kit is necessary for any healthcare professional as it allows them to gain knowledge and look back on their errors. Communication and information sharing has been a part of medical practices and it allows the professionals to share their knowledge and methodologies with others in this way they can learn about their shortfalls and gain peer insight into their wrongdoings. A full plan tool kit is there to help any nurse so that they can read and gain the necessary knowledge to enhance their skills and practice. Medication errors are unfortunately very common in the medical field. The cause and effect of medication errors are studied by many government departments as well as many researchers around the world. The government departments have made many policies as well as guidelines to report, reduce and prevent such errors from happening. Researchers have experimented and reported the cause of medication errors and the factors that influence them.

These papers were taken with the help of PubMed, ScienceDirect, and CINAHL.

Organization Policies and Guidelines

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy, 75(19), 1493-1517. https://doi.org/10.2146/ajhp170811

This article explains the aims of medication treatment to produce specific therapeutic outcomes that increase the quality of life for patients while lowering their risk. The use of drugs comes with some hazards, both recognized and unknown (prescription and nonprescription). Pharmaceutical problems are considered as any avoidable incident which may lead to or contribute to incorrect medicine usage or patient damage while the medications are within the responsibility of a healthcare practitioner, patient, or client. Furthermore, this article explains in detail the ASHP guidelines that health professionals should adhere to when a prescription error takes place to ensure the safety of the patient, their relatives as well as themselves. They have placed 11 guidelines that should be followed as well as specific strategies for the healthcare provider that is giving the medication.

Reporting Medication Errors

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046. https://doi.org/10.1111/scs.12546

Although each incident is different, there still are bound to be commonalities and patterns in risk sources that would otherwise go unreported if occurrences were not documented and examined. The ability to spot patient safety issues relies heavily on reporting. Yet, it will never be able to provide a full view of all risk sources and adverse reactions on its own. Other types of patient safety data that can be used by health care services internationally are also suggested in the guidelines. The following high-level aspects that healthcare providers aspire to incorporate through the application of solid safety programs: all employees bear responsibility for their own, work colleagues’, and patients’ protection; they emphasize safety above operating and financial objectives; they promote communication and clarification of safety concerns which provide institutional resiliency. This research paper lists all the factors that are associated with medication errors and also explains why nurses fail to report them. By reading this paper, nurses can learn more about the factors that influence them in not reporting the errors they make and what consequences they might face if they do so. This can help them feel confident in reporting their mistakes and not be involved in a blame game.

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Technology and Tools

Baumann, L. A., Baker, J., & Elshaug, A. G. (2018). The impact of electronic health record systems on clinical documentation times: a systematic review. Health Policy, 122(8), 827-836. https://doi.org/10.1016/j.healthpol.2018.05.014

Hospital personnel is a significant healthcare asset, and the efficient use of their talents is a significant predictor of care quality and accomplishment of public healthcare objectives. It is therefore critical that employee time be allocated to guarantee efficiency and optimal patient quality care. The time spent on paperwork and repetitive tasks by hospital physicians has increased over the previous two decades, reducing the time required for direct patient care and connection with patients and family members. The increased focus on record quality, as well as the necessity to document more detail about the treatment process, has resulted in increased tight schedules and personnel unhappiness. Burnout is a result of this. With the broad implementation of electronic health record systems in recent times, clinical personnel could share data more efficiently. It was thought that switching from print to EHR systems would allow personnel to spend more time on direct patient care and less time on paperwork. Computer-based decision support systems, for instance, have been found to increase the safety of patients by lowering the rate of prescription and reporting errors, as well as the incidence of adverse occurrences. They can notify staff of proposed correlative steps, drug interactions, and dose adjustments, a task that is impossible for human practitioners to complete without assistance. Furthermore, EHR devices can increase the flow of information and awareness, conduct real-time inspections, and help with surveillance.

Costa, J., Martins de Assis, J., Melo, M., Xavier, S., Melo, G., & Costa, I. (2017).
Technologies Involved in the Promotion of Patient Safety in the Medication Process: An
Integrative Review. Cogitare Enfermagem,22(2), https://doi.org/10.5380/ce.v22i4

This study shows the technologies involved in medical care and how they improve patient safety outcomes. Technologies like electronic health records and mobile technologies not only help patients in their treatment but also help medical professionals as well. Nurses in particular are involved in the documentation process of the treatment and the medication administration process. Most of the time a single nurse is involved with multiple patients with different diseases and hence has multiple various medicines. Therefore, the process duration for documentation has to be decreased so that they can take time to rest and not burn out. Since they are dealing with multiple patients a foolproof record of the patients is necessary so that there will be no medication errors where the wrong medicine is given to the patient. The use and knowledge of EHR help nurses a lot. 

Talyor, Z. B. (2019). Eliminating Medication Errors in Nursing Practice with an Innovative Quality Improvement Tool Proposal. https://commons.lib.niu.edu/handle/10843/21691

Medication errors will be reduced if nurses use a designed tool that targets and walks through the 5 principles of administration of medication, step by step. Nurses’ priority in their work is to deliver the highest possible standard of patient healthcare to produce the highest potential patient outcomes. When it comes to handling the highest level of care, there are numerous obstacles to overcome. Nevertheless, one that is quite common in today’s profession is linked to medication prescription mistakes. A medication error is defined as the failure to execute any one of the five rights to administration. A misdiagnosis in any of these categories, whether it’s the method, the dose, the medicine itself, the victim, or the timing, can result in serious side effects that could result in the patient’s harm or death. Prescription errors have a variety of causes, and a pragmatic approach is needed to assist nurses in minimizing medical errors and the associated adverse outcomes. Nurses can use the data obtained from a thorough literature study to construct and suggest a basic quality and safety development strategy that will aid in the eradication of medication mistakes.

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NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Krick T, Huter K, Domhoff D, Schmidt A, Rothgang H, Wolf-Ostermann K. Digital technology and nursing care: a scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC Health Serv Res. 2019 Jun 20;19(1):400. DOI: 10.1186/s12913-019-4238-3

Given the current discussion on technology as possible solutions to challenges such as the scarcity of qualified people and the rising need for long-term care, the availability, use, and advantages of digital technologies in nursing care are significant subjects. Its goal was to describe the area of digital technologies for formal and informal care that had previously been investigated in terms of acceptability, efficiency, and effectiveness (AEE), as well as to indicate the extent of the methods utilized, target locations, target populations, and supporting fields. This study focuses on what nurses should do in terms of digital technology. The research is in favor of the nurses being efficient in their knowledge and skills of the user of these digital technologies as these tech solutions are now more prevalent in the medical field as they help increase the patient safety and satisfaction during their treatment. These technologies can help them communicate with other staff members and with the patients, allowing them to make decisions that would be helpful to the treatment. 

Aguirre RR, Suarez O, Fuentes M, Sanchez-Gonzalez MA. Electronic Health Record Implementation: A Review of Resources and Tools. Cureus. 2019 Sep 13;11(9): e5649. DOI: 10.7759/cureus.5649

Adopting an electronic health record (EHR) may be a tough endeavor, and preparing ahead of time is critical to avoid mistakes. Significant responsibility is evaluating an EHR system’s selection criteria and deployment strategy, intending to assure portability, privacy, accessibility, and safety of patient healthcare information records while also providing rapid, accurate, and regulatory-compliant report creation. This article describes the decision and implementation strategy, which will essentially consist of examining the existing institutional processes for each department, as well as the institution’s requirements and preferences for the EHR system for the company to run correctly. There are resources and tools to help with product selection, as well as suggestions for training and evaluating employee preparedness. Regulatory restrictions are also taken into account during the early stage. The use of an electronic health record (EHR) improves workflow productivity and makes patient care safer. To guarantee efficiency, the provider’s team must follow a set of measures to ensure effective deployment and administration of the EHR system. It is advised that a testing strategy is in place before deploying the deployed EHR to ensure that areas of potential staff misunderstanding be identified and handled. A good implementation approach for a new EHR system will help organizations succeed, cut down on delays, and boost healthcare worker satisfaction.

Stakeholders in Medication Errors

Di Simone, E., Fabbian, F., Giannetta, N., Dionisi, S., Renzi, E., Cappadona, R., … & Manfredini, R. (2020). Risk of medication errors and nurses’ quality of sleep: a national cross-sectional web survey study. Eur Rev Med Pharmacol Sci, 24(12), 7058-7062.  DOI: 10.26355/eurrev_202006_21699 

Even if nurses believe they had a good night’s sleep, the lack of appropriate rest has a significant impact on performance. The link involving working shifts, poor sleeping conditions, and the risk of medical error is critical for all members of the healthcare community, and the web survey provides useful information for capturing the chances of making mistakes. Such study should be encouraged by healthcare institutions to demonstrate a more active approach to patient safety. From this study, we can understand how necessary it is to allow nurses a period in their working shift to rest their body and mind so that they wouldn’t cause any errors in their practices. 

Kieft, R.A., de Brouwer, B.B., Francke, A.L. and Delnoij, D.M. (2014). How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC Health Services Research, 14(1), pp.1-10. DOI: 10.1186/1472-6963-14-249

Patient experiences are monitored by healthcare organizations to assess and enhance the quality of services. Nurses have a direct influence on patient satisfaction since they spend so much time with them. Nurses must understand what aspects of the nursing environment have an impact on patient satisfaction with care. The major goal of this study was to learn how Dutch nurses perceive their employment and work environment concerning pleasant patient experiences. Skills & knowledge of nursing staff, cooperative work interactions, autonomous nursing practice, adequate resources, command over nursing practice, management support, and a patient-centered culture were all mentioned by the nurses as crucial components that they consider would enhance patient perspectives of nursing quality of care. They also cited some impediments, including cost-effectiveness policies and transparency aims for external accountability. Nurses report a significant administrative workload and feel pressed to boost productivity. They claim that these characteristics will not increase patient perceptions of nursing care quality. Patients’ perceptions of the care quality are influenced by a variety of factors, according to volunteers. They think that adding these features into everyday nursing practice would lead to better patient outcomes. Nurses, on the other hand, operate in a healthcare environment where they must balance cost-effectiveness and responsibility with their commitment to offering nursing services that are tailored to the requirements and preferences of patients, and they frequently face a contradiction between the two methods. Nurses must establish control of their practice to enhance the experience of the patients. 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Patel, R.S., Bachu, R., Adikey, A., Malik, M. and Shah, M., (2018). Factors related to physician burnout and its consequences: a review. Behavioral Sciences8(11), p.98. https://doi.org/10.3390/bs8110098

Medical burnout is a common problem among healthcare workers, especially doctors and nurses, and is marked by emotional tiredness, dissociation, and a sense of poor personal achievement. This study explores the causes that contribute to physician burnout, as well as the repercussions for the physician’s well-being, clinical outcomes, and the medical system, in this review. Physicians confront everyday obstacles in delivering treatment to their clients, and higher stress levels among overworked physicians may contribute to burnout. Physicians are also required by the healthcare system to keep careful records of their physician-patient contacts as well as secretarial tasks. Practitioners are not very good at handling secretarial responsibilities, which may divert their attention away from providing care to their patients. From this research, nurses can distinguish their skill and educational shortcomings and what they can do to solve them.

Cho, I., Lee, M., & Kim, Y. (2020). What are the main patient safety concerns of healthcare stakeholders: a mixed-method study of Web-based text. International journal of medical informatics, 140, 104162. DOI: 10.1016/j.ijmedinf.2020.104162

Quality of care is defined in a variety of ways by various healthcare stakeholders. All of these issues might be addressed by public policy. The purpose of this study was to determine the key topics on patient safety voiced by stakeholders before and after Korea’s Patient Safety Act was implemented in 2015. Various stakeholders, including society as a whole, patients, clinicians such as doctors and nurses, instructors, administration staff, scientists, professional organizations, authorities and legislative bodies, and accrediting agencies, are responsible for making sure that patient care is delivered safely and that patients are not harmed. According to this study, all of these stakeholders have their concerns about the safety of patient care, especially in medication errors. Nurses can read this research and gain knowledge about the international practices that are taking place and what are the concerns of these stakeholders so that they can implement these practices and reduce the concerns of the stakeholders as much as they can.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Shitu, Z., Hassan, I., Aung, M. M. T., Kamaruzaman, T. H. T., & Musa, R. M. (2018). Avoiding medication errors through effective communication in a healthcare environment. Malaysian Journal of Movement, Health & Exercise, 7(1), 115-128. http://dx.doi.org/10.15282/mohe.v6i2.157

The communication gap among patients and medical workers is one of the leading causes of drug mistakes. This study examines communication challenges in the healthcare setting and how better communication may help prevent prescription mistakes. In hospital settings, the necessity of strong communication strategies for optimal health and enhanced patient safety has been underlined. Poor communication is the leading cause of unpleasant effects, treatment delays, prescription mistakes, and surgery in the wrong location, according to this analysis. Language hurdles, communication medium, physical location, and social context are all key communication challenges in the healthcare sector. Because they perceive the style of conversation to be constantly professional, healthcare personnel tend to employ technical jargon in the workplace. It has been proven that understanding professional-patient communication is crucial to increasing therapeutic results. Patients want information and encouragement in terms of being able and encouraged to participate in medicinal therapy. Demanding and fostering an atmosphere where high-quality healthcare counseling is consistently conducted is the responsibility of health practitioners. Clinicians should stick to collaboration and excellent communication with patients to ensure safe and efficient treatment in hospitals and minimize pharmaceutical mistakes. Designing techniques such as efficient communication and collaboration among healthcare professionals, which can impact the efficiency of medical services and patient outcomes, is necessary.

References

Aguirre RR, Suarez O, Fuentes M, Sanchez-Gonzalez MA. Electronic Health Record Implementation: A Review of Resources and Tools. Cureus. 2019 Sep 13;11(9): e5649. DOI: 10.7759/cureus.5649

Baumann, L. A., Baker, J., & Elshaug, A. G. (2018). The impact of electronic health record systems on clinical documentation times: a systematic review. Health Policy, 122(8), 827-836. https://doi.org/10.1016/j.healthpol.2018.05.014

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy, 75(19), 1493-1517. https://doi.org/10.2146/ajhp170811

Cho, I., Lee, M., & Kim, Y. (2020). What are the main patient safety concerns of healthcare stakeholders: a mixed-method study of Web-based text. International journal of medical informatics, 140, 104162. DOI: 10.1016/j.ijmedinf.2020.104162

Costa, J., Martins de Assis, J., Melo, M., Xavier, S., Melo, G., & Costa, I. (2017).
Technologies Involved in the Promotion of Patient Safety in the Medication Process: An
Integrative Review. Cogitare Enfermagem,22(2), https://doi.org/10.5380/ce.v22i4

Di Simone, E., Fabbian, F., Giannetta, N., Dionisi, S., Renzi, E., Cappadona, R., & Manfredini, R. (2020). Risk of medication errors and nurses’ quality of sleep: a national cross-sectional web survey study. Eur Rev Med Pharmacol Sci, 24(12), 7058-7062.  DOI: 10.26355/eurrev_202006_21699 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046. https://doi.org/10.1111/scs.12546

Krick T, Huter K, Domhoff D, Schmidt A, Rothgang H, Wolf-Ostermann K. Digital technology and nursing care: a scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC Health Serv Res. 2019 Jun 20;19(1):400. DOI: 10.1186/s12913-019-4238-3

Patel, R.S., Bachu, R., Adikey, A., Malik, M. and Shah, M., (2018). Factors related to physician burnout and its consequences: a review. Behavioral Sciences8(11), p.98. https://doi.org/10.3390/bs8110098

Shitu, Z., Hassan, I., Aung, M. M. T., Kamaruzaman, T. H. T., & Musa, R. M. (2018). Avoiding medication errors through effective communication in a healthcare environment. Malaysian Journal of Movement, Health & Exercise, 7(1), 115-128. http://dx.doi.org/10.15282/mohe.v6i2.157

Talyor, Z. B. (2019). Eliminating Medication Errors in Nursing Practice with an Innovative Quality Improvement Tool Proposal. https://commons.lib.niu.edu/handle/10843/21691