Improvement Plan Tool Kit

This improvement plan tool kit will equip nurses with relevant skills and knowledge about safe medication administration. This improvement plan is organized into four sections: application of technology to improve medication safety, patient education handling of high alert medication, handling of look-alike and sound-alike medications, and environmental safety.

Application of Technology to Improve Medication Safety

Andrade, A. Q., & Roughead, E. E. (2019). Consumer-directed technologies to improve medication management and safety. Medical Journal of Australia, 210(S6), S24–S27. https://doi.org/10.5694/mja2.50029

The article evaluates the technologies that can be used to enhance medication administration safety. According to the authors, technology helps to reduce medication errors in various ways. Firstly, technology promotes patient education via text messages and promotes real-time interactions via videos. This can help to improve compliance and reduce medication administration errors. Secondly, technology enables nurses and patients to access and use reminder techniques like alarms. Furthermore, technological advancement has made personal tacking a reality. Unique tracking technology, such as wearable devices, facilitates remote patient monitoring to ensure medication adherence and the correct administration techniques are upheld.

Nurses and other healthcare providers should uphold technology to improve medication adherence and increase medication administration safety. For example, educational technologies like videos allow real-time patient monitoring to promote safe medication administration. Nurses should embrace technology to promote perpetual patient monitoring and education to reduce the incidence of medication administration errors.

Kuitunen, S., Niittynen, I., Airaksinen, M., & Holmström, A. R. (2021). Systemic defenses to prevent intravenous medication errors in hospitals: A systematic review. Journal of Patient Safety, 17(8), E1669–E1680. https://doi.org/10.1097/PTS.0000000000000688

This article analyzes the strategies that can be used to avert intravenous medication administration errors. According to the authors, medication errors occur during prescribing, dispensing, and administration. Closed-loop management systems can be used to minimize medication administration errors. Examples of these systems include the use of smart pumps, electronic prescribing, color-coded systems, and the use of barcode scanners. The other technique consists of the use of automated dispensing cabinets. Electronic prescribing via computerized physician order entries helps to reduce administration errors that illegible prescriptions could cause. Smart pumps detect errors related to infusion rates, dosage, and pump settings. By so doing, the incidence of administration errors is reduced.

This resource is relevant to nurses and other healthcare providers. Knowledge of closed-loop management systems forms the basis of policy formulation and resource allocation to acquire necessary technology. Closed-loop management systems, such as barcode scanners, facilitate the accurate identification of patients and prevent medication administration errors.

Macias, M., Bernabeu-Andreu, F. A., Arribas, I., Navarro, F., & Baldominos, G. (2018). Impact of a barcode medication administration system on patient safety. Oncology Nursing Forum, 45(1), E1–E13. https://doi.org/10.1188/18.ONF.E1-E13

The article evaluates barcode medication administration’s impact on the prevalence of medication administration errors. The authors used a control group and an intervention group. Accordingly, findings indicate that barcode medication administration reduced medication errors by approximately 85 percent. The specific types of errors that were mitigated are related to the medication, dosage, administration frequency, patient selection, and administration route.

This resource is relevant to nurses and other healthcare providers. Nurses should use barcode medication administration to ensure that the proper medication is given to the right patient at the right time, in the correct dosage, and via a valid route. Furthermore, this article enables nurses and other healthcare providers to recognize the significance of barcode medication administration in reducing medication administration errors. Therefore, appropriate policies and procedures that advocate for barcode medication administration can be formulated. In addition, healthcare facilities can allocate adequate resources to acquire and implement this technology.

Vilela, R. P. B., & Jericó, M. de C. (2019). Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results. Einstein (Sao Paulo, Brazil), 17(4), eGS4621. https://doi.org/10.31744/einstein_journal/2019GS4621

This article aims to evaluate the impact of technology on minimizing medication errors. The article identifies thirteen types of technologies that can be used to avert medication errors. They include intelligent infusion pumps, barcode readers, electronic medication prescriptions, and techniques such as using colored labels to identify high-risk medications. Other than administration errors, the methods reduce the incidence of drug and dispensing errors. These technologies are categorized into hard and soft technologies. Soft technologies entail perpetual education, whereas complex technologies entail various hardware used in these technologies. According to the authors, the average cost of implementing these technologies is approximately R$10.259.505,10.

This article is relevant to nursing practice because it identifies various technologies that can be used to reduce medication administration errors. Adequate knowledge and skills about technologies such as using smart infusion pumps reduce medication administration errors and increase patient safety.

Patient Education Handling of High-Alert Medication

Sessions, L. C., Nemeth, L. S., Catchpole, K., & Kelechi, T. J. (2019). Nurses’ perceptions of high-alert medication administration safety: A qualitative descriptive study. Journal of Advanced Nursing, 75(12), 3654–3667. https://doi.org/10.1111/jan.14173

This article evaluates nurses’ perspectives about the facilitators and barriers to the safety of administering high-alert medication. Findings indicate that three factors affect the administration safety of the high alert medication. They include organizational culture, teamwork, and competency. Healthcare facilities that uphold a safety culture are associated with a low incidence of administration errors involving high-alert medication. Furthermore, interdisciplinary collaboration cultivates teamwork in the decision-making process. By so doing, medication administration errors are reduced significantly. Competency and engagement of nursing staff are achieved by continuous training and education. Training and education equip the nurses with relevant knowledge and skills about medication administration. As such, the incidence of administration errors is reduced. According to the authors, medication administration errors are commonly caused by distractions and high workloads.

This resource is helpful because it identifies the main factors that impact the safety of medication administration. This knowledge enables nurses to take relevant precautions to reduce these errors and increase patient safety. This information also allows a healthcare facility to formulate policies and guidelines to minimize administration errors for high-alert medication.

Sessions, L., Nemeth, L. S., Catchpole, K., & Kelechi, T. (2020). Use of Simulation-Based Learning to Teach High-Alert Medication Safety: A Feasibility Study. Clinical Simulation in Nursing, 47(October), 60–64. https://doi.org/10.1016/j.ecns.2020.06.013

This article analyzes the use of simulation to enhance nurses’ knowledge and skills in administering high-alert medication. According to the authors, simulation equips nurses with relevant knowledge and skills by mimicking real-time occurrences. Simulation facilitators include adequate network coverage, the availability of smart pumps, and other technological advances such as computers and simulators. Factors that impede the successful implementation of simulation include the absence of electronic health record systems and the lack of perpetual training and education sessions.

This resource is relevant because it identifies the importance of simulations in reducing administration errors for high-alert medications. Furthermore, the article identifies the enablers for simulations and the factors that impede simulation. Various stakeholders, such as nursing educators, can use this information to implement simulation programs in healthcare facilities and educational settings.

Younis, I., Shaheen, N., & Bano, S. (2021). Knowledge and practice About Administration of High Alert Medication in the Tertiary Care Hospital in Lahore. International Journal of Health, Medicine and Nursing Practice, 3(4), 1–16. https://doi.org/10.47941/ijhmnp.644

This article evaluates nurses’ awareness of high-alert medication. High-alert medications bear an increased risk of toxicities and adverse events when they are not administered correctly. Examples of these medications include anti-neoplastic agents and anticoagulants such as warfarin. Findings indicate that approximately 30 percent of the respondents lacked sufficient knowledge about administering high-alert medication. Furthermore, about 33 percent of the respondents require adequate training and educational sessions on safe handling and administering high-alert medication. The risk factors for medication administration errors include lack of care coordination, lack of elaborate standard operating procedures, absence of regular training sessions, and the absence of interdisciplinary collaboration.

This resource enables stakeholders such as hospital administrators to identify the enablers of administration errors for high-alert medication by nurses. Furthermore, the article identifies the causes of medication administration errors. This information forms the basis for formulating policies and procedures to mitigate medication administration errors.

Handling Look-Alike and Sound-Alike Medications

Bryan, R., Aronson, J. K., Williams, A., & Jordan, S. (2021). The problem of look-alike, sound-alike name errors: Drivers and solutions. British Journal of Clinical Pharmacology, 87(2), 386–394. https://doi.org/10.1111/bcp.14285

This article analyzes the problem of look-alike, sound-alike (LASA) medication and proposes strategies for handling the situation. The authors report that in 2018, LASA-associated errors accounted for approximately 10% of medication errors within three months. On average, LASA accounts for roughly six percent to fourteen percent of all medication errors. These errors can occur at any stage of medication use, including during administration. Notably, LASA errors can cause inappropriate use, underdoses, and overdoses. Various strategies can be used to mitigate LASA-associated medication errors. They include minimizing distractions and interruptions, storing LASA medication in different locations, using Tall Man lettering, barcoding, and computerized physician order entry.

This resource is relevant to nursing practice because it equips nurses with appropriate strategies for mitigating LASA-associated medication errors. Additionally, this resource identifies the prevalence of LASA-associated medication administration errors. Nurses should embrace techniques such as Tall Man lettering to facilitate accurate medication identification and reduce the incidence of LASA-associated medication errors.

Emmerton, L., Curtain, C., Swaminathan, G., & Dowling, H. (2020). Development and exploratory analysis of software to detect look-alike and sound-alike medicine names. International Journal of Medical Informatics, 137, 1–25. https://doi.org/10.1016/j.ijmedinf.2020.104119

This article seeks to develop software that detects look-alike and sound-alike (LASA) medicine names. LASA-associated medication errors account for a significant proportion of medication errors. Various strategies have been developed to tackle this problem. They include using the Tall Man Lettering List and the Phonetic and Orthographic Computer Analysis (POCA). Essentially, POCA identifies sound-alike medications, hence preventing administration errors. The authors used POCA as the blueprint for developing their software, LASA v2. The authors report that LASA v2 will play a significant role in the identity of sound-alike medications.

This article is relevant to nursing practice. It identifies the current strategies for minimizing LASA-associated medication administration errors and proposes a new software to tackle them. This software will increase the accuracy of medication identification, reduce medication administration errors, and improve patient safety.

Ruutiainen, H. K., Kallio, M. M., & Kuitunen, S. K. (2021). Identification and Safe Storage of Look-Alike, Sound-Alike Medicines in Automated Dispensing Cabinets. European Journal of Hospital Pharmacy, 151–156. https://doi.org/10.1136/ejhpharm-2020-002531

The authors aim to evaluate the characteristics of LASA medications and the role of automated dispensing cabinets in promoting the safe administration of these medications. Automated dispensing cabinets use monitoring devices, such as barcodes, to promote medication safety. Automated dispensing cabinets are components of closed-loop medication management systems that reflect technological advancements in reducing medication administration errors. According to the authors, automated dispensing cabinets reduce mix-ups related to similar brands and generic names. However, the authors note that human factors could still increase the risk of medication administration errors when automated dispensing cabinets are used.

This resource equips nurses with relevant knowledge about automated dispensing cabinets (ADCs). These cabinets should be distributed in inpatient units to promote medication administration safety. Besides ADCs, nurses should embrace other strategies, such as avoiding distractions and interruptions, to prevent medication errors.

Environmental Safety

Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D. (2019). Medication administration errors and mortality: Incidents reported in England and Wales between 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858–863. https://doi.org/10.1016/j.sapharm.2018.11.010

This article evaluates various stakeholders’ role in reducing medication errors. Medication errors are common in healthcare facilities. Notably, the incidence of these errors increases during patient referrals. Referrals increase the risk of discrepancies and medication errors. Medication errors, such as those related to medication administration, can be minimized by embracing patient-centeredness. Patient-centeredness addresses the unique needs of the patient by advocating for autonomy. The other strategy is the maintenance of accurate records. This can be accomplished by implementing an electronic health record system. Interprofessional collaboration promotes medication reconciliation and reduces the risk of medication administration errors.

This resource is relevant because it identifies the roles of various stakeholders in mitigating medication administration errors. By so doing, healthcare providers are held accountable for their actions. Furthermore, the article advocates for care coordination and interdisciplinary collaboration to reduce medication administration. Nurses should work in concert with other stakeholders to reduce medication administration errors.

Keers, R. N., Plácido, M., Bennett, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018). What Causes Medication Administration Errors in a Mental Health Hospital? A Qualitative Study with Nursing Staff. PLoS ONE, 13(10), 1–18. https://doi.org/10.1371/journal.pone.0206233

This article aims at identifying the causes of medication errors in a mental health facility in England. Common causes of medication errors include interruptions and distractions, lack of optimized staff ratios, improper communication, and skill-based slips. Healthcare facilities should formulate various strategies to combat these factors. They include double-checking, optimization of nurse-to-patient ratios, open communication, and perpetual staff training and education. The problem of distractions and interruptions can be mitigated by establishing hospital practice standards and cultivating an organizational culture of upholding silence in the inpatient units.

This article is relevant to nursing practice because it identifies the etiologies of medication administration errors and proposes strategies for mitigating these factors. Nurses and other healthcare providers should embrace these strategies for safe medication administration and patient safety.

Koyama, A. K., Maddox, C. S. S., Li, L., Bucknall, T., & Westbrook, J. I. (2020). Effectiveness of double checking to reduce medication administration errors: A systematic review. BMJ Quality and Safety, 29(7), 595–603. https://doi.org/10.1136/bmjqs-2019-009552

This article evaluates the impact of double-checking on reducing medication administration errors. The authors conducted a systematic review of studies. Their findings indicate that one out of three studies established a relationship between double-checking and medication administration errors. Adherence rates to double-check range from 52 percent to 97 percent. According to the authors, further research should establish the relationship between double-checking and medication administration errors. This resource is relevant to nursing practice. It reveals that one of three quality studies found a relationship between double-checking and medication administration errors. Additionally, nurses and other healthcare providers should be active participants in conducting further research on this topic.

References

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Question

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan about medication administration to understand or implement to ensure the plan’s success.

Improvement Plan Tool Kit

Communication in the healthcare environment consists of an information-sharing experience, whether through oral or written messages (Chard & Makary, 2015). As healthcare organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to disseminating information and evidence-based findings and developing tool kits, continuous support for and availability of such resources is critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in times of need or crisis and how to support one another in the workplace; wikis, in particular, enable nurses to continue that support beyond the work environment. Here, they can be free to share their unique perspectives, educate others, and promote healthcare wellness at local and global levels (Kaminski, 2016).

Before developing the repository, you must complete the Determining the Relevance and Usefulness of Resources activity. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your practice and self-assessment and demonstrates course engagement.

Demonstration of Proficiency
By completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze the elements of a successful quality improvement initiative.
Analyze the usefulness of resources for the role group responsible for implementing quality and safety improvements with medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the value of resources to reduce patient safety risks or improve quality with medication administration.
Competency 3: Identify organizational interventions to promote patient safety.
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Present reasons and relevant situations for a resource tool kit to be used by its target audience.
Communicate resource tool kit in a clear, logically structured, professional manner that applies current APA style and formatting.
References
Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context
Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage the sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help reinforce attendees’ new knowledge and the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario
For this assessment, consider taking one of these two approaches:

Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan about medication administration and put the plan into action.
Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) about medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.
Preparation
Google Sites is recommended for this assessment; the tools are free to use and should offer flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or Google Docs login or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you start with Google Sites: https://sites.google.com/new.

G Suite Learning Center. (n.d.). Get started with Sites. https://gsuite.google.com/learning-center/products/sites/get-started/#!/
Google. (n.d.). Sites. https://sites.google.com
Google. (n.d.). Sites help. https://support.google.com/sites/?hl=en#topic=
Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes concerning your safety improvement initiative regarding medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices, environmental safety and quality risks, individual strategies to improve personal and team safety, and process best practices for reporting and improving environmental safety issues.

Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories, focusing on safety with medication administration. Each resource listing should include the following:

An APA-formatted citation of the resource with a working link.
A description of the resource’s information, skills, or tools.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative about medication administration.
A description of how nurses can use this resource and when its use may be appropriate.
Remember to make your site ‘public’ so your faculty can access it. Check out the Google Sites resources for more information.

Here is an example entry:

Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.
This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse-led project can be implemented and used to improve collaboration int,erdisciplinary teamwork, and healthcare service delivery. This resource is likely more helpful to nurses as a resource for strategies and models for assembling and participating in a multidisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed before creating a multidisciplinary team for a collaborative project in a healthcare setting.
Additionally, be sure that your plan addresses the following, corresponding to the grading criteria in the scoring guide. Please study the scoring guide carefully to understand what is needed for a distinguished score.

Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative about medication administration.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
Analyze the value of resources to reduce patient safety risks related to medication administration.
Present reasons and relevant situations for using the resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like. However, keep in mind that your tool kit will focus on promoting safety with medication administration. You do not have to submit your bibliography besides the Google Site; the example bibliography is merely for your reference.

Assessment 4 Example [PDF].
To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
https://sites.google.com/view/safetyimprovementmeasures/home
Example Google Site: You may use the example Google Site, Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment, but keep in mind that your tool kit will focus on promoting safety with medication administration.

Note: Please get in touch with your faculty member if you experience technical or other challenges in completing this assessment.

Additional Requirements
APA formatting: References and citations are formatted according to current APA style

Improvement Plan Tool Kit