Analyzing a Current Health Care Issue-Medication Errors
The previous assessment identified and presented medication errors as a persistent but preventable healthcare issue that significantly impacts patient safety. As such, this paper develops on the previous assessment and aims to identify the elements of medication errors, including causes and contributing factors, and analyze medication errors, including the setting or context for medications, their significance in nursing practice, and the groups of people affected by medication errors. The paper also discusses the potential solutions for medication errors and selects one solution for implementation, as well as the ethical principles (beneficence, nonmaleficence, autonomy, and justice) to be considered if the potential solution is implemented.
Elements of the Issue
Medication errors are a serious and preventable problem in healthcare that significantly presents a risk to patient safety. Medication errors have the potential to occur at any stage of the medication process. This means that the risk of such errors occurring is high during the point of prescription or during the administration of the medications. The common types of medication errors in nursing include wrong rate of administration, wrong time, wrong dosage, wrong route, wrong drug type, wrong patient, and drug omissions (Alrabadi et al., 2021).
Medication errors are an issue of concern in healthcare, especially nursing care, for several reasons. For instance, medication errors are related to the development of preventable adverse drug effects (ADEs) (Alghamdi et al., 2019), increased length of stay, patient harm and disability, exacerbation of illnesses, and even patient death. Medication errors are therefore focused on due to their negative impact on the quality and safety of care patients receive, the reputation of facility and care providers, and the unintentional increase in healthcare costs.
Various factors potentially contribute to the occurrence of medication errors in nursing. In all cases, medication errors occur due to human errors. Regardless of their experience in delivering healthcare services, including medical care, healthcare professionals like nurses and physicians are prone to make mistakes while writing down medications, misreading prescriptions, calculating dosages, and quoting medications with similar names. Various factors, such as increased workload and work pressure (leading to burnout) and lack of experience, contribute to these mistakes, leading to medication errors. A study by Wondmieneh et al. (2020) found that a majority of medication errors among nurses occurring at the point of administration were linked to a lack of adequate training, lack of clear medication administration guidelines, the nurses’ inadequate experience in medication administration, and patients interrupting the nurses during medication administration. Other contributing factors include poor communication in terms of both verbal and non-verbal, lack of sufficient tech, and cases of complex polypharmacy.
Analysis
As a nurse, it is important to be able to understand medication errors in terms of what they actually are, the settings or context in which they may occur, their significance in nursing practice, and the groups of people affected by or prone to medication errors. In simple terms, medication errors are the resulting events following the mistakes healthcare providers make during the prescription, dispensation, and administration of medications that can potentially harm the patient physically and psychologically.
Setting or Context for Medication Errors
Medication errors can occur in all healthcare settings where pharmacotherapeutic approaches are employed to manage conditions or diseases. This means they may occur in inpatient and outpatient settings and at home. The most common settings are hospital and inpatient settings. Medication errors occur mostly in hospital and inpatient settings due to the high number of people visiting the hospitals and the risk of confusion and pressure from dealing with different types of patients, conditions, and medications. Another common setting where medications occur is in long-term care facilities. Long-term care facilities such as nursing homes and other assisted care settings majorly deal with elderly patients with multiple and complex conditions requiring complex treatment regimens. In elderly care settings, polypharmacy is highly associated with the risk of errors occurring during medication and patients experiencing adverse health outcomes (AL-Musawe et al., 2019). Other settings where medication errors can occur include homecare settings. The risks of medication errors within homecare settings are higher as patients manage the medication administration processes themselves. Issues such as confusion with medications in case of polypharmacy, as well as lack of sufficient knowledge on the medication in terms of time and rate of administration, can increase the risk of medication errors.
Importance of Medication Errors
Understanding medication errors is important to me as a nurse. As noted, medication errors have significant consequences on patients, nurses, and any other healthcare professionals involved in prescribing and administering the medications. Medication errors can harm patients, prolong their hospital stay, and increase the cost of care. In this regard, researching evidence on factors contributing to medication errors and approaches to prevent their occurrence improves my knowledge and skills to employ evidence-based approaches to prevent their occurrence, ensure patient safety, and avoid related liabilities.
Population Groups Affected by Medication Errors
Medication errors affect all population groups within a healthcare system. Medication errors can affect young and elderly patients, women, and men. However, the risk of medication errors varies with disease, the complexity of medication regimens, and the context of medication prescription and administration. However, the experience of adverse drug effects may vary with age and gender, with women being more likely to experience adverse drug reactions due to medication errors (Zucker & Prendergast, 2020).
Considering Options
Various solutions can be implemented in nursing practice to help reduce and prevent the occurrence of medication. Some options that can be adopted as solutions include improving the efficiency of communication among the healthcare providers and between the providers and the patient, improving the nurses’ and patients’ knowledge of medications through training, and using advanced technologies throughout the medication process.
Most medication errors occur due to a breakdown of communication in the medication process. Communication can be improved by recording and using clear terms that all members of a patient care plan, including the patient, understand. This ensures that all members of the team can share accurate information on medication, including dosage and times, hence reducing the risks of medication errors. Besides clear communication, training nurses on medication, such as safe medication administration practices and possible risk factors for medication errors, can improve safety during medication. Enhancing the nurses’ medication knowledge can also make it easy to transfer such knowledge to the patients. Such training can also improve the safety of medication reconciliation during patient transfers.
The implementation of technologies can assist with the medication process from prescription to the point of administration. Technologies such as physician order management systems, barcode medication systems, smart-dispensing cabinets, barcode patient tags, and mobile apps improve the safety of medication administration. Notably, ignoring medication errors can increase patient harm, lead to death, reduce patient satisfaction, and lead to higher costs of care and even malpractice cases. Medication errors alone are linked to 7,000 to 9,000 deaths a year while contributing to a total of $40 billion in medication error-associated costs annually (Tariq et al., 2023).
Solution
The best solution is to employ technology aids in medication administration, especially the Barcode Medication Administration System (BCMA). The BCMA system uses unique identifiers for each patient and each administering provider, as well as the medication type and dosage. The care provider uses the BCMA system to scan and verify medications to determine the appropriate patient, dosage rate, time, and route. The BCMA system significantly improves the safety of the medication administration process (Pruitt et al., 2023). In addition, it is simple and easy to implement. However, knowledge of the system is required to use it efficiently.
Implementation
BCMA system implementation depends on the specific needs of the facility. Generally, the BCMA system requires a uniquely-coded wristband printer, barcode scanner, and management system. The BCMA system should have a secure user identification system. It should also be able to link with other information systems, such as the EHR system. The implementation and use of the BCMA system must adhere to the regulatory requirements and ethical principles in nursing.
Ethical Implications
Implementing the BCMA system creates patient privacy concerns and a risk for cybersecurity threats. The ethical principles that need to be considered during the implementation of the system include the principles of beneficence, nonmaleficence, autonomy, and justice. The system must be developed and implemented for the benefit of the patient. Considering the principle of nonmaleficence, the system must be safe for use and have no risk of harming the patient. The principles of autonomy and justice must also be considered as the patient must make decisions on the use of the system, and the system must be equally available to every patient regardless of their socioeconomic background, age, and gender.
Conclusion
Medication errors in healthcare are a critical problem that can be prevented. Medication errors affect patient safety, risk death, and affect patient experiences. They majorly occur due to human error at the prescription or administration level. Nonetheless, employing technologies such as the BCMA system can improve the safety of the medication process. Conclusively, it is important to ensure that all systems implemented in patient care align with the current regulations and ethical principles.
References
Alghamdi, A. A., Keers, R. N., Sutherland, A., & Ashcroft, D. M. (2019). Prevalence and nature of medication errors and preventable adverse drug events in pediatric and neonatal intensive care settings: A systematic review. Drug Safety, 42(12), 1423–1436. https://doi.org/10.1007/S40264-019-00856-9/TABLES/4
AL-Musawe, L., Martins, A. P., Raposo, J. F., & Torre, C. (2019). The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis. Diabetes Research and Clinical Practice, 155, 107804. https://doi.org/10.1016/J.DIABRES.2019.107804
Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-Rabadi, D., Farha, R. A., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/JPHSR/RMAA025
Pruitt, Z. M., Kazi, S., Weir, C., Taft, T., Busog, D. N., Ratwani, R., & Hettinger, A. Z. (2023). A systematic review of quantitative methods for evaluating electronic medication administration record and bar-coded medication administration usability. Applied Clinical Informatics, 14(1), 185–198. https://doi.org/10.1055/S-0043-1761435/ID/JR202208R0213-33/BIB
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2023). Medication dispensing errors and prevention. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK519065/
Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 1–9. https://doi.org/10.1186/S12912-020-0397-0
Zucker, I., & Prendergast, B. J. (2020). Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences, 11(1), 1–14. https://doi.org/10.1186/S13293-020-00308-5
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Question 
Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.
Describe the healthcare problem or issue you selected for use in Assessment 2 and provide details about it.
Analyzing a Current Health Care Issue-Medication Errors
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.