Enhancing Quality and Safety
Medication administration should be accomplished with caution and precision. This can help to avert potential medication errors. When administering medication, the healthcare provider should countercheck to ensure that the right patient receives the right dosage at the prescribed time. This paper analyzes an experience in healthcare practice related to medication administration safety risk and proposes an initiative to improve quality in the healthcare facility.
Factors Leading to a Specific Patient-Safety Risk: Medication Errors
Medication administration is an important aspect of healthcare practice. Healthcare providers should embrace the standard procedure when administering medication. This standard procedure entails giving the correct medication at the right dose to the right patient, using the prescribed route at the right time (Salami et al., 2019). Failure to adhere to the standard procedure predisposes the patient to medication errors and safety risks. According to Tsegaye et al. (2020), examples of errors in medication administration include overdosing, underdosing, wrong medications, and omission of medication.
According to Hammoudi et al. (2018), overdosing predisposes patients to adverse drug events (ADEs). ADEs prolong recovery times and worsen the patient’s prognosis (Salami et al., 2019). Furthermore, patients incur extra costs in the management of serious adverse drug events. An example is morphine overdose for patients receiving palliative care for chronic severe pain. Essentially, the recommended dose is 15mg, administered twice or thrice daily (Kiyatkin, 2019). An overdose can cause respiratory depression, somnolence, emesis, pruritus, and peripheral edema (Kiyatkin, 2019). Underdosing reduces recovery rates because the plasma profiles of the drug fail to reach the minimum effective concentration (Salami et al., 2019). Consequently, morbidity and mortality rates are increased.
Administration of the wrong medication implies that the intended clinical effect and response will not be elicited. Furthermore, patients are likely to suffer from the side effects of this medication (Koyama et al., 2020). For instance, severe bleeding can occur when warfarin, an anticoagulant, is administered to the wrong patient (Habet, 2021). Just like underdosing, the omission of medication affects the drug’s plasma time profiles by achieving concentrations below the minimum effective concentration (Salami et al., 2019). Accordingly, this reduces recovery rates, prolongs hospital stays and lowers patients’ quality of life.
Evidence-Based and Best-Practice Solutions to Improve Patient Safety
Various strategies can be used to promote appropriate medication administration, lower treatment costs, and improve patient safety. The first strategy is standardized and open communication. In the healthcare facility, this can be achieved by proper labeling of medication and using certified electronic health record (EHR) systems (Tsegaye et al., 2020). EHR systems allow interprofessional collaboration by sharing permissible patient information (Rathert et al., 2019). As a result, this ensures the right medication is given to the right patient at the right time. Open communication also involves identifying drugs whose packages resemble those with sound-alike names (Rodziewicz et al., 2021). This information should be provided to all healthcare providers to avoid administering the wrong medications. When medications are administered correctly, patients’ recovery times will increase, and hospital stays will reduce. Consequently, treatment costs will be reduced significantly.
The other strategy is patient education. Patients should be informed about the importance of compliance on their recovery rates. This is particularly essential when their medication regimen is changed and when they are taking medication with a narrow therapeutic index such as digoxin (Habet, 2021). The other strategy is adopting optimized workflow systems where the healthcare providers are not distracted or interrupted when administering medication. According to Tsegaye et al. (2020), interruptions can deviate the attention of healthcare providers and increase the incidences of medication errors.
Role of Nurses in Coordinating Care to Increase Patient Safety
According to Koyama et al. (2020), nurses can help coordinate care by adopting three strategies: optimizing their workflow, patient education, and embracing double counterchecks. Double counterchecks involve engaging an independent nurse to countercheck a procedure, action, or calculation before administering medication to the patient (Koyama et al., 2020). This increases the likelihood of pointing out a mistake, such as the correctness of the dose and administration technique. Correct medication administration reduces treatment costs by averting adverse drug events, increasing recovery rates, and shortening hospital stays (Rodziewicz et al., 2021). Nurses should participate in educating the patient about the importance of medication adherence. Notably, this should be used in outpatients or patients who are being discharged.
According to Hammoudi et al. (2018), optimization of workflow involves creating an environment that lacks or has few distractors. They can achieve this by labels that prohibit interruptions. An environment deficient in interruptions is ideal for medication administration. Nurses remain focused, and their accuracy in medication administration is increased (Salami et al., 2019). Accuracy of medication administration is associated with minimal adverse drug events, better recovery rates, and shortened hospital stays. Subsequently, this implies that patients attend to less costly hospital bills, hence lower treatment costs.
Stakeholders that Coordinate with Nurses
The stakeholders involved in ensuring safety enhancements with the administration of medications are nurses, pharmacists, physicians, and hospital administration. Pharmacists should provide sufficient and accurate information regarding the dosage, dosing frequency, and route of administration (Rodziewicz et al., 2021). Furthermore, they should educate patients on the importance of adherence to treatment and the interventions to take following an overdose or missed medication. Physicians should accurately diagnose patients and develop evidence-based treatment plans (Rodziewicz et al., 2021). Ideally, this will ensure that the right patient receives the right medication. They are also involved in patient education concerning the importance of adherence to the prescribed medication. The hospital administration should ensure that nursing workflow services are optimized. This can be achieved by developing strategies that ensure that medication administration areas are devoid of unnecessary distractions.
In conclusion, medication administration should be accomplished with caution and precision. This can help to avert potential medication errors. This standard procedure entails giving the correct medication at the right dose to the right patient, using the prescribed route at the right time. Nurses, pharmacists, physicians, and hospital administrators are key stakeholders in ensuring safety enhancements with medication administration.
References
Habet, S. (2021). Narrow Therapeutic Index Drugs: Clinical Pharmacology Perspective. Journal of Pharmacy and Pharmacology, 73(10), 1285–1291. https://doi.org/10.1093/jpp/rgab102
Hammoudi, B. M., Ismail, 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
Kiyatkin, E. A. (2019). Respiratory Depression and Brain Hypoxia Induced by Opioid Drugs: Morphine, Oxycodone, Heroin, and Fentanyl. Neuropharmacology, 151(443), 219–226. https://doi.org/10.1016/j.neuropharm.2019.02.008
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
Rathert, C., Porter, T. H., Mittler, J. N., & Fleig-Palmer, M. (2019). Seven Years After Meaningful Use: Physicians’ and Nurses’ Experiences with Electronic Health Records. Health Care Management Review, 44(1), 30–40. https://doi.org/10.1097/HMR.0000000000000168
Rodziewicz, T. L., Houseman, B., Hipskind, J. E. (2021). Medical Error Reduction and Prevention. In: StatPearls. StatPearls Publishing, Treasure Island (FL); PMID: 29763131. https://europepmc.org/article/NBK/nbk499956
Salami, I., Subih, M., Darwish, R., Al-Jbarat, M., Saleh, Z., Maharmeh, M., Alasad, J., & Al-Amer, R. (2019). Medication Administration Errors: Perceptions of Jordanian Nurses. Journal of Nursing Care Quality, 34(2), E7–E12. https://doi.org/10.1097/NCQ.0000000000000340
Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication Administration Errors and Associated Factors Among Nurses. International Journal of General Medicine, 13, 1621–1632. https://doi.org/10.2147/IJGM.S289452
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Question 
For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.
Enhancing Quality And Safety
Healthcare organizations and professionals strive to create safe environments for patients; however, due to the complexity of the healthcare system, maintaining safety can be a challenge. Since nurses comprise the largest group of healthcare professionals, a great deal of responsibility falls in the hands of practicing nurses. Quality improvement (QI) measures and safety improvement plans are effective interventions to reduce medical errors and sentinel events such as medication errors, falls, infections, and deaths. A 2000 Institute of Medicine (IOM) report indicated that almost one million people are harmed annually in the United States (Kohn et al., 2000), and 210,000–440,000 die as a result of medical errors (Allen, 2013).
The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improve patient safety, and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care.
You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement.
Demonstration of Proficiency
By successfully 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.
Explain evidence-based and best-practice solutions to improve patient safety, focusing on medication administration and reducing costs.
Competency 2: Analyze factors that lead to patient safety risks.
Explain factors leading to a specific patient safety risk focusing on medication administration.
Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Organize content so ideas flow logically with smooth transitions; contain few errors in grammar or punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
References
Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? Retrieved from https://www.npr.org/sections/health-shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals.
Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in healthcare settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development of a patient safety culture.
Scenario
Consider a previous experience or hypothetical situation pertaining to medication errors, and consider how the error could have been prevented or alleviated with the use of evidence-based guidelines.
Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.
For this assessment:
Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.
Instructions
The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks in a healthcare setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in healthcare settings from organizations such as QSEN and the IOM. Looking through the lens of these professional best practices to examine the current policies and procedures in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance the quality of care and promote medication administration safety in the context of your chosen healthcare setting.
Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.
Explain factors leading to a specific patient safety risk focusing on medication administration.
Explain evidence-based and best-practice solutions to improve patient safety, focusing on medication administration and reducing costs.
Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.
Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using the current APA style.
Additional Requirements
Length of submission: 3–5 pages, plus title and reference pages.
Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: References and citations are formatted according to the current APA style.