Enhancing Quality and Safety
The provision of safe and quality care is a fundamental function of all healthcare providers. Evidence-based care practices inform quality and safe care. The position of nurses in healthcare places them in a strategic position to enhance quality improvement measures and the safety of the patients. Medication administration is a specific healthcare field that accounts for significant quality compromises in nursing practices in healthcare. These compromises include border dosing, adverse drug reactions, and drug interactions, among others. This paper explores administration errors as a medication administration safety risk in the inpatient department.
Factors Leading to Administration Errors
Nurses are primarily involved in administering medication at all levels of care across all settings. Research findings on medication administration reveal an error rate of close to 60% (Härkänen et al., 2019). Factors leading to administration errors during medication administration include inadequate knowledge of medications, negligence of the caregiver, similar drug names, heavy workload on the nurses’ end, and interruptions during drug administration (Wondmieneh et al., 2020). Inadequate knowledge of the pharmacokinetic properties of a drug may cause a nurse to give a medication via the wrong route. Nurse negligence has also been implicated in medication errors. It pushes the nurse to commit medication administration errors, such as giving a drug to the wrong patient. Excessive workload on nurses often causes burnout and subsequently impairs their mental functionalities. As a result, they may commit medication errors. Drugs with similar names or labelling are also a source of administration errors. An example of such a drug is Aggrastat, which is often confused with Argatroban.
Evidence-based and Best-Practice Solutions to Improve Patient Safety
Safety improvement in medication administration focuses on addressing the causal factors for these medication administration errors. Evidence-based and best practice solutions for eliminating medication administration errors include collaborating with a pharmacist during medication administration, educating nurses on medication administration, reducing the workload on nurses by staffing and staff scheduling, and creating an enabling environment for nursing practice (Abdulmutalib & Safwat, 2020). Pharmacists, being drug specialists, can assist nurses in determining the rates of drug administration, route of drug administration, and right dosage of various drugs. The QSEN institute recommends that nurses work collaboratively with other caregivers toward safe and quality care. They are also expected to embrace teamwork in care provision as it enhances the quality of care provision.
Nurses can also boost their knowledge of drugs to minimize education errors. The Institute of Medication (IOM) recommends that nurses have basic knowledge of medications to prevent them from committing medication errors. Education on drugs, dosing, and indication may enable them to make correct decisions on drugs, thus eliminating potential errors. Reducing the workload on nurses can enable them to operate optimally and thus eliminate errors accustomed to poor mental functionalities. The workload on nurses can be reduced by staffing and by nursing schedules. Creating an enabling environment is another healthcare practice that may enable the minimization of medication errors. An optimal clinical environment eliminates disruptions that may arise during drug administration and contribute to medication errors. Minimizing medication errors in the inpatient clinical setting, in turn, reduces the incidence of morbidities associated with medication errors. The impact is often evident in shorter hospital stays, fewer hospital readmissions, and optimal clinical outcomes, the consequence of which is reduced healthcare costs.
Role of Nurses in Coordinating Care to Increase Patient Safety
Care coordination is a special element in care provision that draws multiple disciplines into care processes. Nurses can help coordinate care to increase patient safety by collaborating with other caregivers in designing therapeutic plans, sharing knowledge about the patient with other caregivers, working to ensure a seamless transition of care processes, and supporting individual patients in managing their therapeutic goals (Oldland et al., 2020). Collaborating with other caregivers ensures a broader multifaceted care approach that ensures optimal outcomes. Nurses also coordinate care by sharing their knowledge with other caregivers during patient handling. This knowledge may be valuable in informing quality improvement measures and safety enhancement for the patients. Seamless transitions are also important as they eliminate gaps in care provision that would have otherwise impacted the patients negatively. These measures in care coordination ensure quality and safe care provision.
Stakeholders with Whom Nurses Would Coordinate to Drive Safety Enhancements
Several stakeholders in healthcare are valuable in driving safety enhancement during medication administration. These stakeholders include clinicians, patients, hospital administration, legislative and professional bodies, and accrediting bodies (Salar et al., 2020). Other clinicians besides nurses are directly involved in patient handling and may work with nurses to put down measures to enhance the safety of the patients. Administrators are also key as they help in functional support and capacity enhancement of hospitals’ staff and functionalities, therefore, ensuring quality care provision. Legislative bodies define the contractual and legal requirements of healthcare facilities and healthcare providers towards enhancing the safety of patients. On the other hand, professional bodies define the standards of practice and ensure that nurses work within their scope of practice and in a manner consistent with the aggregable standards of the profession. Nurses should coordinate with all these bodies due to their significance in ensuring quality and safe care provision.
Conclusion
Quality and safe care provision remains a fundamental functionality of healthcare providers. Nurses, in particular, play a pivotal role in enhancing quality improvement measures and the safety of their patients. Medication administration provides a challenging aspect of nursing practice and a source for compromises in quality. Understanding aspects of medications and medication administration, as well as care coordination, may enable them to execute their mandate in a manner that guarantees quality and safety.
References
Abdulmutalib, I., & Safwat, A. (2020). Nursing Strategies for Reducing Medication Errors. Egyptian Journal of Nursing and Health Sciences, 1(1), 26-41. https://doi.org/10.21608/ejnhs.2020.80266.
Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A., & Franklin, B. (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.
Oldland, E., Botti, M., Hutchinson, A., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare — Exploration of content validity. Collegian, 27(2), 150-163. https://doi.org/10.1016/j.colegn.2019.07.007.
Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. https://doi.org/10.1016/j.ijans.2020.100235.
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). https://doi.org/10.1186/s12912-020-0397-0
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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 practising 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 practising 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; contains 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 health care 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 at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care 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 currently 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 quality of care and promote medication administration safety in the context of your chosen health care 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 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 current APA style