Enhancing Quality and Safety

Enhancing Quality and Safety

Factors Leading to A Specific Patient-Safety Risk

One major safety quality issue related to medication administration is the wrong dosage. This risks patient safety since overdosing on a medication can lead to serious adverse drug reactions that worsen a patient’s health or even cause death. This is a common safety issue caused by nurses because most medical orders are carried out by nurses, who also spend most of their time in hospitals giving out medication. Administration of the wrong drug dose among nurses can be caused by similarities in the names, appearance, and packaging of many drugs (Bryan et al., 2021). In some cases, different strengths of a given drug can have similarities in appearance, packaging, or generic names. This can lead to nurses confusing the strengths of the drug; hence, they end up administering the wrong dose. In addition, increased workload among nurses leads to the administration of wrong doses of medications. This is common in healthcare settings where there is understaffing in the nursing department, and a given nurse has to administer medications to many patients.

Inadequate pharmacological knowledge is also a causative factor for the administration of wrong doses of medications. Nurses may lack adequate knowledge to calculate the required doses of drugs before administering them (Escrivá Gracia et al., 2019). The administration of wrong doses of medications among nurses is also caused by their inability to interpret medical orders. This can arise from physicians using abbreviations and illegible handwritten medical orders. The role of human factors in the administration of wrong doses of medications cannot be underrated. Factors such as interruptions, noisy working conditions, poorly designed equipment, failure to communicate, inattention, and fatigue also play a significant role. All these factors can significantly impact patient safety if not resolved.

Evidence-Based and Best-Practice Solutions to Improve Patient Safety

To improve medication safety while reducing costs, strategies targeting the factors causing medication administration errors should be implemented. First, it should be ensured that the nursing departments in hospitals are adequately staffed. The ratio of patients to nurses should be one that does not make nurses overwhelmed with activities. Since poor pharmacological knowledge can lead to medication administration errors, upgrading nurses’ pharmacology knowledge through ongoing education should be emphasized. Medical orders should also be made clearer to nurses. Instead of using illegible handwritten medical orders, electronic prescribing can be implemented. Accordingly, as shown by Kenawy & Kett (2019), electronic prescribing can lead to an 18.2% increase in prescriptions free of errors. Where electronic prescribing cannot be effectively implemented, standards relating to handwritten medical orders should be emphasized. For instance, physicians should ensure they use legible handwriting and include all the necessary information on medical orders.

Physicians should ensure that medical orders have the name of the medication, required dose, frequency of administration, route of administration, indication, and, if relevant to dosage, the age and weight of the patient. Besides, they should only use standardized abbreviations while avoiding the ‘Do Not Use’ abbreviations developed by The Joint Commission. It is also crucial for all team members to reduce interrupting nurses who are administering or preparing to administer medications. Approaches such as using colored vests by nurses when administering medications, do not disturb signs in areas where drugs are administered, and no distraction zones can be used to minimize interruptions (Schroers, 2020). Nurses should also ensure they adhere to the five rights of drug administration: right patient, right medication, right route, right dose, and the right time. This can help them ensure they are doing the right thing.

Role of Nurses in Coordinating Care to Increase Patient Safety

Coordination of patient care has traditionally been one of the responsibilities of nurses. Nurses can promote patient safety by establishing a collaborative culture involving pharmacists, nurses, doctors, and other healthcare professionals. This can enable them to raise concerns when they are not sure of something about a medical order. They should create an environment where other healthcare professionals educate them on administering certain medications. This can be achieved through good interpersonal relationships with other healthcare professionals.

Moreover, nurses can coordinate care by developing a process for reporting medication errors. This would involve setting the best approach that can be used to inform other healthcare professionals about medication errors. Such an approach could be proper documentation of medication errors and organizing sessions where they can present the medication errors. Where mistakes from other healthcare professionals cause medication errors, they would learn about their mistakes and correct them accordingly.

Stakeholders Nurses Can Coordinate With

Nurses must collaborate with several stakeholders to drive quality and safety enhancements with medication administration. First, they would have to collaborate with software development teams during the design of a new drug administration system. Their input in this suggests information and data required to ensure medications are administered without errors. Nurses can also collaborate with drug manufacturers to promote patient safety. They can make recommendations to drug manufacturers on how best drugs should be packaged or labeled to avoid confusion during drug administration. This would help minimize similarities between medications. Also, they should coordinate with health administrators to develop policies that promote patient safety. They can do this by recommending to administrators how a healthcare organization can be organized to ensure medications are administered appropriately. Furthermore, helping health administrators develop policies that regulate healthcare professionals’ conduct would be beneficial. Regulating the conduct of healthcare professionals would help minimize medication errors caused by interruptions.

 References

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

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4481-7

Kenawy, A. S., & Kett, V. (2019). The impact of electronic prescription on reducing medication errors in an Egyptian outpatient clinic. International Journal of Medical Informatics, 127, 80–87. https://doi.org/10.1016/j.ijmedinf.2019.04.005

Schroers, G. (2020). Realistic Interruptions during Simulated Medication Administration: An Examination of Errors and Interruption Management Strategies. ProQuest, 7(1), 37–72. https://www.researchgate.net/publication/269107473_What_is_governance/link/548173090cf22525dcb61443/download%0Ahttp://www.econ.upf.edu/~reynal/Civil wars_12December2010.pdf%0Ahttps://think-asia.org/handle/11540/8282%0Ahttps://www.jstor.org/stable/41857625

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For this assessment, you will develop a 3-5 page paper examining a safety quality issue concerning medication administration in a health care setting. You will analyze the issue and discuss potential evidence-based and best-practice solutions from the literature and 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, maintaining safety can be challenging due to the complexity of the healthcare system. 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 about 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 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 must 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 development of a patient safety culture.

Scenario
Consider a previous experience or hypothetical situation about errors and how the error could have been prevented or alleviated with the use-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
This assessment aims to understand better the baccalaureate-prepared nurse’s role 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 explore the professional guidelines and best practices from organizations such as QSEN and the IOM for improving and maintaining patient safety in healthcare settings. Looking through the lens of these professional best practices to examine your chosen organization’s current policies and procedures and the impact on patient safety measures surrounding medication administration, you will consider the nurse’s role in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures and consider evidence-based strategies to enhance the quality of care and promote medication administration safety in your chosen healthcare setting.

Be sure that your plan addresses the following, corresponding to the grading criteria in the scoring guide. Please study the scoring guide carefully to 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 clear, logical, and professional writing, 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 five years old.