Enhancing Quality and Safety in a health care setting.

Enhancing Quality and Safety in a health care setting.

Preventable medication errors can occur at any stage of the medication process; during prescription, registration of orders, during data entry of orders, or during preparation and administration of the medication. The riskiest are errors occurring at the administration stage. Medication administration errors are linked to adverse drug events that cause patient harm, a prolonged state of illness, patient dissatisfaction with care, and increased costs of care for both the patient and the health system (Elliott et al., 2021). This paper will explain the factors that lead to adverse drug events during medication administration and provide evidence-based practice solutions to improve patient safety and reduce care costs. The paper will also review how nurses can coordinate to improve quality and safety and reduce costs. Finally, it will identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.

Factors Leading to Adverse Drug Events Related to Medication Administration Errors

Adverse drug events (ADEs) are preventable adverse events in healthcare settings that occur when a patient is harmed by the medications administered. Adverse drug events risk patient safety and significantly impact the quality of care patients receive. Additionally, ADEs occur when a medication error occurs during the drug administration process, leading to the patient experiencing a harmful reaction to the administered medications. There are various factors contributing to the occurrence of ADEs in medication administration. A major factor for ADEs is a reaction between two or more medications that a patient has received due to a conflict in the medications’ pharmacological properties. The drug-drug interaction leading to ADEs is majorly unpredictable and, in most cases, results in an increased risk of morbidity and patient mortality (Noor, 2022). Another factor leading to ADEs in medication administration is related to prolonged use of the same medication or a combination of medications. Prolonged drug use can reduce the efficiency of drug clearance from the patient’s bodily systems, leading to toxic concentrations (Gotou et al., 2022). This not only risks patient harm, but it also can lead to dependency. Other factors leading to ADEs are the age-related increase in drug use due to comorbid health conditions, individual patient-specific factors such as allergies to certain medications, the number of medications an individual takes at a time, type of medications, especially those that risk addiction such as opioids, route of medication administration, and the dosage administered.

Evidence-Based and Best-Practice Solutions to Improve Patient Safety with a Focus on Medication Administration and Reducing Costs

The quality and safety of patient care as well as the costs of care, can be improved within healthcare settings by improving the safety of medication administration. Quality improvement initiatives aimed at reducing and preventing the occurrence of medication errors during the administration stage should focus on improving the entire medication process. Various evidence-based and best practices solutions can help improve patient safety and reduce care costs by improving the safety of medication administration. For instance, a study by Alrabadi et al. (2021) focused on improving nursing practice as a major approach to reducing medication errors throughout the treatment process. Alrabadi et al. (2021) found that strategies such as educating and training nurses and establishing standardized medication administration procedures reduced errors throughout the medication process. Additionally, the use of double checking the medications against the physician’s medication orders before the administration can help reduce the occurrence of medication errors with an impact on patient safety. Talking and informing the patient about the type of medications they are being administered with and establishing an environment of open communication between the patient, the healthcare professional, and within the interdisciplinary care team can also help reduce the occurrence of medication errors (Alrabadi et al., 2021). Other evidence-based and best practices to improve the quality and safety of medication administration include improving the clarity and quality of the drug labeling and packaging, reducing distractions within the medication administration environment, and following the guidelines for drug administration, including the time, site, and method of medication administration.

How Nurses Can Help Coordinate Care to Increase Patient Safety in Medication Administration and Reduce Costs

A majority of medication administration errors impact patient safety and increase care costs, which occur mostly in nursing care settings (Wondmieneh et al., 2020). This makes nurses essential to the efforts towards reducing and preventing medication administration errors and increasing patient safety. The reduction of the occurrence of medication administration errors can reduce the financial impacts associated with ADEs, therefore resulting in the reduction of healthcare costs. There are various ways nurses can help coordinate care to reduce and prevent medication administration errors, improve patient safety, and reduce care expenses. Firstly, nurses work at the bedside and are in close contact with patients. They can utilize this to educate patients about medication administration, types of medications, related side effects, risks of overdose or overuse, and potential drug interactions. Nurses can also help maintain the patients’ charts, both physical and electronic, to ensure that each member of the care team has access to the patient’s accurate historical information. This can help reduce the chances of providing medications that can lead to adverse reactions. Additionally, due to their proximity to patients during care, nurses can observe patients during and after medications have been administered and immediately report any signs of adverse reactions for timely treatment.

Stakeholders with Whom Nurses Would Coordinate to Enhance Safety with Medication Administration

In their efforts to improve patient safety by improving medication administration, nurses need to collaborate with other stakeholders within the care settings. As such, nurses must be able to coordinate with interdisciplinary team members such as physicians, pharmacists, the records and patient information management team, the patient, their family members and closest caregivers, and other nurses within the team.

Conclusion

Although medication administration errors are preventable, they continuously occur within nursing settings, compromising patient safety and quality of care. Nurses are key to preventing the occurrence of ADEs by improving the safety and quality of medication administration. However, preventing medication administration errors is a collaborative effort across various stakeholders involved in the treatment and medication process. In conclusion, improving the safety of the medication administration process improves patient safety and quality of care and helps reduce healthcare costs.

References

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

Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2), 96–105. https://doi.org/10.1136/BMJQS-2019-010206

Gotou, M., Suzuki, A., Shiga, T., Wakabayashi, R., Nakazawa, M., Kikuchi, N., & Hagiwara, N. (2022). Adverse Drug Reactions in Japanese Patients with End-Stage Heart Failure Receiving Continuous Morphine Infusion: A Single-Center Retrospective Cohort Study. Drugs – Real World Outcomes, 9(1). https://doi.org/10.1007/S40801-021-00281-4

Noor, A. (2022). A Data-Driven Medical Decision Framework for Associating Adverse Drug Events with Drug-Drug Interaction Mechanisms. Journal of Healthcare Engineering, 2022. https://doi.org/10.1155/2022/9132477

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/TABLES/4

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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 in a health care setting.

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 from organizations such as QSEN and the IOM for improving and maintaining patient safety in health care settings. 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 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.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE