Enhancing Quality and Safety-Role of Nurses in Medication Administration
Nurses play a key role in medication administration. Medication administration is a significant process because it determines treatment outcomes. Nurses should adhere to the standards and protocols when administering medication. After all, ineffective medication administration reduces patient safety and increases the risk of toxicities. This paper discusses the safety risks associated with medication administration, strategies for improving patient safety, and the role of an interdisciplinary team in care coordination.
Factors Leading to a Specific Patient-Safety Risk
Various factors have been implicated in medication administration (M.A.) errors. M.A. errors impact patient safety by increasing the risk of toxicities and suboptimal clinical outcomes (Härkänen et al., 2019). Toxicities result from overdoses, whereas overdoses and wrong administration techniques cause suboptimal clinical outcomes (Härkänen et al., 2019). Firstly, inadequate training increases the risk of medication administration errors. On the other hand, regular training minimizes these errors by ensuring that nurses gain pertinent knowledge and skills regarding medication administration (Tsegaye et al., 2020). Secondly, distractors and interruptions increase the risk of M.A. errors. Distractors and interruptions will likely create confusion and mix-ups, leading to M.A. errors (Tsegaye et al., 2020). Thirdly, the absence of standard operating procedures (SOPs) and policies increases the risk of M.A. errors. Notably, SOPs and policies create harmony in clinical practice by adopting evidence-based practices (Kuitunen et al., 2021). Fourthly, lacking open communication increases the risk of M.A. errors (Tsegaye et al., 2020). Therefore, nurses should communicate effectively with other nurses, members of the interdisciplinary team, and patients. Open communication eliminates confusion and creates harmony among the team.
Evidence-Based and Best-Practice Solutions
Nurses and interdisciplinary team members should adopt different strategies to address M.A. errors to increase patient safety. Firstly, they should optimize their workflow. Optimizing workflow can be accomplished by implementing double checks, avoiding distractors, and reducing interruptions (MacDowell et al., 2021). Double-checking requires an independent nurse to verify and approve medications before administering them (MacDowell et al., 2021). Independent verifications increase the accuracy of medication administration. MacDowell et al. (2021) report that distractions and interruptions can be minimized by establishing dedicated medication areas and formulating policies to limit disruptions.
Secondly, standardized communication and regular training will minimize M.A. errors. Standardized communication via electronic health record systems helps to minimize errors emanating from “look-alike and sound alike” medication (MacDowell et al., 2021). Furthermore, this communication promotes adequate labeling to avoid confusion and mix-ups. By so doing, the risk of M.A. errors is lowered. On the other hand, regular training minimizes these errors by ensuring that nurses gain pertinent knowledge and skills regarding medication administration (MacDowell et al., 2021).
Thirdly, technology should be embraced to mitigate M.A. errors. Using barcodes minimizes medication administration errors by ensuring the right patient receives the correct medication and dosage (Vilela & Jericó, 2019). Findings indicate that using barcodes reduces the risk of medication administration errors by approximately 41 percent (MacDowell et al., 2021). Nurses and other healthcare providers should receive adequate training on using barcodes to improve workflow. Smart infusion pumps are another technological advance that mitigates M.A. errors. MacDowell et al. (2021) report that these infusion pumps are important because they detect potential errors and prompt nurses to correct them.
The Role of Nurses in Care Coordination and Patient Safety
Nurses should adopt optimized workflow, collaborate with other healthcare providers, and provide patient education to achieve care coordination. They can achieve optimized workflow by embracing double checks, limiting distractors, and reducing interruptions (MacDowell et al., 2021). Double-checking allows independent nurses to verify and approve medication before administering it. Independent verifications increase the accuracy of medication administration (MacDowell et al., 2021). As a result, the risk of M.A. errors is reduced, and patient safety is increased. Reduced MA errors are associated with high recovery rates and shortened hospital stays, and hence, reduced treatment costs (Tsegaye et al., 2020). Nurses should work in concert with other healthcare providers to achieve patient safety. As key stakeholders in medication administration and patient monitoring, nurses should update the interdisciplinary team on the treatment process (Tsegaye et al., 2020). Collaboration ensures and promotes accountability among team members. This will increase the quality of care, reduce M.A. errors, and lower treatment costs. Furthermore, nurses should embrace patient education. These sessions should address aspects such as medication adherence and medication use.
Stakeholders Involved in Care Coordination
Nurses should collaborate with other interdisciplinary team members to achieve care coordination and reduce medication administration errors. These members include pharmacists, physicians, and administrators. Hospital administrators play a key role in resource allocation to implement strategies for mitigating M.A. errors. For instance, they should allocate adequate resources to acquire relevant healthcare technology such as barcodes and smart infusion pumps. Furthermore, administrators play a key role in formulating policies that optimize workflow, such as limiting distractions and interruptions in medication administration units. Physicians are key in performing accurate diagnoses and formulating patient-centered treatment plans (Rodziewicz et al., 2021).
Moreover, they educate patients about their condition and the relevance of adherence to the treatment plan. Lastly, pharmacists enforce the rational use of medication such as antimicrobials (Rodziewicz et al., 2021). To accomplish this, they collaborate with physicians and nurses. Also, they provide pertinent patient education regarding medication use. Patient education entails medication administration (insulin administration), medication adherence, and potential adverse effects.
References
Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D. (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
Kuitunen, S., Niittynen, I., Airaksinen, M., & Holmström, A. R. (2021). Systemic defenses to prevent intravenous medication errors in hospitals: A systematic review. Journal of Patient Safety, 17(8), E1669–E1680. https://doi.org/10.1097/PTS.0000000000000688
MacDowell, P., Cabri, A., & Davis, M. (2021). Medication Administration Errors. https://psnet.ahrq.gov/primer/medication-administration-errors
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2021). Medical Error Reduction and Prevention. In: StatPearls. StatPearls Publishing, Treasure Island (F.L.); PMID: 29763131. https://europepmc.org/article/NBK/nbk499956
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
Vilela, R. P. B., & Jericó, M. de C. (2019). Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results. Einstein (Sao Paulo, Brazil), 17(4), eGS4621. https://doi.org/10.31744/einstein_journal/2019GS4621
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Question 
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 examine 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-Role of Nurses in Medication Administration
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 (Q.I.) 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 (Q.I.) and patient safety measures in healthcare settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development a patient safety culture.
Scenario
Consider a previous experience or hypothetical situation about medication errors and how the error could have been prevented or alleviated with 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 (Q.I.) initiative in the healthcare setting.
Instructions
This assessment aims to understand better the baccalaureate-prepared nurse’s role in enhancing quality improvement (Q.I.) 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. You will consider the nurse’s role in driving quality and safety improvements by 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 identify stakeholders in Q.I. 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
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.
APA formatting: References and citations are formatted according to the current APA style.