Improvement Plan Tool Kit

Administering medications safely and accurately is essential in delivering safe medical care. The improvement plan tool kit helps nurses to focus on appropriate measures to reduce medication errors in the hospital setting. This tool kit has four themes with three annotated sources for each theme. The themes include effective communication, best practices for reporting and improving safety, strategies to incorporate medication safety technologies, and the role of staff in reducing medication errors.

Annotated Bibliography

Effective Communication

Aldawood, F., Kazzaz, Y., AlShehri, A., Alali, H., & Al-Surimi, K. (2020). The daily safety huddle tool enhances teamwork communication and patient safety responsiveness in a pediatric intensive care unit. BMJ Open Quality, 9(1), 1–5. https://doi.org/10.1136/bmjoq-2019-000753

The article is about a study on how a Daily Safety Huddle tool can enhance team communication and responsiveness to patient safety. It describes how the TeamSTEPPS quality approach using the Daily Safety Huddle tool can improve communication between frontline staff and unit leadership. The Daily Safety Huddle tool allows frontline staff, such as nurses, to communicate issues related to patient safety, like medication errors. This facilitates the swift handling of such patient safety issues. Since effective communication is essential in promoting teamwork, the article is relevant as it enables nurses to learn how to work in a team using the Daily Safety Huddle tool.

Blake, T., & Blake, T. (2019). Improving therapeutic communication in nursing through simulation exercise. Teaching and Learning in Nursing, 14(4), 260–264. https://doi.org/10.1016/j.teln.2019.06.003

This article discusses the importance of nursing lab simulation in improving the therapeutic communication skills of nursing students. The study in the article used role-play simulation to assess nursing students’ communication skills. The students were also allowed to evaluate their self-efficacy about therapeutic communication. The article is helpful to nurses as it gives them an idea of improving communication in a healthcare setting through role-play simulations, thus minimizing medication errors. Nurses learn that simulation-based training, followed by assessing their self-efficacy, can help them learn how to communicate with patients and other healthcare professionals.

Syyrilä, T., Vehviläinen-Julkunen, K., & Härkänen, M. (2020). Communication issues contributing to medication incidents: Mixed-method analysis of hospitals’ incident reports using indicator phrases based on literature. Journal of Clinical Nursing, 29(13–14), 2466–2481. https://doi.org/10.1111/jocn.15263

This is an article of a study done to assess communication issues contributing to medication errors and compare the problems that led to moderate or severe patient harm. The targeted communication issues are communication pairs, structural, institutional, process, person-related, and prescription-related issues. Twenty-eight communication pairs linked to medication errors were found, with the most common pairs being nurse-physician, nurse-patient, and nurse-nurse. Other communication issues identified were being unaware of guidelines, false assumptions about work processes, lack of communication within a team, and digital communication. The article is relevant and can help a reader identify the most common communication issues that should be targeted in a program that aims at reducing medication errors. Nursing students learn the areas to improve their communication skills based on the most common communication pairs identified in the study.

Best Practices for Reporting and Improving Safety

Kim, M. S., & Kim, C. H. (2019). Canonical correlations between individual self-efficacy/organizational bottom-up approach and perceived barriers to reporting medication errors: A multicenter study. BMC Health Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4194-y

This article is about a study examining individual and organizational factors that correlate with barriers to reporting medication administration errors. The article posits that reporting medication administration errors in the clinical phase can be enhanced through positive collaboration among healthcare professionals and education on medication administration. Also, promoting analytic decision-making through establishing an evidence-based reporting system can improve the reporting of medication errors. Given that the study in the article used questionnaires on nursing decision-making, knowledge of high-alert medication, and nurse-physician collaboration satisfaction, the reader can understand the factors that prevent nurses from reporting medication errors. Therefore, nurse managers can target these barriers to reduce medication errors.

Mutair, A. Al, Alhumaid, S., Shamsan, A., Zaidi, A. R. Z., Mohaini, M. Al, Al Mutairi, A., Rabaan, A. A., Awad, M., & Al-Omari, A. (2021). The Effective Strategies to Avoid Medication Errors and Improving Reporting Systems. Medicines, 8(9), 46. https://doi.org/10.3390/medicines8090046

This article discusses approaches that can be used to minimize medication errors and improve systems for reporting medication errors. It reviews 60 papers after an electronic search, including ProQuest, EMBASE, EBSCOhost, Ovid, and PubMed. The article calls for the need for a reporting culture, the development of incident reporting systems, and the development of an effective reporting method based on the pre-intervention, intervention, and post-intervention phases. In addition, a reporting system should have a blame-free culture, promote anonymity, promote accountability, be system-oriented, promote psychological safety, have enough resources, and promote the physical well-being of health care professionals. The information in the article can help the reader develop an effective medication error reporting program. It is valuable to nurses as it can feed them the information they can use to coordinate with other healthcare providers to improve medication error reporting.

Samsiah, A., Othman, N., Jamshed, S., & Hassali, M. A. (2020). Knowledge, perceived barriers and facilitators of medication error reporting: a quantitative survey in Malaysian primary care clinics. International Journal of Clinical Pharmacy, 42(4), 1118–1127. https://doi.org/10.1007/s11096-020-01041-0

This article helps analyze knowledge, motivations, and barriers to medication error reporting among healthcare professionals. A self-administered survey was administered to healthcare professionals in 27 primary care settings. Based on the article, nurses have poor knowledge about medications compared to doctors and pharmacists. Identified barriers to medication error reporting are poor knowledge, heavy workload, and time constraints. Medication error reporting can be enhanced through anonymous reporting and awareness of patient harm. The article can enable the reader to understand why some healthcare professionals report medication errors while others do not. Given that nurses encounter poor knowledge, heavy workloads, and time constraints, they can be informed through the article about how these challenges prevent them from reporting medication errors.

Strategies to Incorporate the Use of Medication Safety Technologies

Burkoski, V., Yoon, J., Solomon, S., Karas, A., Jarrett, S., Collins, B., & Hall, T. (2019). Closed-Loop Medication System: Leveraging Technology to Elevate Safety. Nursing Leadership, 32. https://doi.org/https://doi.org/10.12927/cjnl.2019.25817

This is an article about a study done to determine the effectiveness of barcode medication administration (BCMA) and closed-loop medication systems (CLMS) in reducing the rates of medication errors and adverse events related to drugs. It describes how the technologies were implemented in a hospital setting. The rates of medication errors and adverse drug events were determined on implementation. From the article, it can be noted that the implementation of the technologies should be done in stages for them to be effective. Healthcare professionals are also required to collaborate in using the technologies. The information in the article is helpful to nurses as they can learn how to use the technologies to reduce medication errors. They also learn how to collaborate with other healthcare professionals when implementing technologies for medication safety.

Harrington, L. (2019). Use errors with health care technologies: An inconvenient truth. AACN Advanced Critical Care, 30(1), 12–15. https://doi.org/10.4037/aacnacc2019884

The article highlights use errors associated with the use of healthcare technologies. Use errors are unintended effects that occur as humans interact with technologies. It is suggested in the article that the majority of use errors arise during the design and testing of healthcare technologies. This implies that strategies to avoid use errors should focus on modification of the design of the technologies. Also, these errors are best identified through a thorough root-cause analysis. This article is valuable as it provides information on the sources of use errors and how they should be handled. Since such errors can be medication errors, the article can help a nurse carry out a root-cause analysis of medication errors arising from issues in the design of medication safety technologies.

Ting, H. W., Chung, S. L., Chen, C. F., Chiu, H. Y., & Hsieh, Y. W. (2020). A drug identification model developed using deep learning technologies: Experience of a medical center in Taiwan. BMC Health Services Research, 20(1), 1–9. https://doi.org/10.1186/s12913-020-05166-w

This article describes how a model developed using deep learning technologies can be used to identify drugs. In the study, You Only Look Once (YOLO) was used to implement the suggested deep learning. It was used to identify blister-packaged medicines, and the drugs were identified using photos taken from various angles. The reader of the article can learn how to use deep learning technologies to minimize medication errors arising from look-alike and sound-alike (LASA) medications. Nurses can use the information in the article to learn how to use deep learning technologies to administer LASA medications without making errors.

The Role of Staff in Reducing Medication Errors

Alomari, A., Sheppard-Law, S., Lewis, J., & Wilson, V. (2020). Effectiveness of Clinical Nurses’ interventions in reducing medication errors in a pediatric ward. Journal of Clinical Nursing, 29(17–18), 3403–3413. https://doi.org/10.1111/jocn.15374

This article analyzes the effectiveness of interventions by clinical nurses in reducing medication errors. The interventions in the article include using medication administration trolleys with a computer, monthly quality and safety meetings, changing medication administration times, updating the medication policy, and using more questions to increase parental involvement. Since nurses are the ones who came up with the times, the article demonstrates to readers how the participation of nurses in active research can help minimize medication errors. Therefore, nurses can use the information in the article to reflect on their practices and devise interventions that can reduce medication errors.

Bukoh, M. X., & Siah, C. J. R. (2019). A systematic review on the structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3). https://doi.org/10.1111/jonm.12936

This is an article of a systematic review done to examine the effectiveness of structured handover in enhancing outcomes for patients. It reviews nine studies found after searching several electronic databases, including Ovid, Scopus, EMBASE, Web of Science, CINAHL, and MEDLINE. From the article, items that should generally be included in a handover process include patient identifying information, clinical impression, treatment, explanation, and directives for expected events. The article provides information on the relationship between structured handovers and patient outcomes. Nurses can also learn from the article how structured handovers should be done and why they must adopt them to improve medication administration.

Levine, K. J., Carmody, M., & Silk, K. J. (2020). The influence of organizational culture, climate, and commitment on speaking up about medical errors. Journal of Nursing Management, 28(1), 130–138. https://doi.org/10.1111/jonm.12906

The article evaluates how a nurse’s active behavior can affect the climate and culture of a hospital. One-on-one interviews and focus groups involving hospital employees were used for data collection. The article demonstrates that organizational climate, but not corporate culture, affects the reporting process for medication errors. Moreover, there is a direct relationship between organizational commitment and the rate of reporting medication errors. The article provides data on the facilitators and barriers to medication error reporting and how they relate to corporate culture, commitment, and climate. The information in the article can help nurse managers promote medication error reporting by developing interventions that can make other nurses speak up in case they note a medication error.

References

Harrington, L. (2019). Use errors with health care technologies: An inconvenient truth. AACN Advanced Critical Care, 30(1), 12–15. https://doi.org/10.4037/aacnacc2019884

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Question

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan about medication administration to understand or implement to ensure the plan’s success.

Improvement Plan Tool Kit

Communication in the healthcare environment consists of an information-sharing experience through oral or written messages (Chard & Makary, 2015). As healthcare organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to disseminating information and evidence-based findings and developing tool kits, continuous support for and availability of such resources is critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in times of need or crisis and how to support one another in the workplace; wikis, in particular, enable nurses to continue that support beyond the work environment. Here, they can be free to share their unique perspectives, educate others, and promote healthcare wellness at local and global levels (Kaminski, 2016).

Before developing the repository, you must complete the Determining the Relevance and Usefulness of Resources activity. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your practice and self-assessment, demonstrating 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.
Analyze the usefulness of resources for the role group responsible for implementing quality and safety improvements with medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the value of resources to reduce patient safety risks or improve quality with medication administration.
Competency 3: Identify organizational interventions to promote patient safety.
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Present reasons and relevant situations for a resource tool kit to be used by its target audience.
Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

References
Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context
Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage the sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help reinforce attendees’ new knowledge and the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario
For this assessment, consider taking one of these two approaches:

Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan about medication administration and put the plan into action.
Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) about medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.
Preparation
Google Sites is recommended for this assessment; the tools are free to use and should offer flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or Google Docs login or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you get started with Google Sites:

G Suite Learning Center. (n.d.). Get started with Sites. https://gsuite.google.com/learning-center/products/sites/get-started/#!/
Google. (n.d.). Sites. https://sites.google.com
Google. (n.d.). Sites help. https://support.google.com/sites/?hl=en#topic=
Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes concerning your safety improvement initiative regarding medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices, environmental safety and quality risks, individual strategies to improve personal and team safety, and process best practices for reporting and improving environmental safety issues.

Improvement Plan Tool Kit