Measurement of Healthcare Outcomes

Measurement of Healthcare Outcomes

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.

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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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Select a health outcome of interest to your community or area of practice that is measured at the nominal level.
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Measurement of Healthcare Outcomes

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