Patient safety is critical in healthcare provision. Medication errors are a breach of patient safety. Knowledge of the factors and the roles of clinicians in the prevention of medication errors are appropriate in ensuring patient safety (Lee et al., 2016). This essay discusses the factors contributing to medication errors, the preventive measures and roles of nurses and other stakeholders in medication patient’s safety.
Medication Errors in Clinical Practice
One of the factors to medication errors in the clinical setting is misreading drug prescriptions. Physicians make drug prescription, pharmacists use the prescriptions to dispense the drugs, and the nurses use the prescriptions to administer the drug (Hayes, Jackson, Davidson, & Power, 2015). If the physician prescription is wrong, the pharmacist is likely to distribute the wrong medicine, at the wrong quantities. In turn, the nurse is likely to administer the wrong drug to the patient and at wrong dosages.
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Existence of several forms of routes of administration is another factor to medication errors. Administration of drugs through the wrong route is another medication error within the clinical setting. Critically ill patients occasionally have intravenous and central lines. The invasive equipment are used for the administration of different drugs. Administration of a drug into the worry invasive equipment is accompanied by side effects such failure to achieve therapeutic biological levels or amplified side effects of the drug.
Adoption of technology in medication is a quality improvement initiative to prevent medication errors in the clinical setting. Information technology avails all the prevent patients’ information, such as the history of allergies at the time of prescription to avoid errors related to omission of patients information during prescription. Computerized physician order entry (CPOE), ensures that prescription orders are complete and legible (Schiff et al., 2015).
Evidence-Based and Best Practice Solutions
Hiring adequate nursing and pharmacist personnel is one of the safety measures that have been proved to be effective. According to Seidling et al., (2016) an adequate number of pharmacists ensures that the high risks drugs are cross-checked physically before dispensation. Also, confirmation of laboratory or any other relevant patient’s information and the right preparation of medication.
Medication reconciliation is appropriate solution to medication errors in the clinical setting. Medication reconciliation involves comparison between the current patient's treatment regimen to the physician's discharge or transfer orders. According to Mekonnen, McLachlan, & Brien (2016), medication reconciliation reduces common medication errors by 35% to 67%. Medication reconciliation identifies and corrects discrepancies between the prescribed drugs and the current patient medication and reduces adverse drug events, especially during patients’ transitions.
Nurses and Patient Safety
The nurse has a role in the coordination of patient monitoring. The nurses provide interpersonal care and spent a significant amount of time with the patients. Through physical and laboratory assessment, nurses can identify deterioration of patients who suffer adverse drug events (Ammouri, Tailakh, Molina, Geethakrishnan, & Al Kindi, 2015). In other words, nurses detect effects resulting from medication errors for the patient involves the other healthcare professionals, such as a physician and the pharmacists.
Nurses are critical team players in the identification of system failures as pertains to medication and the general patient's safety. The nurses are in constant interaction with the patients and other stakeholders with the clinical and administrative settings. Nurses are also custodians of the different equipment and consumables used in patient care. The nurses can, therefore, identify the causes of any of the adverse events related to the medication. The nurses are also capable of detecting the failures of nursing staffing and the safety issues related to the medication (Ammouri et al., 2015). Nursing staffing has been linked to burning out, stress, and fatigue, which in turn cause nursing omission errors. Subsequently, severe breach of patients’ safety occurs.
Stakeholders to Drive Quality and Safety
One of the stakeholders in achieving patient medication safety is the pharmacists. According pharmacists have a role in monitoring the patients’ adherence to medications, and the side effects, and thus make recommendations for change in the medication, dosage, and any other necessary therapies. Additionally, pharmacists have a role in reviewing medication interactions (Mansur, 2016). Nurses and pharmacists detect and discuss adverse drug effects and recommend changes to the precision on the combination of the prescribed drugs.
Pharmacists collaborate with nurses to monitor patient health status. Nurses take vital signs for the patient and review the data with pharmacists. Such data includes blood pressure and temperature. The nurse and the pharmacists, therefore, make suggestions for drug and dosage adjustments. Both the nurses and pharmacists have a role of ensuring the wellness and the proper health of the patient (Mansur, 2016). The nurse and the pharmacists collaboratively assess the patient to ensure that the underlying patient conditions are well controlled through the treatment regime.
The nurse coordinates with the physician in the prevention of medications errors. The nurse facilitates the physician role in the collection of patient data. During history taking as the general assessment, the nurse obtains data and information on the patient history of drug interactions, renal or hepatic impairment. The nurse also informs the physician on any illegibility in prescription orders. The nurse coordinates the medication reconciliation (Ammouri et al., 2015). The treatment reconciliation comprises of the nurse, the pharmacist and the physician.
In conclusion, the existence of several routes of drug administration, and the form of prescription orders are the leading factors predisposing to medication errors. Adoption of technology and sufficient clinical personnel and coordination of physicians’ and pharmacists’ prevents medication is essential in prevention of medication errors.
References
Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015). Patient safety culture among nurses. International nursing review , 62 (1), 102-110.
Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration. Journal of clinical nursing , 24 (21-22), 3063-3076.
Lee, Y. C., Wu, H. H., Hsieh, W. L., Weng, S. J., Hsieh, L. P., & Huang, C. H. (2015). Applying importance-performance analysis to patient safety culture. International journal of health care quality assurance , 28 (8), 826-840.
Mansur, J. M. (2016). Medication safety systems and the important role of pharmacists. Drugs & aging , 33 (3), 213-221.
Mekonnen, A. B., McLachlan, A. J., & Brien, J. A. E. (2016). Pharmacy‐led medication reconciliation programmes at hospital transitions: a systematic review and meta‐analysis. Journal of clinical pharmacy and therapeutics , 41 (2), 128-144.
Schiff, G. D., Amato, M. G., Eguale, T., Boehne, J. J., Wright, A., Koppel, R., ... & Bates, D. W. (2015). Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems. BMJ Qual Saf , 24 (4), 264-271.
Seidling, H. M., Stützle, M., Hoppe-Tichy, T., Allenet, B., Bedouch, P., Bonnabry, P., ... & Störzinger, D. (2016). Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions. International journal of clinical pharmacy , 38 (2), 362-373.
