Quality Improvement: What Is It and What Are the Benefits?

Medication administration errors have increased a significant amount of attention over the past few years. There have been significant concerns that medication administration errors usually result in the reduction of patient outcomes. Medication administration errors occur frequently and there are adverse effects that usually lead to harm to patients. Errors due to medication administration are preventable and can be solved through the use of quality improvement processes. Steps to improve medication administration can include the use of technology and policy implementation strategies. This paper analyses improvement of patient safety by reducing medication administration errors by identifying the problem, identifying the significance, steps to implement quality improvement, evaluation, and identification variables, hypothesis, and statistical test. 

Problem in Practice 

One of the factors that reduce patient safety during medical administration is medical administration errors. Medication administration errors are associated with the provision of wrong medications. Some of the factors that are associated with medication errors are the provision of medications with similar names or packaging, medications that are not commonly used or prescribed, provision of medications that could lead to allergic reactions, and the provision of medications that are toxic errors. Medications that have similar names or look-alike could also lead to medication errors. 

Medication errors usually lead to a reduction in patient safety because they lead to an adverse drug event (ADE). These are situations where the medicine becomes harmful to the patient and leads to further complications for the patient. Complications that could take place include deterioration of one’s health and interference with one’s nervous system. In adverse cases, medication administration can result in death. Medication errors are a hindrance to patient safety and result in the reduction of patient outcomes in the quality of care. 

The significance of Quality Improvement 

There is a great need to engage in quality improvement and decrease medication errors so as to enhance patient safety. Quality improvement strategies will also lead to better and effective management of the illness and improve patient outcomes. The quality improvement will also result in a reduction of costs in terms of human suffering and additional health care costs. The projected outcome of quality improvement is that it reduces medication errors, increases patient safety, and results in an overall reduction in deaths from drug-related errors. Addressing quality improvement issues is critical to improving patient outcomes and the quality of care. 

Demonstration of Support from Previous Research 

There are multiple pieces of evidence which demonstrate the support of quality improvement strategies and their potential outcomes. One of the strategies analyzed by Redman (2017) is to make use of bar code technology and a team-based approach to reduce errors. Bar code technology makes use of administration of medicine through the use of medical health records. The outcomes identified by the study was that the number of errors and patients that were harmed by medical errors reduced. 

Limiting interruptions when nurses are administrating medications have been found to reduce medical errors. Flynn et al., (2016) identified the reduction of interruptions as a quality improvement strategy. The results of the study were that interruption and medical errors significantly decreased after the introduction of quality improvement strategies. The conclusion from the study was that the use of evidence-based strategies to limit interruptions during medication administration promotes patient safety. 

The reduction in medication errors was also observed by Leahy et al., (2018). The study was used to analyze the frequency of anesthetic medication errors, identify quality improvement strategies, and measure the effects in terms of error reduction. The conclusion from the study identified that there was a significant reduction of errors throughout the period of study. The study made use of various quality improvement programs that prevented medical errors, decreased their incidence and resulted in an overall improvement of patient safety. 

Steps Necessary to Implement Quality Improvement 

There are several steps that should be performed in order to implement a quality improvement plan to improve patient safety and reduce medication administration errors. The steps are divided into policy and technology implementations. Policies that will be implemented include the introduction of a medication safety program in health care facilities and the implementation of a zero-tolerance philosophy for medication errors (Leahy et al., 2018). The Medication Safety Program should promote the reporting of medication errors so as to reduce the repeat of future errors. The zero-tolerance philosophy will involve enforcing a philosophy where there is no excuse for medication administration errors. Those that administer any medications are expected to do the medication perfectly right. 

The next step will involve the use of technologies to engage in quality improvement. The first technology to be implemented will be the use of a barcode-based safety system. The barcode system was analyzed by Bowdle et al., (2018) and was found to improve patient safety. The barcode system will work with a computerized prescribing system to ensure the accuracy in the prescription of drugs and medications. A study by Maaskant et al., (2015) analyzed the two interventions for reducing medication errors and found that the two interventions were effective. The computerized prescribing system would make use of a control and checklist. The barcode system would be used in the final delivery of medication. 

Evaluation of Quality Improvement 

The quality improvement would be evaluated by measuring by identifying various changes and effects in patient safety medication. The first outcome to be measured will the number of medical errors reported. The frequency of medical errors in a given duration of time will be evaluated. The study will involve an evaluation period of approximately 6 months without the quality improvement strategies and another 6-month evaluation period after the introduction of the quality improvement strategies. It is expected that there will be an improvement in patient outcomes and quality of care. This will be identified through a reduction in medication errors and reduction in harm or injuries caused by the medication administration errors. 

Identification of Variables, Hypothesis Test, and Statistical Test 

The variables that will be used to evaluate quality improvement are medication errors and harm or injuries as a result of the errors. It is expected that nurses, pharmacists, and other medication practitioners will report any medical error and harm or injuries to the patient. The variables used for the study will be the presence or absence of medical errors. The hypothesis for the study is that the introduction of the quality improvement strategies will result in a significant reduction of patient errors. The statistical test will be analyzed with the dependent variables of presence or absence of errors and the interaction between time as the independent variables. A statistical significance level of 0.05 will be used. A 95% confidence interval (CI) for the interaction variable will be considered as the main result for the reduction of errors. 

Conclusion 

Patient safety is a critical topic that is largely influenced by medical administration errors. Medical administration errors are an increasingly huge problem that results in the reduction of patient safety and patient outcomes. Addressing the problem is important so as to reduce harm, injuries, and death that occur from medication errors. The steps necessary to address quality improvement will involve the use of policies and various technologies such as bar codes. The evaluation will be analyzed by considering the frequency of medical errors. It is expected that the use of quality improvement strategies should reduce the frequency of medical errors. 

References 

Bowdle, T. A., Jelacic, S., Nair, B., Togashi, K., Caine, K., Bussey, L., ... & Merry, A. F. (2018). Facilitated self-reported anesthetic medication errors before and after implementation of a safety bundle and barcode-based safety system.  British journal of anesthesia ,  121 (6), 1338-1345. 

Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive care nurses improving patient safety by limiting interruptions during medication administration.  Critical care nurse ,  36 (4), 19-35. 

Leahy, I. C., Lavoie, M., Zurakowski, D., Baier, A. W., & Brustowicz, R. M. (2018). Medication errors in a pediatric anesthesia setting: Incidence, etiologies, and error reduction strategies.  Journal of clinical anesthesia ,  49 , 107-111. 

Maaskant, J. M., Vermeulen, H., Apampa, B., Fernando, B., Ghaleb, M. A., Neubert, A., ... & Soe, A. (2015). Interventions for reducing medication errors in children in the hospital.  Cochrane Database of Systematic Reviews , (3). 

Redman, D. D. (2017). Reducing medication errors in the OR. AORN Journal, 105(1), 106-109. doi:http://dx.doi.org/10.1016/j.aorn.2016.11.007