Clinical Application Paper
Medication errors are a serious public health problem and they pose a serious threat to patient safety. Medication errors are costly from an economic, human, and social viewpoint since all patients are potentially vulnerable to these errors. It is estimated that in the United States more than 250,000 deaths per year are attributed to medication errors (Dirik, Samur, Seren Intepeler, & Hewison, 2019). Nurses work in a fast-paced healthcare environment which makes administering medication to be a high-risk nursing task. Medication errors can occur at any phase of medication from prescribing, dispensing, transcribing, administering, monitoring, and reporting. When a nurse makes a medication error they are emotionally traumatized since most of them beat themselves up for making such an error and this might undermine their self-esteem and confidence. Medication errors can be caused by any member of the healthcare team, but nurses account for the majority since nurses execute the majority of medical orders and they spend over 40% of their time in the hospital administering medicines (Tong et al., 2017). This paper aims to not only offer an overview of the problem within the clinical setting but to also use evidence-based research to identify solutions that can be used to improve the situation and reduce medication errors. A plan will be developed to address the problem of medication errors and methods of evaluation identified.

The Problem

In our clinical setting, there is a computerized provider order entry system used for specifying patient prescriptions and reducing transcription errors. In the past nurses had a problem trying to transcribe what the provider had written and this was the major cause of medication errors. However, with the installation of the system, it was expected the errors would be eliminated. Sadly, this was not the case. The current problem is mainly due to administration and medication mixing. When a nurse is attending to multiple patients and he or she has to administer medication to the patients at the same time, he or she will prefer to retrieve the drugs at the same time and make only a single round. This is a time-saving strategy and it reduces the time spent moving from the medicine cabinet to the ward and back for other drugs. The problem comes when the nurse fails to label the drugs especially medicines in syringes, basins, and cups. The nurse ends up mixing the medication and administers the wrong medication to a patient. This results in adverse drug events as the patient is likely to react to the drugs and this will worsen the patient's condition. For our clinical setting, the main reason nurses prefer to use this system when administering medication is there is a shortage of nurses. When understaffed, nurses will be overworked and they tend to look for ways they can increase their efficiency and reduce the time they spend moving up and down instead of attending to patients.

During the administration of intravenous medicines, there are many stages where an error might occur. In our case, most of the errors have been due to selection errors where the wrong drug is selected and reconstitution errors where the dosage is administered. Looking at the errors mentioned one would assume this would be easy to correct, but this is not the case. The administration of the wrong medication as mentioned earlier has to do with mixing up drugs since the nurse failed to properly label the drugs. Reconstitution errors are caused by the administration of the wrong drug doses. There are standard dosages that patients should be given and when this is not indicated in the prescription most nurses will assume, they are to use the normal dosage. However, there might be instances where a nurse is not familiar with a particular drug, and instructions are not given as to the correct administration or dilution of a drug. This would result in the patient getting a higher dosage concentration than would be expected.

Background & Literature Review

A...…drugs. This will ensure the incoming nurse is aware of the patients who need medication and they can administer the medicines when the time comes.

Method of Evaluation

The clinical project will be measured based on the number of medication errors taking place and comparing them to how many there were before the implementation of the project. Initially, the evaluation will be done daily to ensure compliance is maintained. Nurses will be monitored closely and there will be leaflets across the nursing rooms reminding the nurses to observe the new changes and to continue the collaboration. The safety culture will be reinforced across all departments within the organization. Measures will be the number of errors and types of errors that have occurred within a given day, week, or month. With these measures, it will be easy to identify what needs to be changed and the improvements needed. All areas of the organization will be monitored and evaluated especially areas that touch on patient care and patient safety. The strategy is to ensure medication errors are eliminated and the errors that were being made were rectified. Also, the project would monitor for other areas where medication errors might occur.

Conclusion

Reducing and eliminating medication errors is the best way of ensuring and improving patient safety. The proposed project will modify the culture of the organization and have a safety culture in place. With this culture in place the organization can improve the quality of care it offers to its patients. The strategies mentioned in the project will ensure the project is successful. Encouraging the nurses to report any errors and not have any punitive measure issued against them will push them to report any errors. However, with a culture of punishment, nurses will continue hiding their mistakes for fear of being punished. Therefore, changing the culture to focus on what went wrong instead of who caused the error will demonstrate to the nurses the organization's desire to rectify the problem and not to punish the employee.…