CLASS #4, ASSESSMENT #1

Running head: ASSESSMENT 1 1

ASSESSMENT 1

2

Assessment 1: Enhancing Quality and Safety

Rody Zapata

School of Nursing and Health Sciences, Capella University

NURS-FPX4020: Improving Quality of Care and Patient Safety

Dr Sandy Arnold

09/09/2021

Medication errors are amongst the key challenges that threaten the safety of the patients. The issue has attracted the attention of many people and it is known to be the eighth amongst the factors that lead to the high rates of death in the United States. The issue of medication errors has led to several different injuries, deaths, and an increase in medical costs. Based on these alarming statistics, the hospital and the regulatory agencies like The Joint Commission have reassessed the importance of patient safety within the healthcare facilities (Jain & Rani, 2017). The recommendations that have been made by these agencies are based on the medication and patient safety principles that should be introduced early in the education of healthcare professionals.

The causes of medication errors are rarely the fault of a single individual practicing within the vast and complex medication use process (Macias et al., 2018). Rather, these errors result from the breakdown of not less than one of the steps in medication use.

The steps in the medication administration process are interrelated and they include the five core steps during the medication process, i.e. the prescription of the medication, the order processing, dispensing, the administration, and the monitoring process. The key elements entail the patient information that is accessible and accurate; the drug information that can be easily accessed, accurate, and usable; and the consistent and non-complicated process of communication, the drug labelling and packaging to help in the facilitation of the safety, and consistent or suitable use of the nomenclature (Jain & Rani, 2017).

Other key elements that affect the medication use are the drug storage and the stock that facilitates suitable distribution using standardized drug concentrations and administration time; the methods used in the acquisition of the drug for the proper use and monitoring; and the creation of a work environment that offers suitable workload, and limiting the unfavourable conditions like the poor lighting, noise, and poor space, among other interferences; competency of the staffs in assessing and improvement the opportunities for the ongoing education; offering accurate and consistent patient education; adoption of the assessment protocol for the quality and the redesigning of the medication to improve safety (Jain & Rani, 2017).

The Application of the Evidence-Based Interventions

Various interventions have been proposed to help in the reduction of this issue. The implementation of some of these strategies has been proven to be effective in helping in reducing the rates of medication errors. One of the major effectiveness is the digitalization of the process of medication administration. Adoption of digital technologies that involves a barcode medication administration system, so the patient’s identity, the right medication, right dose, right route of administration, and the right time, they could be all confirmed digitally in an efficient time and manner. This is a system that is designed by Glenna Sue to help in the prevention of medication errors within healthcare facilities (Baraki, et al., 2018). It is also aimed at improving the quality and the safety of medication administration.

Medical administration is a task that is mostly performed by the nurses and this is placing a greater risk since it cannot be devoid of errors. Even though medication errors is a major concern to the patients, the issue is being overlooked by the management and other healthcare professionals. Some of the most common medication administration errors are mostly due to the wrong timing and delays since they are important steps in the medication administration that are managed by the nurses, thus exposing patients to the risk of health complications. Nurses play an important role in protecting patients and improving their safety against the mistakes that are witnessed during the administration of the medications (Bifftu et al., 2016). The lack of skills and effective training is affecting the efforts towards the full implementation of all the barcode medication administration system in most of the healthcare facilities.

The improvement plan using the evidence-based and best-practice strategies.

The improvement plan is aimed at reducing medication administration errors. Therefore, there is a need to have resources required for this implementation. The resources include the system of a barcode management system which is composed of the scanners objects such as the bar code printer, the bar code scanner, computer server, and the software. The healthcare providers especially nurses are then trained on the utilization and implementation of the activities of the barcode medication administration system (Macias et al., 2018). The training activity will take around three weeks and this will be a continuous process in the future even for the recruited nurses. Once nurses have acquired the skills and knowledge on the operation of the barcode medication administration system, the implementation process picks up.

The activities aimed at reduction of medication administration errors will involve the action of faxing prescribed medications which are then electronically delivered or manually delivered to the hospital pharmacy whereby the nurse enters the computer system. The bracelet is then attached to the patient by the nurse. A wristband with a unique bar code is used. As the patient is used by the physician in the management of their condition, the nurse handheld the device to scan the identification badge, the wrist band, and the bar code on the drug. When the bar code is not matching because of the unique ID provided to the patient, then the nurse is provided with a visual warning as each patient code holds all the information about the patient and the medication provided (Jain & Rani, 2017). This procedure will be done for the first six months to compare the pre and post-intervention data to determine the effectiveness of the intervention and then implemented continuously while prescribing the medication to reduce the errors.

Existing organizational resources.

The success in the implementation of the intervention relies on the availability of the existing organizational resources. One of the existing resources is the adequate nurses who will help sure that barcode medication administration system intervention is fully implemented and made to be part of the basic operating procedures within the organization. The other resource is the management who will be playing an important role in ensuring that the other required resources are provided at the right time for the full implementation of the barcode medication administration system within the hospital (Thompson, et al.).

The other important resource that is available is a computer system and the source of power. The organization is already having some computers in place to ensure that the operation of the system is fully installed and implemented towards the reduction of medication administration errors. The computer system available can be used for the start of the program or training of the nurses while the plan to purchase more is made. The other available resource that might be a challenge to get is the training room for the nurses or physicians. The hospital is having a large conference hall that can host more than 50 people (Thompson, et al.). The hall has power installation done already therefore, the only task will be to transfer the computers to the hall to ensure that nurses can access them for their training process.

However, the organization will have to look for other resources that are not available within the firm. One of the resources is the software to help in the operation of the barcode medication administration system. The other resources that the organization will have to purchase are the barcode system materials for example bar code printer, the bar code scanner, and the computer server. Since this is a new aspect being implemented within the organization, the management will have to work closely with the Information Technology (IT) Department to help in providing the guideline on what is needed and what is lacking to fully operate the system (Thompson, et al.). Therefore, the organization will be forced to hire external informatics, for example the three of them to help with the training of the nurses and making sure that the installation of all the systems is done perfectly.

Conclusions

Medication error is an issue of concern that affects the quality of healthcare services delivered to the patients that can incurred in serious health complications, even death. Many concerns have been raised about the adverse effects of medication administration errors, not only by the patients, but also the healthcare providers since it affects their satisfaction with the services they provide to the patients. Even though various interventions can be used to help the situation, for example, the digitalization of the whole medication administration system with the use of barcodes, not enough attention has been given to the role played by such interventions in the reduction of medication errors. Therefore, it is the responsibility of the hospital management to ensure that nurses are informed about such interventions so that they can be fully implemented through collaboration with IT department.

References

Baraki, Z., Abay, M., Tsegay, L., Kebede, A., Gerensea, H., & Teklay, H. (2018). Medication Administration and contributing factors among pediatric inpatient in public hospitals of Tigray, Northern Ethiopia. BMC Pediatr, 18, 321.

Bifftu, B. B., Dachew, B. A., Tiruneh, B. T., & Beshad, D. T. (2016). Medication administration error reporting and associated factors among nurses working at the University of Gondar referral hospital, Northwest Ethiopia. BMC Nurs, 15(1), 43.

Jain, M., & Rani, U. (2017). Auto Documentation to Hospital Information System Using "Bar-Coded Medication Administration". Asian Journal of Pharmaceutical and Clinical Research. doi:http://dx.doi.org/10.22159/ajpcr.2017.v10s1.124

Macias, M., Bernabeu-Andreu, F. A., Arribas, I., Navarro, F., & Baldominos, G. (2018). Impact of a Barcode Medication Administration System on Patient Safety. Oncology Nursing Forum, 45(1), E1-E13. doi:10.1188/18.ONF.E1-E13

Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russel, J. J., Wermers, R. A., . . . Nassens, J. M. (n.d.). Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clinic Proceedings: Innovations, Quality, & Outcomes, 2(4), 342-351. doi:10.1016/j.mayocpiqo.2018.09.001