PATIENT SAFETY IN MEDICATION ADMINISTRATION: MONITORING ERRORS
Introduction
Medication administration safety is an important subject of consideration because medication therapy is predominantly the intervention used for illnesses (Hughes & Blegen). While medication administration has many benefits, there are any errors that can result from staff errors during medication administration. Some of the factors contributing to these errors include staff work overload, inadequate nursing education, Illegible writing, and problems while labeling medication. There are ten “right” principles that should govern nurses in their administration of medication. These include Right time and frequency, Right patient, Right drug, right dose, Right route, Right documentation, right history, and assessment, patient right to refuse medication, right drug-drug interaction, and right information and education (Vera, 2020). One common error is monitoring error.
Monitoring Errors and Causes
The monitoring error occurs when the person administering, ordering, or prescribing the medication fails to consider a serious patient’s serious condition that could react wrongly with the medication prescribed (Aronson,2009). It could be due to a serious condition such as diabetes, kidney dysfunction, liver failure, or an allergy. This error is knowledge-based. It largely relies on acquiring the right patient information before making a prescription (Aronson, 2009). One major cause of this error is the work environment.
The hospital work environment can be quite tiresome and distracting. When physicians are administering medication, they could be asked to address another issue, failing to consider all the patient’s information. In other cases, they could be slightly distracted while on a phone call or something similar (Hughes & Blegen, 2008). Staff shortages could also lead to an overburdening of the doctors and nurses, making it hard for them to pay enough attention to patients before administering medication. A hospital could also have medication safety protocols that are not appropriately designed to prevent the workers from making significant medication errors (Ross, 2019).
Another cause of monitoring error could occur during the administration. There are over 6800 medications that are in use, and some of them sound and look the same. This medication could lead to the patient being given the medication that was not prescribed, and it could react with the condition the patient has badly. This cause could also occur due to illegible writing on the part of the physician. When the medication is not legible, it could look the same as another medication that could badly affect the patient.
Another predominant reason for this error is the lack of pharmacological knowledge. Some of the nurses and physicians lack enough knowledge to know how a certain drug or dosage of a drug could react with a patient with a serious health condition or allergy. This could lead to the patient getting medication that could lead to an Adverse Drug Event (ADE) (Ghasemi & Valisadeh, 2009).
Solutions for improving patient safety
The first solution to monitoring errors is assessing the work environment and ensuring that it is suitable for physicians to work in. Hospitals should ensure that doctors and nurses are not overburdened by work. Too much work leads to distraction, which leads to inadequate attention being paid to patients. When doctors are writing prescriptions and seeing patients, they should not be distracted unless an emergency that needs their attention occurs. Another way of improving the work environment is an optimal shift schedule (Ross, 2019). A hospital should ensure that the staff is scheduled to come in after they have had enough rest to make sure they pay enough attention to the patients.
The other solution includes coming up with medication technologies to reduce medication errors. Monitoring errors have been attributed to illegible writing. To reduce monitoring errors attributed to this, as well as those attributed to distractions, a technology that helps doctors make a decision based on the information provided by the patient should be formulated to make sure that all information is taken into consideration. The technology could print out prescriptions rather than have handwritten ones. It is also essential for nurses and physicians to be aware of Look-Alike and Sound-Alike (LASA) medication. The technology developed should be tailored in a way that physicians are notified when there is a medication that looks like the one they are looking for.
One of the most important solutions is the involvement of patients. Patients should be encouraged to speak out on any information that could influence the medication dosage or the medication itself. Patients should be educated along with their caregivers of the potential reactions that could occur due to any conditions they may have. This is important because the patients would be able to understand the importance of voicing any allergies or serious conditions they may have.
Stakeholder involvement
Nurses play an essential role in the prevention of monitoring errors. They are the primary information collectors. They should be aware of any conditions that the patients could have and the possible reactions to a different medication since they often administer medication. Nurses, along with doctors, should also get trained on the technology developed to avoid missing any vital information that could be developed in the course of treating the patient, as well as to the LASA medication (Ross, 2019). This training could solve a lot of issues since they would not have to memorize information about a patient or rely on a doctor’s handwriting before administering medication.
Nurses also have the responsibility of reporting any medication error that could occur in the course of treatment. When a nurse realizes that an error has been made, they should report the error and prepare appropriately for the reactions that could occur. Finally, nurses should make sure that doctors remain undistracted while they are administering medication. Most errors come as a result of distractions. Therefore nurses should make sure that doctors have enough time to evaluate each patient without being disturbed. Doctors should only be called upon when there is an emergency that needs their attention.
Doctors have the responsibility of giving each patient their undivided attention and making sure that they consider all the variables concerned before writing a prescription. Patients and their caregivers also have the responsibility to reveal every condition they have that could react with the medication.
References
Aronson, J.K. (2009). Medication errors: what they are, how they happen, and how to avoid them. An International Journal of Medicine, 102(8), 513-521. https://doi.org/10.1093/qjmed/hcp052 Retrieved from: https://academic.oup.com/qjmed/article/102/8/513/1598923
Ghasemi F, Valizadeh F, Nasab M. M. (2009). Analyzing the knowledge and attitude of nurses regarding medication error and its prophylactic ways in educational and therapeutic hospitals of Khorramabad. Yafteh, 10(2), 55–63.
Hughes RG, Blegen MA. (2008). Medication Administration Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US), Chapter 37. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2656/
Ross, Michael. (2019). The Importance of Medication Administration: 5 Ways to Improve. Retrieved from: https://blog.cureatr.com/the-importance-of-medication-administration-5-ways-to-improve
Vera, Matt. (2020). The 10 Rights of Drug Administration. Retrieved from: https://nurseslabs.com/10-rs-rights-of-drug-administration/