NURS FPX 4020 Assessment 1 Enhancing Quality and Safety TS

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety TS

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety TS

Enhancing Quality and Safety 

          Maintaining patient safety and providing the highest quality of care to patients are two of the most important factors in providing satisfactory care in any healthcare setting. Nurses, physicians, pharmacists, and other healthcare professionals play crucial roles in delivering quality care and avoiding adverse events such as medication errors. According to the World Health Organization (WHO), medication error is defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. This life-threatening event may be related but not limited to the prescribing physician, product labeling, dispensing, distribution, telephone verbal orders, administration, education, and monitoring systems.

      Medications errors are the leading cause of hospital adverse events and can attribute to an increase in healthcare cost and longer hospital stay. This adverse event also contributes to lower patients’ satisfaction and employees left with the feeling of poor job satisfaction. This paper will analyze medication administration issues and how it relates to patient safety, best evidenced-based practices, and Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety TS

Patient-safety risk focusing on medication administration

 There are multiple factors that can contribute to medication errors in a healthcare setting. Medication errors are the most common type of medical errors in healthcare sectors. They may cause or lead to inappropriate medication use or patient harm . 6–7% of hospital admissions are due to medication errors (Yousef, N., Yousef, F 2017). Such error in healthcare can lead to poor patient satisfaction and can leave healthcare workers feeling hopeless. Pharmacists, physicians, informatics nurses, and other healthcare professionals all play a critical role in the process that cat can lead to medication error.  The administering nurse, however, plays the most crucial role as this is last stop before the patient gets the medication.  Having a professional dialect and respect for each other’s role using teamwork and interdisciplinary collaboration can have a positive impact on both the healthcare professional and the patients. According to the American Psychological Association, to work in interdisciplinary teams, to coordinate, collaborate, communicate, and integrate care in teams will ensure that care is continuous and reliable (Rosen, M. A., et al, 2018). 

     Other common factors are distraction and the interference of medication administration. Distractions from other staff member, patients, or family members can disturb the normal medication administration process. This can result in medication confusion and can delay the process. Nurses must consider the five rights of medication administration such as: the right patient, Route, time, dose, and documentation whenever medication is being administered to decrease medication error occurrences. Any diversion of this process can lead to an error and possibly adverse event such as death.

Evidence-based and best practice solutions

     Quality and Safety Education for Nurses (QSEN) is an EBP solution that is used to train and educate nurses and healthcare staff. The guideline defines the patient safety competency as: minimize risk of harm to patients and providers through both system effectiveness and individual performance (Armstrong, G, 2017). The guidelines include nurses using a tall man lettering system to decrease the confusion between look alike sound alike medication, using of electronic health records (EHRs), barcode for scanning medications, and use of smart infusion pumps to help decrease dosage calculations. By using this system process, nurses can prevent adverse effects and reduce cost associated with administering the wrong medication to a patient. 

     Another best practice solution is for nurses and other healthcare providers to be mindful of interruptions and distraction especially when dispensing and administering medication. In healthcare, distraction and interruption are inevitable. Conversing with other staff members, usage of personal telephones should all cease when such task is being performed. The incorporation of mindfulness strategies, memory management devices such as checklist, and visual cues such as warning signs for silence in the medication areas, with the frontline nurses having the responsibility of choosing what works for them to attain safety goals ( Thomas, Lilly., et al, 2017). 

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety TS

Coordinated care among nurses to increase patient safety and reduce cost

          According to Thomas, medication administration is a high – volume as well as high -risk nursing activity. Nurses paly a critical role in managing their performance as well as taking control of environmental elements in the effort to decrease medication error. Nurses are central to all the process of medication administration form taking the physician order, receiving the medication from pharmacy, dispensing the medication ,and administering the medication to patients. Coordinating and collaborating care with other nurses are important especially during medication administration. For example, a nurse that is not passing medication can attend to non-emergent issues for the other nurse so not to cause mix up or confusion. Also, nurses can communicate with each other if one is not sure about a medication side effect and allergic reactions associated with such medication. Having an open dialect and respect for one another breaks the barrier to communication which enhance the work environment and foster a sense of  security for nurses, and reduce cost associated with adverse events associated with medication errors. 

Stakeholders and safety enhancement

      Nurses in any healthcare setting need to coordinate with stakeholders such as physicians, pharmacist, therapists, specialists, nurse leaders, patients, and board members of the organization. Coordinating care with stakeholder such as patients are important for the healthcare institution success. Knowing about their conditions, past and present history, allergy information and other health details help health practitioners make informed decisions regarding treatment plan. Working with physicians and pharmacists is crucial as they prescribe and dispense the drugs for nurses to administer. Coordinating with them to correct medication errors identified is crucial to the safety of patients. 

     According to the Journal of Clinical Nursing,  findings demonstrated how the use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centered medication management ( Liu, Wei, 2016). Failure to coordinate with such stakeholders  will result in errors during the administration process. Reducing incidence of medication errors is vital to the healthcare organization as this will increase patient satisfaction, foster a safe work environment, decrease adverse event, and decrease the overall cost of healthcare.

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References

Armstrong, G. ( 2019). QSEN safety competency: the key ingredients is just culture. The Journal of Continuing Education nursing, 50(10), 4444-447.DOI:10.3928/00220124-20190917-05

Liu, Wei (10/2016). “Creating opportunities for interdisciplinary collaboration and patient‐centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting”. Journal of clinical nursing (0962-1067), 25 (19-20), p. 2943.

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., 

& Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-

quality care. American Psychologist73(4), 433–450. https://doi.org/10.1037/amp0000298

Thomas, L. , Donohue-Porter, P. & Stein Fishbein, J. (2017). Impact of Interruptions, Distractions, and Cognitive Load on Procedure Failures and Medication Administration Errors. Journal of Nursing Care Quality, 32 (4), 309-317. doi: 10.1097/NCQ.0000000000000256

World Health Organization. (2016). Medication Errors: Technical Series on Safer Primary Care. Geneva: World Health Organization; 2016. License: CC BY-NC-SA 3.0 IGO

Yousef, N., Yousef, F. (2017). Using total quality management approach to improve patient 

safety by preventing medication error incidences** . BMC Health Serv Res 17, 621 

https://doi.org/10.1186/s12913-017-2531-6

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