NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Introduction

The medication errors related to prescription, transmission, administration, dissemination, and monitoring are common in primary and secondary health care settings. It has been reported that every 1 in 20 events of medication administration and every second operation often show adverse drug reactions or medication errors (Nanji et al., 2016). The prevention of this global burden of medication errors costing around more than 1 billion to the global economy can be reduced by implementation of the existing policies and guidelines and incorporating awareness pieces of training and educational events related to the issue. The medication errors prevention strategies have been analyzed by researchers and global policymakers that can help to improve patient safety and quality care at health care settings and reduce medication errors. The guidelines can be categorized to address the different factors discussed below. 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Global policies and tools 

World Health Organization. (2016). Medication errors. https://apps.who.int/iris/bitstream/handle/10665/252274/9789241511643-eng.pdf.

WHO provides a technical series: Safe Primary Care guidelines for preventing medication errors in the healthcare settings. It strengthens the use of electronic prescription and alert systems to prevent medication prescription errors. The computer provided order entry (COPE) concerning the decision support system of the computer can be efficient in ruling out inappropriate medicines and thus reduce the burden of focusing on clinically relevant warnings. The decision system based on the computer will analyze which will be particularly effective when targeting a limited number of inappropriate medications. The quick wins and incorporations in the practice related to the target use of injection with a mix of education, medication reviews, involvement of community pharmacists, and informatics can reduce the wring administration errors.

World Health Organization. (2018). Patient safety policies.  https://www.who.int/teams/integrated-health-services/patient-safety/policy

World health organization issued global practice guidelines to ensure patients safety can reduce medication errors. The global expenditure is estimated to be more than 1 billion caused by medication errors. The patient safety assessment manual issued by WHO in 2016 provides a protocol of patient assessment at the primary and secondary hospital care settings to deliver safe, efficient, and quality health care. The general guidelines provided by WHO suggest incorporating skill and education training of the nurses and ensure patient safety and nurse practice as well as reduce the health care costs of the procedures and medication. If the weekly or monthly training and sessions are conducted regarding the implementation of national and international policies of preventing medication errors the risk of the increasing burden of medication error can be reduced. The nurse leadership can aware the nurse workforce about the present policies and their protocols of implementation. The awareness must follow by transformational leadership motivation, encouragements, incentive wins, and personal interests development in building patient’s safety and quality health. 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

General improvement tools

Subramanyam, R., Mahmoud, M., Buck, D. and Varughese, A.(2016). Infusion medication error reduction by two-person verification: a quality improvement initiative. Pediatrics138(6).

In this source, the researcher has suggested a 2 person medication verification system before administration in the patient. The aim was to enhance the health care and safety of the patient and reduce medication errors. The improvement plan was based on the frequent educational meetings with fellow expert clinicians, timely written reminders of the administration protocol followed by the display of feedback on the performed event, and display run charts. The outcome of the plan reported 4 medication errors which were rectified before the administration. 

Errors made in the administration of intravenous medication can lead to catastrophic harm. The frequency of hospital settings in which medication pumps are being used is increasing. We sought to improve medication safety by implementing a 2-person verification system before medication administration. This study was based on the plan to study act cycles with significant improvement of the hospital safety culture in the radiology and anesthesia department where the study was conducted. 

Skill and knowledge improvement tools

Irajpour, A., Farzi, S., Saghaei, M. and Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of education and health promotion8.

The incidence of medication errors can be a life and death matter in the critical care and intensive care units. The implementation of an interprofessional education program to address medication safety in a health care setting was significant to reduce medication errors. The professional integration of physicians, clinical pharmacists, and nurses regarding the identical educational program for medication safety reduced the medication errors after 1 month of implementation of the plan.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Di Simone, E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D. and Di Muzio, M.  (2018). Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine22(5), p.346.

The behavioral aspects of the nurses and staff members also impact the professional attitude and quality of service. The evidence provided by Simone et al. elaborated that appropriate knowledge of the subject matter, positive attitude of working, and right behavioral treatment of the patients and fellow nurses is related to the administration of intravenous medication appropriately. The continuous advancements in the pharmacology industry require nurses to update their knowledge of evidence-based medications and their possible health effects by individual education and skill-building.

Havens, D.S., Gittell, J.H. and Vasey, J. (2018). Impact of relational coordination on nurse job satisfaction, work engagement, and burnout: Achieving the quadruple aim. JONA: The Journal of Nursing Administration48(3), pp.132-140.

The increased medication errors have been attributing to the personal individual health d mental state. It has been reported that nurse burnout and job dissatisfaction interferes with medication administration errors. The relational coordination among nurses enhances job satisfaction in the nursing staff. The engagement ratio in working output also increases positively with decreased burnout of nurses. The relational coordination among nurses enhances the efficiency, quality outcome of patients and affects the direct nurse outcomes like burnout engagement at work, care provisions, job satisfaction. Relational coordination is built on the communication ties, using accurate, timely, frequent, and problem-solving communication ties. The goals of the communication are based on the mutual practice goals, shared knowledge, and mutual respect of the professional behavior.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Organizational interventions tools

Alomari, A., Sheppard‐Law, S., Lewis, J., and Wilson, V. (2020). Effectiveness of Clinical Nurses’ interventions in reducing medication errors in a pediatric ward. Journal of Clinical Nursing29(17-18), pp.3403-3413.

Several interventions for medication administration provisions ignore the role of nurses in the agenda and fail to actively involve the workforce for health in the development of solutions. In this source, the researcher has emphasized the exemplary involvement of nurses in the organizational agenda of medication safety ensures sustainable patient safety and health. The active involvement of the nurses bounds them to analyze and review the working issues and formulate an innovative solution to the problem. The three-phased action research with phase 1 of medication prescription, phase 2 development and implementation of the targeted intervention, and phase 3data collection of medication and incidence. The outcomes reduced the medical errors by 56.9% with increased compliance of the policies by nurses, active engagement in the regular tasks, and tailored to the practice and culture. 

Wondmieneh, A., Alemu, W., Tadele, N. and Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC nursing19(1), pp.1-9.

A large proportion of medication errors are related to medication administration. Nurses play an important role in the preventive measures and action in this regard. The research proposed that nurses with inadequate experience, unavailability of the medication administration guidelines, lack of training and skill, and interruption during the administration procedure are significant predictors of the errors. The nurses require continuous training, medication administration guidelines, recruiting skilled and educated nurses with more experience can be critical steps to improve the quality and safety of the medication.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Stakeholder interventions

Kim, M.S., Seok, J.H. and Kim, B.M. (2020). Mediating role of the perceived benefits of using a medication safety system in the relationship between transformational leadership and the medication-error management climate. Journal of Research in Nursing25(1), pp.22-34.

This source accounts for the importance of nursing leadership in health care settings. The incorporation of technology to health improves the safety of medication end enhances medication-error management. The system of mediation concerning the transformational leadership and management of medication errors establishes the culture of patient-centered health care provisions. A nursing leader has the role to regulate the motivation, positive attitude, patient-centered health, safety, and knowledge building environment in the practice setting. The leadership provides the guidelines related to medication administration preventing the risk of errors. The leadership can also conduct meetings, pieces of training,, and sessions to incorporate awareness regarding the medication information on skill development

Antony, J., Forthun, S.C., Trakulsunti, Y., Farrington, T., McFarlane, J., Brennan, A. and Dempsey, M. (2019). An exploratory study into the use of lean six sigma to reduce medication errors in the Norwegian public healthcare context. Leadership in Health Services.

This source provides guidelines practiced in the Norwegian hospital public health medical care settings specifically in context with reducing medication errors. The lean Six Sigma (LSS) implementation is a quality improvement model implemented at the hospital setting that can uplift the mediation errors and provide guidelines to the leadership to enhance the efficiency of the system. It can formulate a set of medication error prevention and ensuring patient safety guidelines that enhance organizational management 

improvement, patient safety outcomes reduce return or readmission of patients, an average hospital stay of patients, and preventing administration errors.  

Dirik, H.F., Samur, M., Seren Intepeler, S. and Hewison, A. (2019). Nurses’ identification and reporting of medication errors. Journal of clinical nursing28(5-6), pp.931-938.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

The in-time identification for the error and misconduct can also event the larger extent of error and drugs abuse. This source emphasizes the in-time reporting of the error as used in the Turkey model. Sometimes nurses detected the error caused by them or someone else but they are reluctant to report the error to avoid the consequences and pressure of the hospital organization. The on-time reporting can save the patient and amend the long-term complications caused by the poor administration or dosage of the medicine. The on-time availability of physicians and emergency measures can be adapted for avoiding and further misconduct. It is a positive step for ensuring the patient’s safety if the reporting nurse is not punished.  

Strudwick, G., Reisdorfer, E., Warnock, C., Kalia, K., Sulkers, H., Clark, C. and Booth, R. (2018). Factors associated with barcode medication administration technology that contribute to patient safety: an integrative review. Journal of nursing care quality33(1), pp.79-85.

The administration process of medication can also be simplified by incorporating technology and protocol with it. As described in this source the barcode technology in medication administration can prevent medication errors. The workflow of nurses is usually high because of overcrowding that can lead to medication errors and negligence in the dose preparation, the workflow analysis of the nurses day by the clinical staff can identify the deviation from the normal medication requirements of the patients, The use of scanners and barcodes identification at the counters can record the medication used in terms of dose and type. The worksheet analysis can thus analyze the error on time and issue countermeasures. The leadership in nursing can play a role in this technology implication which can take this strategy to a vast level of implementation. Nurses may require additional support in technology and practice supplemented with the relevant information and training that can lead to compliance with the strategy.

References

Nanji, K.C., Patel, A., Shaikh, S., Seger, D.L. and Bates, D.W., 2016. Evaluation of perioperative medication errors and adverse drug events. Anesthesiology124(1), pp.25-34.

Strudwick, G., Reisdorfer, E., Warnock, C., Kalia, K., Sulkers, H., Clark, C. and Booth, R. (2018). Factors associated with barcode medication administration technology that contribute to patient safety: an integrative review. Journal of nursing care quality, 33(1), pp.79-85.

Antony, J., Forthun, S.C., Trakulsunti, Y., Farrington, T., McFarlane, J., Brennan, A. and Dempsey, M. (2019). An exploratory study into the use of lean six sigma to reduce medication errors in the Norwegian public healthcare context. Leadership in Health Services.

Alomari, A., Sheppard‐Law, S., Lewis, J. and Wilson, V. (2020). Effectiveness of Clinical Nurses’ interventions in reducing medication errors in a pediatric ward. Journal of Clinical Nursing, 29(17-18), pp.3403-3413.

Wondmieneh, A., Alemu, W., Tadele, N. and Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC nursing, 19(1), pp.1-9.

Dirik, H.F., Samur, M., Seren Intepeler, S. and Hewison, A. (2019). Nurses’ identification and reporting of medication errors. Journal of clinical nursing, 28(5-6), pp.931-938.

Kim, M.S., Seok, J.H. and Kim, B.M. (2020). Mediating role of the perceived benefits of using a medication safety system in the relationship between transformational leadership and the medication-error management climate. Journal of Research in Nursing, 25(1), pp.22-34.

Havens, D.S., Gittell, J.H. and Vasey, J. (2018). Impact of relational coordination on nurse job satisfaction, work engagement, and burnout: Achieving the quadruple aim. JONA: The Journal of Nursing Administration, 48(3), pp.132-140.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit JJ

Di Simone, E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D. and Di Muzio, M.  (2018). Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(5), p.346.

Irajpour, A., Farzi, S., Saghaei, M. and Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of education and health promotion, 8.

Subramanyam, R., Mahmoud, M., Buck, D. and Varughese, A.(2016). Infusion medication error reduction by two-person verification: a quality improvement initiative. Pediatrics, 138(6).

World Health Organization. (2018). Patient safety policies.  https://www.who.int/teams/integrated-health-services/patient-safety/policy

World Health Organization. (2016). Medication errors. https://apps.who.int/iris/bitstream/handle/10665/252274/9789241511643-eng.pdf.computer-provided

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