Assignment task: Please help me to provide a detailed abstract paper.
Introduction:
Medication errors represent a significant and preventable threat to patient safety within healthcare settings. These errors, which can occur at any stage of the medication process, are defined as preventable events that may lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer. The problem is pervasive, with an estimated 1.3 million people in the United States harmed each year due to medication errors, according to The Joint Commission Journal on Quality and Patient Safety (Schroers et al., 2021). The implications of these errors are far-reaching, compromising patient safety and contributing to increased healthcare costs due to extended hospital stays and legal expenses (Tsegaye et al., 2020). The causes of medication errors are multifaceted and complex, encompassing human error, system failures, communication breakdowns, and lack of knowledge or training. Human error can be influenced by factors such as fatigue, stress, or distraction, while system failures can be attributed to inadequate systems or processes in place for medication management. Communication breakdowns between healthcare professionals can lead to errors, and a lack of knowledge or training can result in incorrect medication being prescribed or administered. The purpose of this study is to delve deeper into the causes and consequences of medication errors, with the aim of identifying effective strategies to prevent these errors and improve patient safety. By gaining a comprehensive understanding of the factors contributing to medication errors, we can develop targeted interventions to address these issues and ultimately enhance the quality of care provided in healthcare settings.
SWOT Analysis:
Medication errors in healthcare are a significant issue that can lead to severe patient harm, including adverse drug events and even death (Tsegaye et al., 2020). They occur when an error is made in prescribing, dispensing, or taking a medication. A SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis can help identify the factors contributing to medication errors and provide a framework for developing strategies to reduce these errors. Strengths: These are the internal positive aspects that can help reduce medication errors. For example, well-trained healthcare professionals, robust medication reconciliation processes, and advanced technology like electronic health records and computerized physician order entry systems. Weaknesses: These internal negative aspects can contribute to medication errors. For example, lack of proper training, understaffing or high workload, poor communication among healthcare professionals, and lack of standardized procedures. Opportunities: These external factors can be exploited to reduce medication errors. For example, advancements in technology, increasing awareness about medication safety, and regulatory policies promoting patient safety. Threats: These external factors could negatively impact the organization's ability to reduce medication errors, such as increasing care complexity and legal and financial consequences. Healthcare organizations can develop effective strategies to reduce medication errors and improve patient safety by understanding these factors.
Literature Review:
The three selected evidence-based articles provide valuable insights into medication administration errors, examining different aspects and contributing factors. The synthesis of these articles underscores the importance of a comprehensive approach to reducing errors, incorporating technology, policy adherence, addressing underlying causes, and creating a supportive work environment.
The first article is a mixed-methods study that emphasizes the role of Barcode Medication Administration technology in hospital practice. The findings highlight the prevalence of policy deviations, encompassing various factors such as tasks, organization, technology, environment, and nurse-related issues. The study suggests that while technology can be effective, policy adherence is crucial. Therefore, efforts to mitigate medication errors should involve implementing advanced technology and ensuring nurses understand and comply with associated policies (Mulac et al., 2021).
The second article, a qualitative systematic review, explores nurses' perceived causes of medication administration errors. The study identifies knowledge-based, personal, and environmental variables, revealing recurring themes such as a lack of pharmaceutical knowledge, exhaustion, complacency, severe workloads, and interruptions. The results suggest that interventions to reduce medication errors should target these underlying causes, including providing adequate training, managing workload effectively, and minimizing distractions (Schroers et al., 2021).
The third article is a cross-sectional study in Ethiopia that assesses the prevalence and associated factors of medication administration errors among nurses. The research reveals a high prevalence of errors (57.5%). It identifies workload, interruptions, lack of pharmacological knowledge, and professional expertise as contributing factors. Notably, a positive work environment is associated with fewer errors, emphasizing the importance of creating a supportive work environment for nurses to enhance patient safety outcomes (Tsegaye et al., 2020).
Implementation Plan and Method for Initiation Change:
Evidence-based practices (EBPs) can help reduce these errors and improve patient safety and quality of care. Barcode Medication Administration (BCMA) and medication reconciliation are two evidence-based practices that aim to reduce medication errors in healthcare settings. Barcode medication administration (BCMA) systems scan the barcodes on patients' wristbands and medications to ensure the right patient gets the right medication at the right time (Mulac et al., 2021). If there's a mismatch, the system alerts the nurse. On the other hand, medication reconciliation is a process where healthcare professionals review all the medications a patient takes to ensure that they are all necessary, safe, and do not cause harmful interactions. At each transition point (admission, transfer, discharge), the healthcare team creates a comprehensive list of the patient's medications (Stolldorf et al., 2021). This list is compared against the physician's orders. Any discrepancies are resolved before the patient receives any medication. This comparison aims to ensure that any changes in medication (new medications, changes in dose, or discontinued medications) are intentional and appropriate and that the patient and their healthcare providers are all aware of these changes. Both these practices are crucial in ensuring patient safety and reducing healthcare costs by minimizing medication errors.
Lewin's Change Theory can be utilized to implement the proposed SWOT Analysis in a medication error, and this theory consists of three stages: unfreezing, changing, and refreezing (Barrow et al., 2022). The unfreezing stage involves preparing the organization to accept that change is necessary. In the context of medication errors, this could involve presenting data on the prevalence and impact of medication errors and how BCMA and medication reconciliation can help reduce these errors. The change stage involves the actual implementation of the change. For BCMA, this could involve purchasing and installing the necessary equipment, training staff on how to use the system, and integrating it into existing workflows. Medication reconciliation could involve training staff on the process, integrating it into existing workflows, and ensuring that it is done at each transition point. Refreezing involves reinforcing the changes to make them part of the standard operating procedures. This could involve regular audits to ensure that BCMA and medication reconciliation are being done correctly, providing feedback to staff, and making any necessary adjustments. By following these steps, healthcare organizations can effectively implement BCMA and medication reconciliation to reduce medication errors and improve patient safety and quality of care.
Strengths and Weaknesses (Barriers) in Promoting the Implementation Plan
The implementation plan for medication errors can have several strengths and weaknesses. Strengths: Well-Trained Healthcare Professionals: Healthcare professionals who are well-trained in medication administration and error prevention can significantly reduce the occurrence of medication errors. They can identify potential errors before they occur and take necessary steps to prevent them. Robust Medication Reconciliation Processes: A strong medication reconciliation process can help identify and resolve patient medication order discrepancies. This can prevent errors related to incorrect medication orders. Advanced Technology: Electronic health records (EHRs) and computerized physician order entry (CPOE) systems can help reduce medication errors by providing accurate and up-to-date information about the patient's medication history, allergies, and other relevant information. These strengths can be utilized to promote change by providing continuous training to healthcare professionals, improving the medication reconciliation process, and implementing advanced technology in healthcare settings. Weaknesses: Lack of Proper Training: Lack of proper training can lead to medication errors. Healthcare professionals need to be adequately trained in medication administration and error prevention. Understaffing or High Workload: Understaffing or high workload can lead to medication errors as healthcare professionals may be rushed or fatigued, which can lead to mistakes. Poor Communication: Poor communication among healthcare professionals can lead to medication errors. Clear and effective communication is essential to ensure accurate medication administration. Lack of Standardized Procedures: Lack of standardized procedures can lead to inconsistencies in medication administration, which can result in errors.
The nurse leader's role can significantly impact these identified barriers to medication error. They can advocate for proper training programs and ensure that all healthcare professionals are adequately trained. They can also address staffing issues and work towards maintaining a balanced workload for all staff members to reduce the risk of errors due to fatigue or rushing. Furthermore, they can also promote using advanced technology like EHRs and CPOE systems to reduce medication errors.
The Role of Informatics, Technology, and Interprofessional Collaboration on Improving Quality
Informatics, technology, and interprofessional collaboration can significantly improve healthcare issues, particularly medication errors. Electronic Health Records (EHRs) are a form of health informatics that can reduce medication errors. They provide a comprehensive and up-to-date patient medical history record, including medications prescribed, dosage, and frequency (Fischer et al., 2020). This can prevent errors such as prescribing a medication that a patient is allergic to, or that could interact negatively with another medication the patient is taking. For example, if a patient is already on a blood thinner, the EHR would alert the physician if they try to prescribe another medication that could increase the risk of bleeding. Computerized Physician Order Entry (CPOE) technology allows healthcare providers to enter medication orders directly into a computer system (Fischer et al., 2020). The system can then check for potential errors such as incorrect dosage, drug-drug interactions, or drug-allergy reactions. For instance, if a physician accidentally enters a dosage that is too high for a patient's weight, the system alerts the provider, who can adjust the order accordingly. This can significantly reduce medication errors. Interprofessional collaboration is another key factor in reducing medication errors. It involves different healthcare professionals (doctors, nurses, pharmacists, etc.) working together to provide patient care. For example, a pharmacist might notice a potential medication error and bring it to the attention of the prescribing provider. This collaboration can also extend to regular team meetings to discuss patient care, including medication management, which can help identify potential errors before they occur.