Forensic Nursing Chronicles

Medication errors include prescribing the wrong medication, administering the wrong medication or using the wrong route, interval, or doses, and failing to administer a medication. As a result, critical care in error prevention rests in a large part with the nurse. Nurses play a major role in medication preparation and administration, medication teaching, and evaluating clients’ responses to medications. As a result, they are required to have knowledge about the actions and effects of the medications being taken by their clients. We, as nursing students, are trained to take several steps to prevent errors. First we have the six patient rights of administering meds: right medication, right dose, right client, right route, right time, and right documentation. We are also taught to check the labels at least three times, to use at least two client identifiers, and to double-check all calculations with verification by another nurse. If we cannot read handwriting, we are not to guess, but to immediately verify the medication order with the prescriber. We are taught to question unusually large or small doses and to document all medications as soon as they are given. When available, nurses should also attend any in-service programs that focus on the medications commonly administered. If these steps are followed and distractions during the preparation and administration of medications are not allowed, the incidences of medication errors will be dramatically reduced.

Original Post
December 17, 2009
Title: Reduction in Medication Errors, comment
Recent research indicates that there is an increase in medication errors with nurses working on the night shift. It is noted that sleep deprivation interferes with concentration and increases distractibility. Assumptions can be drawn that the lack of concentration and distractibility may also affect other aspects of the night nurses care, including assessments, charting accuracy and critical thinking skills. To compound these issues, many new nurses work night shifts as it is often where the open positions are available. What can be done to address these issues? Organizations may want to explore resources to aid nurses with acclimation to the night shift. Education on circadian rhythms and how best to facilitate a healthy life style while working on nights is a great place to begin. Offering resources such as written materials, and formal classes may be of benefit. In addition, encouraging a culture that promotes power naps, healthy eating and exercise during breaks is recommended. Tracking changes in incident reports that relate to night shift medication errors and reckless behaviors may prove beneficial to support a culture of addressing night shift needs.

Original Post
November 6, 2009
Title: Reduction in Medication Errors-comment
In addition to medication administration practice for student and graduate nurses, there should also be continuous education on Pharmacology updates and practices for staff nurses. There is a wide variety of resources available, including monthly ISMP news letters providing insight into medication errors – not only showing nursing errors in judgement, but also shedding light on system errors as well. Electronic medication administration records and Physician order entry applications are also computerized tools that can be utilized by organizations to decrease the incidence and cost of medication errors.

Original Post
November 3, 2009
Title: Reduction in medication errors
It has become obvious to me in my practice as a nurse administrator that medication errors are a major liability to a health care facility. Efforts to reduce them are paramount to quality standards of practice.. A combination of education and interdisciplinary approach to error reduction is crucial. By "humanizing" medication directions i.e. at bedtime instead of hs the potential for the wrong med at the wrong time at the wrong dose is minimized. By educating new nursing students to the need for safe practice and insisting on that practice prior to graduating nurses, medication errors as well as quality of care will improve. By utilizing pharmacy consultants to review MD orders for correct utilization of meds the potential for error is again reduced.

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This entry was posted on January 11, 2010 at 2:37 pm and is filed under Medication Error. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.