What is the Best Way to Prevent Medication Errors in Hospitals?
Safety during patient’s admission in the hospitals comprises one of their fundamental rights as well as a priority of medical professionals (Merry & Anderson, 2011). Errors made during healthcare delivery have drawn researcher’s attention over the last decade. The errors that appear in a hospital set up involves lots of incidents such as the use of wrong equipment’s by the health professionals, patient falls, hospital infections, medication errors, and much more (Acquisto, Bodkin, & Johnstone, 2007). Statistics show that medication errors in America account 6500 deaths annually, an estimate of 0.002% of the total population, where 0.1% of the latter results in death. A study that examined the types of medication errors categorized them into omission errors, wrong route/time errors, and over prescription or under prescription errors to mention just a few. Therefore, to prevent any form of failure committed in the hospitals, the adoption of preventive measures in undoubtedly significant as stated by Maaskant et al., (2015).
A breakdown of literature from the bibliographies presented in this report show that preventive measures for medication are related with a wide range of factors such as the dosing calculation technique, medical preparation plus administration, oral medication errors, nursing education, the interdisciplinary education, e.tc.
Dosing Calculation Techniques and Nursing Education
These measures make health professionals like the nursing students ready for the clinical duties during their fieldwork. Calculation skills like mathematical computations may complicate the application of mathematics operations, especially when prescribing medications to a patient (Lopez et al., 2012). The article Interventions for Reducing Medication Errors in Hospitalized Adults analyses all types of medication operations and according to the authors, it would be a bold move to consider the establishment of protocols in the medical field. Therefore, it would be much easier for the health professionals to meet the correct dosing calculations and avoid medical errors Lopez et al., (2012). A separate study on accessing unsafe actions for the clients, found that over 52% of unsafe actions connected to medical mistakes where 23% of those were connected with nursing skills.
Moreover, taking education classes that boost medication calculation techniques via scientific trials appears very helpful. According to Martin and Bryan (2013), the provision of books with examples as well as recommendations appear to be beneficial in enhancing learner’s skills of learning. Else way, strengthening theoretical pharmacological background for the practicing health professionals can help them know medical errors, as they become future health professionals.
The key tenet of medical safety is to lower medical error rates, reduce their earlier identification prior to people get harm as well as timely treatment (Khalil et al, 2017). Some of the preventive strategies of this type of error are the standardization, as well as the simplification of medical procedures. These procedures involve the following measures; firstly, is to ensure a safe environment by putting labels to deter visitors from interrupting a doctor at that particular time. The labels can also be used as a reminder to enable the healthcare professionals to concentrate when delivering a healthcare service to their patients. Secondly is the delivery of premixed medics from the pharmacy to the hospital wards without the need for special preparations or further dialysis by the medical staff. As stated by Khalil et al., (2017) a mandatory double check of medication by two different health professionals can also be helpful in reducing risks that may lead to the severity of the patient’s health. Lastly, the preparation or administration of drugs the same time alongside the check of whether the medication is administered to the right patient can be other safety measures that can be practiced in healthcare units to help reduce medication errors
Oral Medication Orders/Interdisciplinary Collaboration/ Computerized Monitoring
The medication orders transmitted via phone from one health professional to another are hiding risks. According to the American Pharmacists Association (2015), the existence of noises or voices at the background of the speaker, poor phone connection, unfamiliarity with patient’s situation at hand, as well as quick way of communication or conversing over the phone are some of the factors that may make communication difficult. Therefore, to evade medication faults in such instances, it is prudent to understand the order, then confirm the client's name, the exact dosing, the reason for administering the dosage and the mediation involved. All these actions, are done before a physicist hangs up the phone. What is important here is the collaboration between the nurses, doctors, and the pharmacologist, when seeking ways and policies through which the incidence of medication errors can be reduced. Coxon and Rees, (2015) holds that the interdisciplinary cooperation should also obtain a comprehensive view regarding the problems of medication errors, their main causes, and how medical health professionals tackle them.
On the other hand, computerized monitoring is a modern way of voluntary pharmacists reporting. They detect an error like order error, rectify it, and then fill out the report. This implies that medication mistakes can be intercepted prior to the occurrence of any adverse event. In an event where Computerised physician order entry is in use, prescription plus dispensing errors can be easily detected (Goel, 2009). The systems improve safety needs to be used in combination with clinical decision support systems. However, adoption of technology can be costly, but it can also lead to a rise in new and unknown risks in the medical field.
Special populations such as the elderly and children have been the leading causes of medical errors. For the children, they have been shown to be vulnerable to medications errors. Goldspiel et al., (2015) states that these errors have been shown to be rampant in paediatric hospital setups with the rate for severe drug events being three times higher for children than adults. Ideally, dosses of children medication are determined by weight, hence any extra calculation involved may leave a room for error. Moreover, few drugs have been tested for paediatric use; therefore, doctors should estimate dosage to treat children. In some instances, it may be difficult to have the children cooperate fully, with different aspects of care and also, poor familiarity among the healthcare professionals with standards of care for unusual paediatric illness can also lead to a medical error (Merry & Anderson, 2011). Another group of people that appear to be vulnerable to medical errors includes the elderly. This has been influenced by the heightened complexity of their care compared to systemic discrimination against the provision of quality care to the same group.
Currently, different databases exist that collect data on certain types of errors, like the centre for disease control and prevention (Johnson, Guirguis, & Grace, 2015). Individual healthcare systems or institutions might have their internal data collection system like that at the veteran’s health administration. However, many countries have put in place systems for facilities within their regions, but such systems have been affected by underreporting of severe events. This problem is pervasive for systems designed to hold individuals or organizations responsible for errors or adverse outcomes. For medical error reduction to be effective in every system, it is prudent for errors to be reported as well as evaluated (Lopez et al., 2012). Where effective programs should put protection from legal discovery as well as a liability that cause errors to be hidden.
The primary aspect of a good reporting system are where those that report should feel secure when doing so as well as their confidentiality be protected. Unfortunately, systems where such tenets are missing is ineffective in procurement of information that is imperfect and inaccurate as well. According to Lopez et al., (2012) the question of who made this error is not essential, but it important to find out what happened and how the same mistake can be prevented in future.
The IOM suggests a two-tier reporting system; a voluntary reporting system for medical errors including close calls and nationwide reporting system that entails mandatory reporting of faults that result in serious in death or severe injuries. Great support exists for the state and federal legislation that protects both the provider as well as the patient confidentiality, whilst safeguarding the remedies, for those who health has been compromised (Kasbekar et al., 2014)
The present report highlights some of the best ways of prevention or reduction of medication error rates. Physicist’s watchfulness, as well as the adoption of precaution measures regarding medical errors, are detrimental to preventing medication faults. Research has shown that shifts in health system characteristics regarding medication management comprise another tenet to protect a client from medical mistakes. It is evident that the exclusion of medical faults is hard to be successful, however the drop of their occurrence is something that can be achieved. Ultimately, it is evident that the minimization of every type of medical error during the delivery of healthcare promotes a safe environment for hospitalization
Acquisto, N., Bodkin, R., & Johnstone, C. (2017). Response to: “Response to: Medication errors with push dose pressors in the ED and ICU”. The American Journal Of Emergency Medicine.
American Pharmacists Association. (2015). what could go wrong? Preventing medication errors before they happen. Pharmacy Today, 21(12), 69-81.
Coxon, J., & Rees, J. (2015). Avoiding medical errors in general practice. Trends In Urology & Men's Health, 6(4), 13-17.
Goel, A. (2009). Disclosure of medical errors. Indian Journal Of Medical Ethics, (2).
Goldspiel, B., Hoffman, J., Griffith, N., Goodin, S., DeChristoforo, R., & Montello, C. et al. (2015). ASHP Guidelines on Preventing Medication Errors with Chemotherapy and Biotherapy. American Journal Of Health-System Pharmacy, 72(8), e6-e35.
Johnson, A., Guirguis, E., & Grace, Y. (2015). Preventing medication errors in transitions of care: A patient case approach. Journal Of The American Pharmacists Association, 55(2), e264-e276.
Kasbekar, R., Maples, M., Bernacchi, A., Duong, L., & Oramasionwu, C. (2014). The Pharmacist's Role in Preventing Medication Errors in Older Adults. The Consultant Pharmacist, 29(12), 838-842.
Khalil, H., Bell, B., Chambers, H., Sheikh, A., & Avery, A. (2017). Professional, structural and organisational interventions in primary care for reducing medication errors. Cochrane Database Of Systematic Reviews.
Martin, C., & Bryan, G. (2013). Recognizing and Preventing Medication Administration Errors. The Consultant Pharmacist, 28(5), 272-277.
Lopez, A., Sol?, I., Ciapponi, A., & Durieux, P. (2012). Interventions for reducing medication errors in hospitalised adults. Cochrane Database Of Systematic Reviews.
Maaskant, J., Vermeulen, H., Apampa, B., Fernando, B., Ghaleb, M., & Neubert, A. et al. (2015). Interventions for reducing medication errors in children in hospital. Cochrane Database Of Systematic Reviews.
Merry, A., & Anderson, B. (2011). Medication errors - new approaches to prevention. Pediatric Anesthesia, 21(7), 743-753.