Medication Error and Elimination – Health System Example

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"Medication Error and Elimination" is a decent example of a paper on the health system. In the United States of America, around 15% of the prescription medication is done erroneously; the primary goal of the paper is to give evidence for strategies to reduce or eliminate the occurrences of medication errors pertaining to administrating dispensing and prescribing of medicines in patients in the acute, residential, and subacute care settings. Strategies having evidence of reducing error in medication include the computerized ordering systems; the individual or personal medication supply systems instead of the ward stock approach dispensing system; utilization of the clinical pharmacists in case of the inpatient setting; and two nurses counter checking of medication orders prior to dispensing medication.

Generally, evidence of the effectiveness of the intervention strategies towards reductions of medication error occurrences are not definite; hence high-quality regulated trials are required in all fields of medication delivery or prescription. Medication errors are the preventable or avoidable incidents in which patients are given the wrong dosage, the wrong form of medications, the wrong medications, or given medication at the wrong time as the result of an erroneous dispensing, prescribing, or administration process. Medication errors are present at all stages during the medication delivery process, that is, from the prescription by physicians to the provision of these medications to the patients by the nurses, therefore it is essential for any site or location in the health system to embrace interventions that coordinate well all the aspects of medication delivery. This paper presents some of the available and tangible settings related to the management of medication errors related to prescription, administration, and dispensing of the medications in the subacute, residential, and acute health care settings. Background A medication error is a noteworthy problem in the medical or healthcare in the world.

The United States (US) experienced 15% medical errors of the medication despite the efforts in reducing them. The older population has been primarily affected by erroneous medication occurrences due to their higher levels of medication intake than other age groups.   There is a staggering financial burden with the US spends about $16 and $28 billion per year on the cost of preventable medication errors (Jones & Schaubhut, 2014). Literature A large number of unfavorable drug events and effects (UDEE) in long-term care scenarios or settings are the result of preventable errors.

In the US, a case-control study was carried in order to assess the incidences of and also the risk factors for UDEE in the long-term care settings and indicated that 40% of the identified UDEE were judged preventable (Jones & Schaubhut, 2014). A US study of eleven health care units found out the most common errors types exposed to patients; prescribing wrong medication choice (10%), includes wrong dosage(27%), administering the wrong type of medication ( 9%), identified allergy (9%), missing dosage (8%), providing medication at the frequency (6%) or wrong time (7%) (Jones & Schaubhut, 2014). A systematic survey entailing 29 studies revealed drugs regularly associated with UDEE included analgesics, cardiovascular drugs, and hypoglycemic agents.

Moreover, medication errors related to preventable UDEEs included the failure in prescribing prophylaxis for patients that regularly take anti-platelet drugs in preventing gastrointestinal toxicity, nonsteroidal anti-inflammatory drugs, patients who do not monitor hypoglycemic or diuretic, and the anticoagulant usage resulting from under- or over-diuresis, bleeding, and hypo- or hyperglycemia (Roark, 2004). The most common genesis of medication error is associated with ignorance, at 22%, when it comes to awareness in the medication interactions, correct mixing, and proper dosages.

The second common cause is lack of patient information, at 14%, which results in inappropriate medication (Jones & Schaubhut, 2014). One of the most regular types of dispensing errors includes the selection of the incorrect concentration drugs and incorrect interpretation of a prescription. Other factors that contribute to medication errors include inadequate continuity of health care in particular between the community and the hospital the patient’ s discharge, many health care providers prescribing medication or polypharmacy, misunderstanding or confusion among brand names, and also label instructions. Interventions Effective interventions towards the reduction of medication errors or UDEE include the following five categories; nursing care models, computerized systems, usage of pharmacists, training or education, and individual or personal patient medical supplies. Computerized Ordering System (COS) when combined Clinical Resolution Support Systems (CRSS) provide one of the best platforms in curbing medication errors; COS allows the physician to make all orders online, while CRSS avails computerized advice on routes, drugs doses, and frequencies.

CRSS can also do the drug allergy or drug-drug interaction comparisons and checks. Administration records in medical care (ARMC) are initially produced by the order entry at the pharmacy. There is always effectiveness when a single report is utilized; especially where computerized ARMC is employed since they improve readability as compared to handwritten documents. Usage of bedside terminal systems can reduce medication errors significantly. Barcodes utilization in health care information system reduces the medication error rate, but the system has to be under check in order to avoid circumventing resulting from: Nurses reducing activities to lower workload during busy schedule Reduced coordination among the physicians and the nursing staff Nurses’ confusions over automated removal or transfer of medications via the barcode administration system Increased choices of monitored activities during the busy schedules Reduced capability in deviating from routine activities and sequences When a health facility embraces an automated dispensing system, quality service evident, and there are improved safety outcomes with a reduced rate of error filling of dosages by healthcare technicians.

Additionally, synchronized individual, or personal medication supplies systems reduce medication errors at a high rate when compared to any other dispensing systems; for example, ward stock or the stock bottle methods.

However, the system has chances for errors of distractions from the nursing ward towards the pharmacy. Education on medication or written medication examinations on calculations improve the nurses’ competence but do not prevent errors, since they already accrued these skills from colleges. On other hand, the utilization of pharmacists for patient education or consultation at discharge or medication rounds reduces medication errors (Briggs, 2002). Conclusion Health care service providers, with help of experts, should come up with a best-practice set of guidelines synchronized in their setting of duty, for example, rules and regulations or checklists to be used by a nurse during dispensing medicine.

Nurses should embrace double-checking care model, that is, in which two nurses confirm medication orders and prescriptions before dispensing the medication in reducing medication errors.

References

Briggs, B. (2002). Medication Error Reduction. Health Data Mgt, 41-47.

Dimant, J. (2001). Medication Errors: The Problems, Causes, and Solutions. J Am Med Assoc, 80-94.

Jones, C., & Schaubhut, M. (2000). Systematic Approach Towards Medication Error Reduction. Journal of Nursing Care, 12-28.

Nay, R., Koch, S., & Hodgkinson, B. (2006). Strategies on Reduction Medication Errors. Intl J of the Evidence-Based H.Care, 3-40.

Roark, C. (2004). The Bar Codes and Drug Administration. The American Journal of Nursing, 62-67.

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