Introduction
Delivery of healthcare is not inerrant, and the preponderance of medication errors is a perennial problem in the clinical field. It should be noted that a majority of the medication errors are not life threatening. However, it is the reason for many wrongful deaths in the United States and is a factor in the morbidity and mortality statistics recorded in the medical field.
Omissions and Commissions
Medication errors can be caused by undesirable commission and omissions by the medical personnel. Omissions occur where the medication is not administered fully while commissions occur when there is inappropriate administration of medication. Omissions occur whereby only a fraction of the appropriate medication is administered while commissions occur when the wrong drug is administered, or a wrong dosage is served. This reflects in the form of lapses and slips (Moyen et al., 2008).
Lapses and Slips
Lapses account for medication errors that result from personnel failing to administer a medication because they forget or neglect to do so. Mistakes involve knowledge-based faults. These reflect in the form of misperceptions, poor judgements, wrong inference and misinterpretation errors. They may occur due to faulty thought processes. On the other hand, slips result from administering the mediation but failing on the correct rates or doses. The other cause of medication errors is situation factors this is in the form of general effects such as fatigue, execution of multiple tasks, stress, and working under the influence of drugs or alcohol. These events lead to diversion of personnel concentration and could conduce to medication errors (Moyen et al., 2008).
Medical Equipment
Medical equipment coupled with their use can contribute to medication errors. This is in the form of either equipment used to administer drugs to admitted patients or those used from prescription purposes. Medication errors can reflect in the use of automated prescription and dispensation systems employed in high-tech hospitals. It is important that such dispensation systems are monitored because machines have the tendency to commit errors at some point. There are also cases when the equipment is wrongly configured by the medical personnel, this has the effect of administering the wrong dosage or administers the does for a wrong amount of time (Moyen et al., 2008).
Clinical Decision Systems
The other reason for medication errors is the lack of a system or tool to guide nurses on making clinical decisions. This tool should be able to generate recommendations on how to schedule medication based on dietary restrictions, the desirable infusion rates, and the necessary preparations prior to parenteral administration. In order to implement this, it is necessary to develop a nurses’ working routine (Lilley et al., 2011).
Assessing medication Errors in a pediatric care unit
I take the case of the pediatric care unit of the Capitol Hill Family Health Center. In order to assess the errors three measures; a definition of the different type of errors would have to be put in place, thereafter, a system of monitoring and recording would be set up, and finally, assessment results would be provided. Most medication errors can be pinned down to a member of staff, therefore, each nurse’s profile will be developed (as prescriber) (Cimino, 2004).
The assessment model would have three surveillance levels to source for medication errors. Foremost, there would be a review of the pharmacy order forms and the computer entries made. It would be followed by an analysis of the nurse order transcriptions for any errors. Finally, there would be an overall oversight assessment on the medications prescribed over the period under study. After this, a profile of the each of the different prescribers will be created, the cause of the medication error and a recommendation. Such a system would effectively manage and ensure medication errors are kept at a minimum (Levine et al., 2001).
References
Cimino, M. A., Kirschbaum, M. S., Brodsky, L., Shaha, S. H., & Child Health Accountability Initiative. (January 01, 2004). Assessing medication prescribing errors in paediatric intensive care units. Pediatric Critical Care Medicine: a Journal of the Society of Critical Care.
Levine, S. R., Cohen, M. R., Blanchard, N. R., Federico, F., Magelli, M., Lomax, C., Greiner, G., Lesko, A. (January 01, 2001). Guidelines for preventing medication errors in pediatrics. Journal of Pediatric Pharmacology and Therapeutics, 6, 5, 426-442.
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Lilley, L. L., Savoca, D., & Lilley, L. L. (2011).Pharmacology and the nursing process. Maryland Heights, MO: Mosby.
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Moyen, Eric, Camiré, Eric, & Stelfox, Henry Thomas. (2008). Clinical review: Medication errors in critical care. BioMed Central.
