Medical error refers to wrong administration of medication with the intention of healing. Medication errors have serious direct and indirect harm to the patient. The medication errors arise from various parts but mostly they arise because of system breakdown. The medication errors lead to many costs. The direct costs include direct harm to the patient. It sometimes even leads to loss of lives and disability. It leads to loss of income through the need for replacements. It leads to loss of assurance in the health care professionals. The satisfaction of the patients and the practitioners reduces. The patients who have to stay long in hospital facilities because of wrong medication pay huge bills. They experience physical and psychological problems (Cima et al, 2012). The morale of other professionals in the medical facility reduces because of the inability to provide best and correct care to the patients. The society also bears costs. Errors lead to loss in productivity of workers and it leads to the reduction of school attendance. The health of the population reduces. Nurses have a bigger responsibility to play in reducing the errors that occur. The type of errors that occur most of the times include diagnostic, treatment and preventive errors.
Nurses are the people that have much time with the patients. They are the people that administer drugs to patients and they are the last people to determine safe medication. The nursing environment has really changed and this calls for nurses cognizant skills to prevent and protect their practice. The nurses should provide an environment that will allow safe administration of medications to the patients. The nurses have the skills they have received in college. They have their skills sharpened because of the drilling they get in college that makes their conscious change to unconscious practice as nurses. Nurses should administer the right medication, right dose, and the right time to the right patient (Choo et al, 2010). This ensures safe administration of medication to patients in the health care setting.
The nursing career is very interesting but it comes with its challenges. For safe administration of drugs, nurses should have the right to demand a clear written order from the physician requesting for drug administration. The physician prescribes a medication and the appropriate route for the administration. Nurses should demand this before deciding to administer the medication. The order should specify the dosage and it must include the numerical dosages. The order should specify the type of drugs and not just vague orders. Orders should indicate specificity and explicitness. The nurses should not take verbal orders or orders through the phone not unless the physician is present. Taking time to process an order is important because it helps in avoiding errors.
Technology has improved how things happen and orders now come in printed format. This improves legibility. The cost of implementing systems that allow physicians to order medication directly from the office is high but it is worth it. In cases where these systems exist, they should not take handwritten orders. It is the obligation of the nurses to question the legibility of the orders and the physician prescribing the medication. This will help in preventing cases of fraud and cases of the patient receiving wrong medication. It is the nurse’s duty to administer medications to the patient. The pharmacist’s responsibility is to dispense the drugs and sometimes nurses might have pressures and might dispense wrong drugs. The nurse should discover this error and notify the pharmacist. This will help in assisting the system to work well. Most of the times the nurse receives information that no one is available in the pharmacy department to give drugs to the patient; the nurse has the option of waiting for the pharmacist of going and collect the drugs. Such cases put the patient at risk of not receiving the medication on time. This calls for the nurse to take the responsibility of collecting the drugs. The nurses should do so without haste to ensure that no quick decisions happen that might lead to improper dosage administration.
The systems automated to dispense drugs should allow nurses to first access it. This allows the nurses to reduce instances of wrong medication. Information is important to the nurse and they have the right to access drug information. This necessitates the presence of hospital formulary and nursing drug reference book. This helps the patient refer in cases of doubt. They have the responsibility and right of asking questions about the drugs before administering it to the patients. They should have close contact with the pharmacists because they are the experts of drugs. Nurses should develop more dialogue with the pharmacist to improve patient outcome and recuse chances of medication errors. Nurses should continuously update their knowledge because the field of pharmacology is a dynamic one. The practice of nursing spells out that a nurse should not administer drugs that they are not familiar. If the drug is not in the reference book, nurses should find the information pertaining to the drug. They should not administer the drug until they have sufficient information concerning the dosage and route of administration.
Nursing policies guide the practice of nursing. Nurses should follow the policies, failure to which makes the nurse risk litigation or even suspension of license. Many new medications enter the market every day. Researchers discover new ways to administer medications. Nurses need to develop ways and systems that will allow them keep abreast with the new ways. Nurses should devote part of their time in advancing their knowledge through self-learning programs. Through the learning and training, nurses increase their knowledge on safe administration of medication. It helps the nurses avoid errors in their practice. The nursing administrators should support and allow nurses to further their education.
Nurses shape the environment of the medical facility. They have the responsibility of speaking of situations that present potential risks that can lead to medication errors. Nurses should take their time to recognize problems in the systems. Taking time helps in identification and proper address to the problem. Reporting medication errors is one of the effective ways to eliminating wrong administration of medication. Nurses should develop the culture of reporting errors immediately to the respective authorities to avoid wrong administration (Page & Institute of Medicine, 2004). The nurse inability to detect an error can lead to the costs
Nurses should always supervise the interns under their care. Interns are not fully conversant with the drug administration. The interns learn and develop a culture during their internship. Qualified nurses should inculcate the culture of correct administration of medication to the interns. The interns will have that culture in them and this will prevent future errors from occurring (Koppel et al, 2005). The nurses should teach them all the procedures and systems that need adherence. They need to learn how to use formulary and inculcate a culture of learning. Research indicates that the student nurses develop their good or bad attitude during their internship.
The nursing department should implement a program of continuous quality improvement with respect to safe administration of medication. This will involve collaborative efforts from the medical field, pharmaceutical field and nursing field. Integration and coordination of the departments in the hospital facility will lead to quality improvement. The program of quality improvement should also focus on the correct use of drugs that involve high frequency usage. This program should also incorporate a system of monitoring, looking over and reporting of medication errors (Cohen, 2007). This will help nurses in identifying and eliminating chances of medication errors. It also prevents their recurrence if they happen to occur. The medical environment should have a culture that puts safety first before anything. Nurses should encourage their patients to counter check on their safety in the hospital facility. Patients can identify an error in medical prescription and if the nurses are not keen enough to counter check with the physician and the pharmacist, it could lead to serious disaster.
Nurses should use correctly the facilities accorded to them. This can only happen through adequate leadership, improvement of resources and self-discipline. Medication errors may happen in unprecedented cases but it is the responsibility of medical professionals to recognize the errors and take corrective actions to prevent an error from recurring in the future. All these systems will lead to a safer health system that will guarantee a safer society. Nursing has a role in ensuring a safe society.
References
Choo, J., Hutchinson, A., & Bucknall, T. (2010). Nurses' role in medication safety. Journal of nursing management, 18(7), 853-861.
Cima, L., Clarke, S., & Joint Commission Resources, Inc. (2012). The nurse's role in medication safety. Oakbrook Terrace, Ill: Joint Commission Resources.
Cohen, M. R. (2007). Medication errors. Washington, D.C: American Pharmaceutical Association.
Koppel, R., Metlay, J. P., Cohen, A., Abaluck, B., Localio, A. R., Kimmel, S. E., & Strom, B. L. (2005). Role of computerized physician order entry systems in facilitating medication errors. Jama, 293(10), 1197-1203.
Page, A., & Institute of Medicine (U.S.). (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, D.C: National Academies Press.
