Medication administration to patients is a part of clinical nursing practice with high risk of errors occurrence. The causing factors of medication errors are either individual or systemic.
Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change practice.
Medication errors in hospital settings lead to devastating consequences for both nurse and patient that can be reduced significantly through the use of technology that improves patient care and saves time for busy nurses.
Bar-coded medication administration is one type of technology that uses a scanning device to compare bar codes on patient identification bands with bar codes on prescribed medications, electronically verifying the medications against the medication records, thereby reducing medication errors significantly.
Keywords Change management, Lewin change theory, Medication errors, Bar-coded Medication Administration Introduction Medication safety has been identified by the Institute for Safe Medication Practices Canada ISMPC as a priority among hospitals and long term care facilities since medication errors in hospitals are a serious threat to patient safety.
The ramifications of medication errors affect all healthcare organizations, resulting in consumer mistrust, increased healthcare costs, and patient injury or death Carroll, Bar coded medication administration is one such tool that has the potential to reduce medication errors significantly, when used correctly Carroll, ; Dennison, The current system of medication delivery and administration at our facility involves old medication carts in poor repair and relies on manual checks to ensure the right drug is given to the right patient at the right time, route, site and dosage by the nurse.
The psychiatric facility in question is now planning a complete overhaul of the pharmacy system and is incorporating automated dispensing machines, along with electronic medication records and bar coding of medications to modernize their care and improve patient safety.
|Announcements||Medication Errors Administration of medications is an important nursing function and one that if not properly carried out, can lead to a host of problems for the patient and nurse. It is estimated that over 1.|
|Quality and Safety Education for Nurses||Better Environments for Nurses Mean Fewer Medication Errors August 28, Medication errors can compound a medical crisis, sometimes with tragic results. On average, a U.|
|QSEN Competencies||The Nursing Practice Act NPA includes the "administration of medications or treatments ordered by a physician, podiatrist or dentist" as part of the practice of nursing. Although PAs are not included in the NPA, the Board recognizes that nurses work collaboratively with PAs to provide patient care in various practice settings.|
|Automatic Bibliography Maker||When printing this page, you must include the entire legal notice. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission.|
This large project will have the greatest impact on front line nurses, many of whom are skeptical of change or lack confidence in their ability to adapt to new technologies, therefore careful implementation of this project is imperative. Without a framework for guidance, new technologies can result in workarounds that threaten patient safety.
Medication errors are a common occurrence in healthcare facilities around the globe, with serious consequences resulting in death or harm, increased inpatient days in hospital, erosion of trust between consumer and healthcare organizations, and a great deal of economic expense Carroll, ; Dennison, The economical impact of medication errors is estimated to be around five thousand dollars per error unless there is legal litigation, when the costs can skyrocket into the millions Dennison, No less important, but certainly less discussed, is the harm to nurse morale after being involved in a medication error, potentially leading to lost time from work Dennison, While medication errors can occur at any stage in the process, the nurse is often the last line of defense for catching mistakes due to the nature of the administration of meds at the bedside.
The ISMPC has worked closely with hospitals, pharmacies and drug companies to address many preventable occurrences ranging from medication reconciliation programs to the standardization of drug names and labeling. The introduction of automated pharmacy dispensing machines, bar-coding and scanning of medications is a national project throughout Canada, aimed at reducing medication errors and ultimately improving patient safety.
The technology involved in bar-code scanning also integrates electronic medication records EMR and computerized physician order entry CPOE into practice, thereby reducing paper documents and the possibility of transcription errors, ineligible handwriting or missed signatures.
BCMA technology consists of bar coded medication packets and bar codes on patient identification bands as well as a scanner attached to a medication cart.
With added distractions, complexities of care, and faced paced environments, nurses may inadvertently overlook inconspicuous errors or fail to catch packaging errors, leading to medication mishaps that could have serious consequences.
The introduction of BCMA technology at our psychiatric facility can improve patient safety and also decrease time spent on medication administration, thereby allowing more time for patient contact.
Currently nurses use old medication carts that have worn wheels, broken drawers and some are health and safety hazards. The nurses use paper medication records and must double check medications against the MAR sheets before administering.
The facility has recently introduced new computerized swipe access carts that are bar code scanner friendly with the intent to introduce bar coding once the pharmacy department converts to electronic medication dispensing and electronic medication records.
While many nurses will welcome this time-saving change, others will feel overwhelmed by the magnitude of the change; therefore careful planning and support on the part of the organization will lessen the stress associated with the implementation. Managing change has always been challenging in health care facilities, and new technologies often incite resistance from nurses who already cannot find enough time in their shift to complete patient related tasks.
One barrier that could impact the implementation at our psychiatric hospital is the possibility of a patient refusing to wear identification bands, which are necessary for BCMA to work. Other barriers include short cuts that some nurses have adopted to save time, such as pre pouring medications, which contravenes Canadian nursing standards of practice.
Workarounds are common and are a unprofessional attempts to circumvent computer failures or save time. They come about through frustration on the part of the nurses when they are unable to find a solution to an immediate problem.
For successful implementation of a project as large as bar-coding, careful planning and identification of all barriers are imperative. Not all nurses are comfortable with technology in the work environment, thus they may be resistant to changing practice, or be afraid of failure Bozak, It is important to recognize the different educational needs of the various nurses and acknowledge the varying attitudes and stresses the nurses might have.
When health care organizations fully understand what behaviours drive or oppose change, then work to strengthen the positive driving forces, change can occur successfully Bozak, Unfreezing involves identifying key players that will be affected by the change and gathering them together to communicate ideas and create lists of all driving and static forces that will affect the project.
In this stage, implementation of the project produces the change desired, so it is important to continue to keep lines of communication with the nursing staff open. Key components of this step are communicating with all stakeholders including frontline nurses, managers and administration.
The inclusion of front line staff in planning groups and key decision — making processes promotes a feeling of empowerment that helps to overcome their resistance to the change and enables them to understand the importance of the project and how it will beneficially affect client care.
During the unfreezing stage, round table discussions with the purpose of teasing out the driving and restraining forces will help identify barriers that may need to be overcome. In this facility some restraining forces might be; staff resistance to using computerized devices, the possibility of workarounds, lack of computer experience, lack of trust in the organization, and aversion to using a new system.Edited Nursing Research Paper Uploaded by miss RN ALL THINGS RN these are my projects, research, reviewers, study guides i used during my college years.
hope this will guide/help you through your nursing life, research, assignment, or your 5/5(10). Medication errors lead may lead to dismissal from a nursing program.
Depending on the severity and frequency of medication errors by students, the school may lose its privilege to practice in some facilities. Mar 04, · A research study conducted among a select group of nursing students at a suburban New York university was designed to answer the question: Does the use of PDAs (personal digital assistants) with drug and medication calculation software improve the accuracy and efficiency of medication administration (Greenfield, )?
The rates of nursing medication errors are high in both developed and developing countries.[9,10,11,12,13,14] Studies have shown that almost one-third of medicinal complications are due to medication errors.
According to previous research, thousands of Americans die due to these errors every year. GUIDING PRINCIPLES FOR MEDICATION MANAGEMENT IN RESIDENTIAL AGED CARE FACILITIES. Guiding principles for medication management in residential aged care facilities. Serious medication errors are common in hospitals and often occur during order transcription or administration of medication.
To help prevent such errors, technology has been developed to verify.