Medication errors occur due to technical issues or mistakes made by the chain of healthcare workers, involving physicians prescribing the wrong medications and nurses or other healthcare workers administering the wrong dose, medicine, or treatment, resulting in reversible or irreversible injury, including death. Factors of human error can be distractions, workload, fatigue, or lack of proper knowledge (Niv & Tal, 2024). Medication errors in the emergency department often occur as everyone is rushing to save a patient’s life with little time, increasing room for errors. Although it is not easy and requires time and effort, everyone in the healthcare system needs to partake in working to reduce/eliminate these avoidable medication errors in the Emergency Department. This topic is essential as the potential for patient injury through drug errors can be reduced or eliminated.
Overview of Topic
Preventable medication errors occur in all parts of hospital settings and can result in patient harm and, in worst cases, severe complications and the potential for even death. Some medication errors include administering the wrong medication or dose, performing the wrong treatment, and prescribing incorrect medication and dose. This may happen in outpatient, inpatient, acute or long-term care units, and emergency Departments. Medication errors that occur in the emergency department do not get enough observation and require more attention and investigation. With emergency departments being in a high-paced environment, it is easy to make errors. Pham (2008) found, “The growing number of complicated and chronically ill patients seeking care in EDs and the lack of detailed and valid information regarding patients’ medical histories conspire to increase the risk of errors” (Niv & Tal, 2024). Close observation and auditing of medication errors in ED is essential to find the causes and ways to find an effective method to prevent errors from occurring.
Statistics
Medication errors in emergency departments evoke concern as far as patient safety is concerned. According to recent study reports, it is clear that frequent mediation errors in emergency settings are alarmingly high. Similar reports also suggest that millions of medication errors occur annually across all healthcare settings, with a significant portion likely happening in EDs due to their fast-paced and complex environment. A 2015 study published in the Journal of the American Medical Association found that 1 in 13 hospitalized patients experienced a medication error (Niv & Tal, 2024). While not specific to EDs, it sheds light on the prevalence of the issue.
Similar to the number of errors, quantifying the exact number of near misses and deaths linked to ED medication errors is difficult. However, a 2016 study in the British Medical Journal estimated that medication errors contribute to at least 44,000 preventable deaths annually in the US, with a portion likely stemming from ED errors (Mohiuddin, 2019). The Institute for Safe Medication Practices (ISMP) maintains a database of reported medication errors, including some near misses and deaths. Exploring their website might offer specific cases and insights.
Nursing Implication
Nurses play a significant role in preventing and countering medication errors in the emergency department, as explained by Carol et al. (2020). Ideally, their involvement spans various crucial aspects of patient care in the healthcare team. The primary implications of medication errors in the emergency department include increased awareness and knowledge whereby nurses require a thorough understanding of errors. This is possible through frequent education and training. Another implication is improved caution and communication, where constant patient assessments should be done. In conjunction with caution is communication, whereby the team members should have clear communication and questioning on the emerging discrepancies in orders or medication administration.
Among the effective practices put in practice to minimize medication errors in the emergency department include barcoded medication, double checking, and standardized documentation. Barcoded medication involves the use of barcodes for identification while double-checking involves a thorough check of medications at multiple points before administration. This involves both nurses and other healthcare professionals. Standardized documentation, on the other hand, involves the administration of records and transparent documentation practices to minimize precision errors (Mohiuddin, 2019). These, among other practices, have been effective in minimizing errors; for instance, barcoded medication, as published in the Journal of American Medical Association, has reduced medication errors by 50%.
My Plan
In my practice, I prioritize several key strategies to minimize medication errors in the emergency department. First, I always ensure enhanced awareness and caution by continuously updating my knowledge of medication, safety trends, potential risks, and high-alert medications. I also take caution throughout the administration process by double-checking and employing the five rights principle. Communication and collaboration are another approach that I use in my practice. I always communicate openly with the physicians and colleagues for prompt clarification on ambiguities and concerns regarding medication orders. Last on the same is actively participating in team briefings and huddles to ensure everyone is aware of the patient’s medication history and potential interactions.
Summary
From the analysis in this paper, it is clear that medication errors in emergency departments are common occurrences in American society. However, there are numerous approaches that can be employed to minimize these errors. Through this research and self-reflection, I have gained valuable insights that will help me solidify my commitment to preventing these potentially adverse occurrences. Similarly, this paper has highlighted the nature of medication errors, with estimates suggesting millions occurring annually across healthcare settings. In conclusion, my journey into understanding medication errors in EDs has solidified my dedication to patient safety.
References
Carroll, R. L., ARM, M., CPHRM, H., Charney, F. J., CPHRM, D., Jeffrey Driver, J. D., … & FASHRM, D. (2020). Enterprise Risk Management: Implementing ERM.
Mohiuddin, A. K. (2019). Medication Risk Management. Innovations in Pharmacy, 10(1).
Niv, Y., & Tal, Y. (2024). Patient Safety and Risk Management Organizations and Institutions. In Patient Safety and Risk Management in Medicine: From Theory to Practice (pp. 179–193). Cham: Springer Nature Switzerland.
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