Medical institutions are responsible for ensuring their patients’ health and safety. Medical errors have constantly affected the safety of patients. Medical errors can happen at various stages when healthcare personnels discharge their duties, from drug administration, prescription, and paperwork, and even when a physician issues a drug order. To eliminate these errors, nurses must be on close professional watch with their patients, keen, and work with due diligence. Guidelines and policies are set up to ensure proper adherence by healthcare staff to prevent them from committing medical errors (Rodziewicz & Hipskind, 2020). Because of this, nurses can now focus on the five rights to ensure patient safety; proper dose, patient, time, route and medicine. Healthcare can combat administration errors through well-arranged teamwork and objective effort, taking in staff across all departments (PMC, 2019).
Medical errors adversely affect patients and, in the worst cases, can lead to death (Assiri et al., 2018). The outcomes of pharmaceutical administration errors include unnecessary extra costs, drastic effects, damage to the medical facility’s reputation, and even patient death. This case is a big blow to the facility and society and should, therefore, firmly be dealt with at all costs early enough. This research aims to find out the cause of medical errors, identify strategies that can be used to prevent the occurrence of these errors, the role that nurses have in ensuring patient safety and the influence that all health stakeholders could have in the plan to reduce medication errors occurrence in health institutions.
Causes of Medication Administration Errors
Many factors can cause medical administration errors. According to Europe PMC, 2019), lack of enough records, problematic issues of drugs, and improper dosage are the most common causes of pharmaceutical administration errors. Moreover, there are other causes of medication administration errors; inaccurate patient identification for a certain amount, administering the wrong drug and even using improper channels in providing prescriptions. According to Hammoudi et al. (2018), erroneous patient diagnoses can also result in medical administration errors. As found by the research, lack of expertise, failure to apply established pharmaceutical procedures, and lack of experience can all contribute to medication administration errors (Hammoudi et al., 2018).
Some circumstances can also lead to medication administration errors, such as working night shifts and interruptions when a practitioner is administering medication. Failure to observe proper communication between physicians and pharmacists and lack of adherence to the five rights of drug administration can lead to more incidences of errors in medication delivery (Assiri et al., 2018). From what we have learned, it is clear that medication administration errors are so complex that the issue cannot be dealt with by an individual or department single-handedly but through a coordinated multimodal approach.
Evidence-based and Best-Practice Interventions
Healthcare practitioners can use evidence-based interventions and a variety of best practices to prevent drug delivery errors. Assiri et al. (2018) state that physicians should employ computerized order entry (CPOE) and automated dispensing systems in facilities to reduce MAEs. In addition, the researchers insisted that the two technological interventions are evidence-based mitigation strategies for reducing medication administration errors(Assiri et al., 2018). Furthermore, to reduce the lack of enough records, which is the most common cause of medication, healthcare practitioners can use the computerized provider order entry to share medication errors. According to Hammoudi et al. (2018), The CPOE’s component CDS is a clinical decision engine that supports the CDS framework and reduces medication errors, improving patient care and safety. The CPOE can also lower medication errors by issuing medication in the right dosage to the right patient and at the right time. Due to the reasons stated, CPOE is an efficient and effective intervention in dealing with medication delivery errors. Healthcare practitioners have to double-check best practice strategies to ensure that they counter medication errors. Double checking is scrutinizing whether the dispensed prescription is in the right dosage, is being done at the right time, and is for the right patient. CPOE deals with the risk of error due to a lack of sufficient records, combating medical administration errors by ensuring that the administered drug is in line with the patient’s medical history.
According to Hammoudi et al. (2018), encouraging voluntary error reporting will be an excellent practice strategy. The strategy will help in eliminating future drug errors. Patient safety will be much improved due to this strategy since it encourages the development of quick techniques to reduce error occurrence. Healthcare facilities should create a culture and environment that encourage voluntary drug error reporting freely. Health facility administrators should instruct departments on the proper ways to report medication errors and provide sufficient resources to promote the efficiency of this intervention strategy.
According to Hammoudi et al., (2018). Healthcare administrators should ensure that practitioners receive proper training to ensure organizational compliance; training will be comprehensive to ensure that the practitioners understand error detection and do away with the long process of voluntary reporting, therefore, minimizing future errors. Medical administration errors will be best dealt with by combining electronic medical data and an automated dispensing system. Medication administration errors can be prevented by harmonious collaboration between pharmacists, medical reconciliation, and patient education.
The Role of Nurses in Care Coordinating
Nurses are crucial practitioners in healthcare facilities. Through proper collaboration and coordination, nurses can deal with medication errors. Nurses can reduce errors through medication reconciliation; this is when a nurse inspects any anomalies in drug dispensing, checks prescription histories, and counter-checks and follows up to correct an error identified. Nurses must also collaborate with other healthcare practitioners to eliminate medicine delivery errors. Nurses can seek clarity from pharmacists through collaboration before educating nurses on the drugs provided. According to Salar et al. (2020), Nurses should always ensure adherence when offering medication and make the patients understand the importance of the drugs administered. Nurses have a role to play in following up with the patients after being discharged to ensure that the patients are taking the drugs in the right dosage and at the right time; in this way, nurses can check the progress of patients. The above discussion proves that nurses are ideal professionals in reducing medication administration errors (Chan et al., 2020).
Stakeholders’ Influence on Medication Administration
Stakeholder dynamics are a vital factor to consider in dealing with medication errors because this greatly influences the frequency of medication administration errors. In collaboration, these stakeholders can eliminate several issues that result in medication errors, according to Chen et al. (2019). Stakeholders can improve patients’ healthcare quality and safety through proper collaboration, improving patient outcomes. Many kinds of literature have been published that emphasize that teamwork effort plays a vital role in reducing and eliminating issues that contribute to pharmaceutical delivery errors (Chan et al., 2020). For example, in reducing prescription administration errors in the healthcare facility, the action team should collaborate with a nurse, a physician, and a pharmacist. Poor communication between healthcare practitioners can result in errors. Patients and their families also have a role in reducing medication administration errors. Proper patient education on their medication can help them identify an error based on their medical history. Nurses can work with pharmacists to ensure that drugs are administered correctly; they can also work with physicians and pharmacists to ensure that incorrect medicine administration or errors are reported on time, ensuring that care delivery and patient safety are achieved (Chen et al., 2019).
Conclusion
Medication administration errors are now a daily turmoil in healthcare facilities. By using technology solutions, such as CPOEs and automated dispensing systems, practitioners can reduce the frequency of medication error occurrence. Best practices involving an interdisciplinary approach can be put in place to ensure error prevention; such include voluntary error reporting, counter-checking, and educating healthcare personnels to identify medication errors before they cause harm to patients. Nurses have been identified as crucial practitioners in reducing medication errors because they can counter-check drug administration against patient history. In coordinating treatment, they can discover errors early enough before they cause harm. Due to this, medical institutions must ensure proper training for nurses in detecting medication errors to reduce the frequency of MAEs in healthcare facilities.
References
Assiri, G. A., Shebl, N. A., Mahmoud, M. A., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8(5), e019101. https://doi.org/10.1136/bmjopen-2017-019101
Chan, A. H. Y., Horne, R., Hankins, M., & Chisari, C. (2020). The Medication Adherence Report Scale: A measurement tool for eliciting patients’ reports of nonadherence. British Journal of Clinical Pharmacology, 86(7), 1281–1288.
https://doi.org/10.1111/bcp.14193
Chen, Y., Wu, X., Huang, Z., Lin, W., Li, Y., Yang, J., & Li, J. (2019). Evaluation of a medication error-monitoring system to reduce the incidence of medication errors in a clinical setting. Research in Social and Administrative Pharmacy, 15(7), 883–888. https://doi.org/10.1016/j.sapharm.2019.02.006
Europe PMC. (2019). Europe PMC. Europepmc.org. https://europepmc.org/article/nbk/nbk499956
Hammoudi, B. M., Ismail, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian Journal of Caring Sciences, 32(3), 1038–1046.
https://doi.org/10.1111/scs.12546
Rodziewicz, T., & Hipskind, J. (2020). Medical error prevention (pp. 1–37). http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf
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