Introduction
Medication errors are one of the common sources of poor health outcomes in healthcare systems. A recent study by John Hopkins hospital indicates that medication error is the third leading cause of patient death in the United States (US) and has surpassed diabetes and stroke (Carrie, 2022). Similarly, at least one in every seven patients receiving care is vulnerable to medication errors in a hospital in the US (Carrie, 2022). Medication errors may result from mistakes in dispensing, prescribing, and giving medication. Even though most medication errors are preventable, a lack of adequate knowledge, training and experience amongst healthcare professionals often results in increased medication errors. According to Rodziewicz et al. (2018), by analyzing medication errors, medical professionals and healthcare systems can protect patients and improve the quality of care received by patients. Therefore, this paper seeks to comprehensively analyze medication errors in healthcare, including the causal factors, possible solutions, and the ethical implication of implementing a possible solution to the problem.
Elements of the Problem
Medication errors threaten patient safety outcomes and may lead to dissatisfaction with patient safety and quality of care. The National Coordinating Council for Medication Error and Prevention (NCCMERP) defines a medication error as a preventable event that may lead to patient harm or inappropriate medication use, Aseeri et al. (2020) argue. However, a medication error is controlled by a healthcare provider and the patient. It is important to note that most medication errors are preventable if appropriate measures and taken into consideration. These errors may be connected to healthcare services, products, professional practices and procedures, including; administration, prescribing, communication, dispensing, product labelling and use. The primary element of medication errors in healthcare systems includes prescribing errors, dispensing, preparation stage, drug administration errors, and lack of care coordination and communication among the healthcare provider (Kozel, 2020).
Prescription errors are the leading cause of medication errors in the healthcare system. Prescription errors may arise due to a lack of critical information about the drug being prescribed to a patient and may result in fatalities, as Rodziewicz et al. (2022) argued. In the preparation stage, medication errors may result from dose miscalculation, wrongful administration of drugs, improper labelling, wrongful medication selection, and incorrect preparation. On the other hand, drug administration errors may arise from acts of care provider or patient, which may include dose omission, improper preparation, poor timing of drug administration, and improper drug administration rate. According to Hammoudi et al. (2018), dispensing errors are another common cause of medication errors. These errors may arise due to a healthcare provider or medical personnel commission. These errors include inappropriate drug prescription, wrong dosage, and incorrect entry into computer systems when dispensing drugs. Overall, dispensing errors may result in incorrect admission of drugs and incorrect dosage (Rodziewicz et al., 2022). Lack of care coordination and poor communication among healthcare providers is also other causes of medication errors. Instances such as miscommunication on the type of s drug, name quantity to be consumed, prescription, side effects and frequency of consumption are common causes of medication errors due to lack of care coordination and communication in the healthcare system.
Analysis of the Problem
Medication errors may result in adverse health outcomes and compromise the safety and quality of healthcare services. Medication errors may lead to more extended hospital stays, increased hospital readmission rate and a lack of trust between healthcare providers and patients; as Hammoudi et al. (2018) argued, these errors often lead to legal action against healthcare organizations and healthcare providers. This way, professional training and education are paramount in mitigating such errors. According to Hammoudi et al. (2018), healthcare providers, particularly nurses, account for nearly a significant proportion of medication errors. This number shows that even the most qualified healthcare practitioners are susceptible to a medication errors, hence the need for professional training and education for medical staff. Healthcare professionals must understand the possible causes of medication errors in a healthcare setting and the risk of adverse health outcomes. In addition, healthcare professionals should practice proper medication prescription and medication to reduce the likelihood of these errors. Healthcare professionals are equally involved in the preparation of drugs, administration and prescription of drugs; thus, they can develop solutions to address the problem (Rodziewicz et al., 2022). Addressing this problem is key to the safety and quality of healthcare services received by patients.
Studies indicate that the aged population and patient who requires special medical attention are the most vulnerable to medication errors. For instance, elderly patients are more susceptible to medication errors because of a lack of compliance and knowledge. Medication errors often result in psychological and emotional problems; these patients are constantly stressed, depressed and anxious. Handling the adverse impact on them is a financial burden that often leads to prolonged hospital stays or even readmission. Furthermore, patients are also likely to develop other complications out of medication errors problem (Rodziewicz et al., 2022). Moreover, healthcare professionals are reluctant to create a work culture anchored on shared responsibility and collaboration; this has escalated the problem and led to job dissatisfaction among healthcare providers.
Response to the Health Problem
Healthcare professionals do not commit medication errors intentionally during the medication process. Healthcare professionals are highly trained individuals with top-notch skills and knowledge required for the professional execution of their duties, especially in the prescription and administration of drugs. Perhaps, this is because healthcare professionals should be answerable when a medication error occurs; they are usually blamed for such errors, even though they may not have possibly been involved in the error problem (Rodziewicz et al., 2022). In most cases, they are subject to punishment from professional organizations. In addition, the accused healthcare professionals also tend to lose respect from their counterparts; this may have an adverse impact on their career compared to other forms of punishment that they may be subjected to the problem, Rodziewicz et al. (2018) argued. However, punishment is not a viable option when it comes to reducing medication errors, even though it promotes professional ethics and standards in the practice of the medical profession. This way, it is crucial to spot weaknesses within the healthcare system that could result in a medication error.
Solutions
Care coordination and communication are crucial to finding a long-term solution to the medication problems in healthcare systems. According to Rodziewicz et al. (2022), an effective communication system among the healthcare providers such as pharmacists, nurses and physicians will reduce prescription and prescription errors. Pharmacist-nurse lead prescriptions can only be achieved through effective communication between nurses and pharmacists (Kozel, 2020). Such initiatives can help reduce medication errors during the prescription and administration of drugs. This also ensures that changes and errors during prescriptions are communicated promptly before drugs are administered to a patient.
Similarly, drugs should be labelled and packed accordingly to avoid any confusion. In addition, computerized models and simulated prescriptions should be integrated into the healthcare system to reduce medication errors related to the labelling and packaging of drugs (Kozel, 2020). Labelling also helps healthcare professionals and patients select the right drug for their medication. Drug prescriptions should also be made based on patient information to promote the correct usage of drugs. Modern technology such as barcode systems and EMR should be incorporated into healthcare institutions to help verify drugs before use (Dunn & Hazzard, 2019). Healthcare providers should be educated on medication guides, drug safety, and drug safety communication to avoid incidences of improper administration of drugs to patients. Automated dispensing systems should be incorporated into healthcare institutions as an efficient means of dispensing medication to minimize medication errors (Dunn & Hazzard, 2019). Communication and modern technologies should be enhanced in healthcare institutions to solve the problem of medication errors.
Ethical Implications
The ethical implication has a direct impact on the proposed strategies. The ethics principles and guidelines in healthcare require health professionals to protect the integrity of patient information through the highest standards of professional practice. Literature review indicates that healthcare providers have a role to play in protecting patient information so as not to compromise the well-being of the patients. Similarly, the principle of non-maleficence demands that healthcare providers should not compromise the patient’s well-being and demonstrate honesty, fairness and respect for others during their professional practice, as Rodziewicz et al. (2018) argued. These virtues reduce the incidences of medication errors, and may help healthcare providers to investigate the route course of a medication problem for patients, hence patient safety and quality care. By being accountable for any medication errors caused to patients’ healthcare professionals should strive for high ethical standards in their practice.
Implementation
To successfully adopt the above-proposed solution to the problem, healthcare institutions should incorporate evidence-based practices and best-solution approaches to implement different solutions as proposed (Kozel, 2020). EBP will help implement automated dispensing systems, error reporting systems, automated prescribing systems, and labelling and packaging of drugs to minimize medication errors. Implementation of this system also requires the professional expertise of other staff within the healthcare institutions, such as technicians and IT professionals. Nevertheless, resources such as computers, servers, and network systems will also be required to implement proposed solutions. Best solution approaches that can be implemented also include correct documentation and medication.
Conclusion
Medication errors are prevalent in healthcare systems and may adversely impact the patient’s health outcomes. Healthcare providers or patients themselves may cause these errors. The errors may arise due to improper drug, prescription drug dispensing errors, improper administration of drugs and lack of communication. Collectively these error occurrences of these errors may result in medication errors in healthcare institutions. For this reason, the discussion proposed specific solutions to help minimize the adverse impact of medication error on patient health outcomes. The proposed solution will help improve patient safety and quality of care and mitigate and reduce future incidences of medication errors.
References
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error prevention.
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2022). Medical error reduction and prevention. In StatPearls [Internet]. StatPearls Publishing.
Aseeri, M., Banasser, G., Baduhduh, O., Baksh, S., & Ghalibi, N. (2020). Evaluating medication error incident reports at a tertiary care hospital: Pharmacy, 8(2), 69.
Hammoudi, B. M., Ismaile, 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.
Dunn, P., & Hazzard, E. (2019). Technology approaches digital health literacy. International journal of cardiology, pp. 293, 294–296.
Kozel, V. (2020). Reducing medication errors by adding a pharmacist and standardized communication to interdisciplinary team rounding: A quality improvement project.
Carrie, A. (2022, June 28). The eight most common root causes of medical errors. Always Culture. Retrieved September 28, 2022, from https://alwaysculture.com/hcahps/communication-medications/8-most-common-causes-of-medical-errors/
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