Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

2016 ◽  
Vol 36 (4) ◽  
pp. 19-35 ◽  
Author(s):  
Fran Flynn ◽  
Julie Q. Evanish ◽  
Josephine M. Fernald ◽  
Dawn E. Hutchinson ◽  
Cheryl Lefaiver
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Comparison Group ◽  
Medication Administration ◽  
Cardiac Care ◽  
Evidence Based ◽  
Direct Observations ◽  
Medication Administration Errors ◽  
Before And After ◽  
The Impact

Background Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. Objectives To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. Methods The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. Results Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. Conclusions Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety.

scholarly journals THE IMPACT OF BARCODE MEDICATION ADMINISTRATION ON PATIENT SAFETY: A SYSTEMATIC REVIEW

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Seham Sahal Aloufi
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Medication Error ◽  
Medication Errors ◽  
Improve Patient Safety ◽  
Hospital Setting ◽  
Medication Administration ◽  
Bar Code ◽  
The Impact ◽  
Improve Patient

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety. Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure. This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies. The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration. Keyword: Patient Safety, Impact, BCMA, eMAR

scholarly journals The Impact of a Bedside Medication Scanning Device on Administration Errors in the Hospital Setting: A Prospective Observational Study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i9-i9
Author(s):  
C L Tolley ◽  
N W Watson ◽  
A Heed ◽  
J Einbeck ◽  
S Medows ◽  
...  
Keyword(s):  
Data Collection ◽  
Medication Administration ◽  
Oral Dosage ◽  
Timing Errors ◽  
Scanning Device ◽  
Medication Administration Errors ◽  
Before And After ◽  
Solid Oral Dosage Forms ◽  
Oral Dosage Forms ◽  
The Impact

Abstract Introduction The medication administration process is complex and influenced by interruptions, multi-tasking and responding to patient’s needs and is consequently prone to errors.1 Over half (54.4%) of the 237 million medication errors estimated to have occurred in England each year were found to have taken place at the administration stage and 7.6% were associated with moderate or severe harm. The implementation of a Closed Loop Medication Administration solution aims to reduce medication administration errors and prevent patient harm. Aim We conducted the first evaluation to assess the impact of a novel optical medication scanning device, MedEye, on the rate of medication administration errors in solid oral dosage forms. Methods We performed a before and after study on one ward at a tertiary-care teaching hospital that used a commercial electronic prescribing and medication administration system and was implementing MedEye (a bedside tool for stopping and preventing medication administration errors). Pre-MedEye data collection occurred between Aug-Nov 2019 and post-MedEye data collection occurred between Feb-Mar 2020. We conducted direct observations of nursing drug administration rounds before and after the MedEye implementation. Observers recorded what they observed being administered (e.g., drug name, form, strength and quantity) and compared this to what was prescribed. Errors were classified as either a ‘timing’ error, ‘omission’ error or ‘other’ error. We calculated the rate and type of medication administration errors (MAEs) before and after the MedEye implementation. A sample size calculation suggested that approximately 10,000 medication administrations were needed. Data collection was reduced due to the COVID 19 pandemic and implementation delays. Results Trained pharmacists or nurses observed a total of 1,069 administrations of solid oral dosage forms before and 432 after the MedEye intervention was implemented. The percentage of MAEs pre-MedEye (69.1%) and post-MedEye (69.9%) remained almost the same. Non-timing errors (combination of ‘omission’ + ‘other’ errors) reduced from 51 (4.77%) to 11 (2.55%), which had borderline significance (p=0.05) however after adjusting for confounders, significance was lost. We also saw a non-significant reduction in ‘other’ error types (e.g., dose and documentation errors) following the implementation of MedEye from 34 (3.2%) to 7 (1.62%). An observer witnessed a nurse dispense the wrong medication (prednisolone) instead of the intended medication (furosemide) in the post-MedEye period. After receiving a notification from MedEye that an unexpected medication had been dispensed, the nurse corrected the dose thus preventing an error. We also identified one instance where the nurse correctly dispensed a prescribed medication (amlodipine) but this was mistakenly identified by the MedEye scanner as another prescribed medication (metoclopramide). Conclusions This is the first evaluation of a novel optical medication scanning device, MedEye on the rate of MAEs in one of the largest NHS trusts in England. We found a non-statistically significant reduction in non-timing error rates. This was notable because incidents within this category e.g., dose errors, are more likely to be associated with harm compared to timing errors.2 However, further research is needed to investigate the impact of MedEye on a larger sample size and range of medications. References 1. Elliott, R., et al., Prevalence and economic burden of medication errors in the NHS in England. Rapid evidence synthesis and economic analysis of the prevalence and burden of medication error in the UK, 2018. 2. Poon, E.G., et al., Effect of bar-code technology on the safety of medication administration. New England Journal of Medicine, 2010. 362(18): p. 1698–1707.

scholarly journals Medication Administration Errors and Contributing Factors at Nurses Workplace: Literature Review

2021 ◽  
Vol 2 (10 (298)) ◽  
pp. 1-10
Author(s):  
Dovilė Sakalauskaitė ◽  
Viktorija Kielė
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Work Environment ◽  
Medication Errors ◽  
Human Factor ◽  
Medication Administration ◽  
Medical Team ◽  
Contributing Factors ◽  
Medication Administration Errors ◽  
Administration Time

Abstract. Medication errors are a serious problem that can be a threat to health and patient safety and can lead to mistrust of the health system and the work of professionals. Medication administration errors occur at any stage of patient care and can be related to a variety of influencing factors [1]. This literature review identifies the main medication administration errors, which are grouped into medication administration and incorrect documentation of administered medication groups. Along with medication administration errors, the main reasons why nurses make errors in medication administration are identified. The study focuses on medication administration errors and their determinants in nurses' work. The aim of the literature review was to analyze medication errors and their determinants in nurses' work. Methods: an exploratory review was conducted to analyze medication administration errors and their determinants in nurses' work. The methodology considered five main stages that contributed to a focused analysis of the selected studies. Results of the literature review. It was found that medication errors are influenced by the work environment, which is full of extraneous sounds, other members of the medical team, and conversations unrelated to the administration of medicines. The human factor is also a factor in medication administration errors related to the medication, its dose, or the wrong administration time. Medication administration errors are inevitable, no matter how advanced the patient's care and nursing techniques.

scholarly journals An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 148
Author(s):  
Sara Barakat ◽  
Bryony Dean Franklin
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Medication Administration ◽  
Patient Identification ◽  
Identification Rate ◽  
Scan Rate ◽  
Nursing Activity ◽  
Administration Time ◽  
Potential Benefits ◽  
The Impact

Barcode medication administration (BCMA) is advocated as a technology that reduces medication errors relating to incorrect patient identity, drug or dose. Little is known, however, about the impact it has on nursing workflow. Our aim was to investigate the impact of BCMA on nursing activity and workflow. A comparative study was conducted on two similar surgical wards within an acute UK hospital. We observed nurses during drug rounds on a non-BCMA ward and a BCMA ward. Data were collected on drug round duration, timeliness of medication administration, patient identification, medication verification and general workflow patterns. BCMA appears not to alter drug round duration, although it may reduce the administration time per dose. Workflow was more streamlined, with less use of the medicines room. The rate of patient identification increased from 74% (of 47) patients to 100% (of 43), with 95% of 255 scannable medication doses verified using the system. This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration. There was reduced variability in the medication administration workflow of nurses, along with an increased patient identification rate and high medication scan rate, representing potential benefits to patient safety.

scholarly journals Preliminary Review of the Effects of Electronic Medical Administration Records (eMAR) and Electronic Doctor Order Entry (CPOE) on Patient Safety Culture in the Era of Universal Health Services

SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 243
Author(s):  
Rahmat Santoso ◽  
Stefanus Nova
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Medication Administration ◽  
Health Care Facilities ◽  
Preliminary Review ◽  
Future Research ◽  
Order Entry ◽  
Pharmaceutical Service ◽  
The Impact ◽  
Universal Health

In the era of universal health service [UHC], medicine was always used as part of curative, preventive, and promotive. Following pharmaceutical service standards in hospitals, health centers, and pharmacies, that medicines must be managed properly, including in their use. Medication errors are a leading cause of death in many parts of the world. The factors causing the increase in medication errors related to individuals, such as heavy workload on health care facilities and pharmaceutical service facilities, are often experienced by medical staff (General Practitioners and Specialists) and pharmaceutical personnel (Pharmacists and Pharmaceutical Technical Personnel / TTK), or organizational-related factors, such as inadequate facilities and infrastructure to document medication administration records and the entry of physician orders electronically. The study was conducted cross-sectionally retrospectively, by sharing the results of an initial literature review on the impact of electronic medication administration records (eMAR) and doctor's order entry (CPOE) on patient safety. Using PubMed and Google Scholar, we search for the following terms: "eMAR", "CPOE", "medication error", and "patient safety". Our initial findings reveal that eMAR and CPOE can have an impact on the pharmaceutical workflow, and reduce medication errors, thereby increasing patient safety. Based on the initial review, eMAR and CPOE influence the insight of pharmaceutical personnel, pharmaceutical workflows and impact on patient safety. On the other hand, there is a regulatory direction which is still in the form of a Regulation of the Minister of Health Regulation on Providers of Electronic Pharmaceutical Facilities (PSEF), but it is unfortunate that "eMAR" and "CPOE" have not become clauses governed by the government. Our plan for future research is to conduct a systematic review study to further study the impact of eMAR and CPOE on patient safety.

scholarly journals Nurses’ Perceptions of Medication Administration Safety in Public Hospitals in the Gauteng Province: A Mixed Method Study

2020 ◽  
Author(s):  
Alwiena J Blignaut ◽  
Siedine Knobloch Coetzee ◽  
Suria M Ellis ◽  
Hester C Klopper
Keyword(s):  
South Africa ◽  
Patient Safety ◽  
Resource Management ◽  
Medication Error ◽  
Medication Errors ◽  
Safety Culture ◽  
Medication Administration ◽  
Public Hospitals ◽  
Gauteng Province ◽  
Medication Administration Errors

Abstract Background: This study was carried out to determine factors perceived to impact on medication administration errors and possible solutions to such errors in medical and surgical units of public hospitals in Gauteng Province, South Africa. More data on this challenge to patient health are needed from low- and middle-income countries like South Africa.Methods: A mixed-methods research design with a sequential approach was used. Data were gathered among 683 (n=280) medication administrators using self-report surveys, and 16 (n=15) nursing unit managers using semi-structured individual interviews.Results: Causes of medication error related to communication, human, environmental and medication factors were considered to have a moderate risk. Workload (M=3.39; SD 0.91), stock problems (M=3.18; SD 0.96) and illegible prescriptions (M=3.05; SD 1.09) pose the greatest threats to medication administration safety. Most participants (n=184; 71.1%) agreed that medication errors never or rarely occurred in their units. The majority of respondents graded overall patient safety as excellent or very good (n=161; 61.5%). With regard to safety culture, nurses felt that they are actively attempting to improve medication safety (n=239; 90.5%), that people support one another in the unit (n=216; 80%), and that their procedures and systems are good at preventing errors (n=210; 80.2%). Participants felt that medication administration errors were rarely reported, and the most apparent reason for not reporting medication administration errors was fear and administrative response. Safety culture items were correlated with medication error incidence, grade of overall patient safety and reasons for non-reporting. Qualitative findings supported the quantitative data, adding knowledge, skill and attitude of staff as further threats to medication administration safety. Adherence to protocols, auditing, education and training, collaboration and support, communication, awareness of changes, resource management and time management were identified as possible solutions to medication administration errors.Conclusions: Solutions aimed at mitigating medication errors should be based on causes identified within a specific context. In the Gauteng Province of South Africa, multidisciplinary collaboration and communication; support of nurses by the hospital administration; hospital systems, procedures and initiatives; better resource management and improved pharmacological training could be seen as the foundation for improved medication administration safety.

Analisis Faktor Perawat Dalam Pelaksanakan Keselamatan Pasien Terhadap Kejadian Medication Administration Error di Rumah Sakit

2020 ◽  
Author(s):  
Bintang Marsondang Rambe
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Medication Error ◽  
Medication Errors ◽  
Medication Administration ◽  
Prescribing Error ◽  
Medication Administration Error ◽  
Administration Error

Latar Belakang Keselamatan pasien (patient safety) rumah sakit adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman yang meliputi assessment risiko, identifikasi dan pengelolaan hal yang berhubungan dengan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya serta implementasi solusi untuk meminimalkan timbulnya risiko dan mencegah terjadinya cedera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil yang dilakukan oleh perawat (Kemenkes, 2011).Salah satu kesalahan yang dapat merugikan pasien adalah medication error. Menurut WHO (2016) medication error adalah setiap kejadian yang dapat dicegah yang menyebabkan penggunaan obat yang tidak tepat yang menyebabkan bahaya kepasien, dimana obat berada dalam kendali profesional perawatan kesehatan. proses terjadi medication error dimulai dari tahap prescribing, transcribing, dispensing,dan administration. Kesalahan peresepan (prescribing error), kesalahan penerjemahan resep (transcribing erorr), kesalahan menyiapkan dan meracik obat (dispensing erorr), dan kesalahan penyerahan obat kepada pasien (administration error). Medication error yang paling sering terjadi adalah pada fase administration / pemberian obat yang dilakukan oleh perawat.Administration error terjadi ketika pemberian obat kepada pasien tidak sesuai dengan prinsip enam benar yaitu benar obat, benar pasien, benar dosis, benar rute pemberian, benar waktu pemberian dan benar pendokumentasian. Secara global, kesalahan pemberian obat (medication errors) sampai saat ini masih menjadi isu keselamatan pasien dan kualitas pelayanan di beberapa rumah sakit (Depkes RI, 2015; AHRQ, 2015). Perawat sebagai bagian terbesar dari tenaga kesehatan di rumah sakit, mempunyai peranan dalam kejadian medication error. Perawat berkontribusi karena perawat banyak berperan dalam proses pemberian obat. Pemberian obat/ Medication Administration adalah salah satu intervensi keperawatan yang paling banyak dilakukan, dengan sekitar 5- 20% waktu perawat dialokasikan untuk kegiatan ini (Härkänen et al.,, 2019). Pemberian obat juga mencakup tugas-tugas lain, seperti menyiapkan dan memeriksa obat obatan, memantau efek obat-obatan, mengedukasi pasien tentang pengobatan, dan memperdalam pengetahuan perawat tentang obat – obatan sendiri (DrachZahavy et al., 2014 dalam Yulianti et al., 2019)Berdasarkan isu tersebut, penulis tertarik untuk melakukan literature review terkait faktor perawat dalam pelaksanakan keselamatan pasien terhadap kejadian medication administration error di Rumah Sakit.

Quality and Patient Safety in a Pathology Residency Training Program

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
R Demkowicz ◽  
S Sapatnekar ◽  
D Chute
Keyword(s):  
Patient Safety ◽  
Residency Training ◽  
Chief Resident ◽  
Residency Training Program ◽  
Basic Structure ◽  
Learning Activities ◽  
Before And After ◽  
Quality And Patient Safety ◽  
The Impact ◽  
Quiz Scores

Abstract Introduction/Objective Since the start of the new millennium, optimization of Quality and Patient Safety (QPS) has taken a renewed focus in the healthcare industry. Consequently, the Accreditation Council for Graduate Medical Education has mandated that QPS be a part of residency training. We have previously presented our curriculum designed to meet the specific needs of Pathology training programs, and covering four content areas: Handoffs, Error Management, Laboratory Administration, and Process Improvement. We are now presenting implementation. Methods To implement this curriculum, we 1) created online modules for self-directed learning on basic topics (using courses developed by IHI and CAP, and assigned articles), and paired these with faculty-facilitated interactive learning activities on more complex topics, including proficiency testing, root cause analysis and test utilization, 2) assigned every resident to a QPS project that was aligned with departmental priorities, led by a faculty advisor, and ran over 8- 10 months, and 3) appointed a QPS Chief Resident to coordinate and support the residents’ QPS activities. We measured the impact of the curriculum by comparing RISE laboratory accreditation percentiles and QPS curriculum quiz scores before and after curriculum implementation. Results After its implementation, RISE percentiles increased by at least 25 for every PGY, and QPS quiz scores increased by at least 10% for 3 of 4 PGY. Every QPS project was presented at Grand Rounds, and 4 were presented externally, including 2 at national conferences. Conclusion Our curriculum was successful in improving residents’ knowledge and competence in QPS. Challenges included designing appropriate learning activities, tracking completion of activities, coordinating faculty schedules and maintaining resident buy-in to the curriculum. We believe that the basic structure of our curriculum offers a solid foundation to which revisions can be made as QPS priorities evolve, and which can be readily adapted to other programs and locations.

scholarly journals Impact of mindfulness for people with arthritis

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Sinead Brophy ◽  
Roxanne Cooksey ◽  
Jonathan Kennedy ◽  
Helen Davies
Keyword(s):  
Cohort Study ◽  
Stress Reduction ◽  
Data Linkage ◽  
Comparison Group ◽  
Effectiveness Analysis ◽  
Before And After ◽  
Number Of Visits ◽  
Mindfulness Based Stress Reduction ◽  
Gp Visits ◽  
The Impact

ABSTRACTObjectiveTo examine the impact of mindfulness-based stress reduction (MBSR) for people with ankylosing spondylitis (AS). Methods193 People with AS were invited to take part in an MBSR 8 week course. The data linkage component of this study examined number of visits to the general practitioner before and after the course in participants and non-participants of the course (500 people taking part in a cohort study but not invited to the course). ResultsOf 193 people invited, 43 (22%) consented and took part in the course, GP records were available for 41 (95%) of MBSR participants and 457 (91%) of the 500 comparison group. There was a mean of 7.6 (median 3) visits to the GP in the 12 month period before the course for those undertaking MBSR and 4.6 (median 0) visits in the 12 month period after the course. This compared with 5.5 (median 0) visits (12 months before a random date) and 4.1 (median 0) visits (12 months after a random date) in the comparison group. Using Wilcoxon rank-sum (Mann-Whitney) test showed a significant reduction in GP visits in the MBSR group after the course compared to the comparison group. ConclusionsThose who chose to attend an MBSR course had a higher number of visits to the GP before attending the course, than the comparison group. However, after attending the stress reduction course the number of visits to the GP reduced to levels equivalent to the comparison group. This study suggests that mindfulness based stress reduction could be effective in reducing the number of visits to the GP for people with arthritis who regularly see their GP. The findings from this study suggest a full RCT and cost effectiveness analysis is warranted.

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