Improvement plan tool kit

Improvement plan tool kit

 

For this assessment, you will develop a Word document of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.

 

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Solution

Medical Errors Safety Improvement Plan

Patient safety is a major priority for healthcare professionals. Nurses and other healthcare professionals must ensure that they avoid medical errors which cause harm to patients or worsens their health. The safety improvement plan aims to help nurses improve the process of medication administration by avoiding and preventing medical mistakes, through implementation of safety and quality standards. The safety improvement plan is divided into four categories with three annotated sources each: General organization safety, and best quality practices, environmental safety, and quality risks, staff-led preventive strategies and finally improving environmental safety issues.

Annotated Bibliography

General organization safety and quality best practices

Wu, A. W., & Busch, I. M. (2019). Patient safety: A new basic science for professional education. GMS Journal for Medical Education, 36(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446473/

The journal is about the incorporation of patient safety education in the curriculum of nurses, so as to improve their competency in medication administration. Entrenching safety standards as part of the education system of nurses ensures they promote safety in their practice of medication administration. Studies conducted since the 1990s have established that patient safety is a serious problem in many hospitals across the world. The studies have attributed the medical errors mostly to nurse incompetence. This awareness on the cause of the problem has led to interventions focusing on changing the nurse curriculum. The traditional nursing curriculum focuses on basic science and knowledge. However, these medical school institutions now recognizes that they play a big role in creating medical errors through a deficient curriculum. This study indicates that changing the nursing curriculum to include safe medication administration protocols and practices can significantly reduce medication errors perpetrated by nurses. Therefore, there is a need to revise the nurse curriculum to improve on medication administration safety. Making safety improvements as part of the curriculum will decrease the cases of medical errors in hospitals.

Mieiro, D. B., Oliveira, É. B. C. D., Fonseca, R. E. P. D., Mininel, V. A., Zem-Mascarenhas, S. H., & Machado, R. C. (2019). Strategies to minimize medication errors in emergency units: an integrative review. Revista Brasileira de Enfermagem, 72, 307-314. https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12546

The journal focusses on establishing the main reasons why medical errors occur in healthcare centers. The main reasons for medical errors are poor medication packaging, poor nurse-physician communication, shortage of nurse staffing, and inadequate hospitals processes. In addition, cases of medication errors go unreported due to fear of retribution. To improve on safety in medication administration, healthcare institutions need to make safety standards a priority and ensure that everyone is able to adhere to safety standards. Implementing standard communication protocols among providers, surveillance and monitoring facilities to improve adherence to safety standards and creating a culture of safety where providers can report medication errors without fear of consequences can help organizations minimize medication errors.

Amiri, M., Khademian, Z., & Nikandish, R. (2018). The effect of nurse empowerment educational program on patient safety culture: a randomized controlled trial. BMC medical education, 18(1), 1-8. https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1255-6

Education strategies are important in ensuring that healthcare workers adhere to safety standards implemented in their organizations.  Effective education and training make nurses take a leading role in integrating safety protocols in medication administration, report cases on non-adherence and influence other healthcare workers to adopt the safety protocols. Education strategy such as conducting campaigns helps create awareness of the need to consider safety standards to reduce the cases of medical errors. Campaigns will make the nursing staff understand the need for safety. Creating explanatory manuals will make the nurses understand the safety procedures and make regular references. These educational strategies are helpful in creating a culture of safety. The creation of a multidisciplinary committee to ensure compliance with safety standards and track the cases of medical errors will reduce the cases of medical errors as preventive measures are implemented and monitored by the multidisciplinary committee.

Environmental safety and quality risks

Kaboodmehri, R., Hasavari, F., Adib, M., Khaleghdoost Mohammadi, T., & Kazemnejhad Leili, E. (2019). Environmental factors contributing to medication errors in intensive care units. Journal of Holistic Nursing and Midwifery29(2), 57-64. http://hnmj.gums.ac.ir/browse.php?a_id=722&slc_lang=en&sid=1&ftxt=1&html=1

The journal focuses on determining preventable environmental factors that influence the occurrence of medication errors in healthcare settings. The nature of the work environment affects the rate of medical errors in a health care setting. The levels of noise in a hospital setting determine the number of medical errors committed. If a hospital is located in an area with high noise levels, then the medical errors will increase as the nurses are frequently distracted by the high levels of outside noise. Also, poor lighting is another factor that contributes to medical errors. A healthcare setting with poor lighting conditions will increase errors as the reduced visibility will make nurses make rush decisions without confirmation. The poor visibility resulting from poor lighting contributes to increased cases of medical errors. Inappropriate room temperature is another major factor contributing to medical errors. A health care facility should consider the three factors of high noise levels, poor lighting, and inappropriate temperature to reduce the cases of medical errors in their health care facility.

Gharaveis, A., Hamilton, D. K., & Pati, D. (2018). The impact of environmental design on teamwork and communication in healthcare facilities: a systematic literature review. HERD: Health Environments Research & Design Journal, 11(1), 119-137. https://journals.sagepub.com/doi/abs/10.1177/1937586717730333

Layout design, visibility and accessibility levels affects medical errors in a health care facility. In addition, the design affects teamwork and cooperation among nurses. To prevent medical errors, there has to be a systematic and easy line of communication among healthcare workers within a facility. Health care facilities should consider having a clear link of communication between the healthcare workers to ensure clear communication of medical information and administration. Those healthcare facilities with designs that allow accessible communication between the nurses experience few medical errors, thus indicating that layout design as an environmental factor affects the safety of a healthcare facility.

Ibrahim, M. I. M., & Izham, N. F. F. M. (2021). Medical Devices to Improve Medication Adherence. In Medical Devices for Pharmacy and Other Healthcare Professions (pp. 39-54). CRC Press. https://www.taylorfrancis.com/chapters/edit/10.1201/9781003002345-6/medical-devices-improve-medication-adherence-mohamed-izham-mohamed-ibrahim-fatin-farhani-mohamed-izham

Poor patient and nurse relationship has been identified as a significant factor in increasing the risk of medication errors. The article suggests the adoption of technology to reduce medical errors by improving the relationship between nurses and patients. Information technology is helpful in monitoring the patients and giving valuable information to the nurses to the patient regarding medication administration, thus preventing the risk of mistakes in education intake. In addition, the use of medical devices to improve patient management is effective in improving patient safety as the nurses are able to keep track of the patients’ condition using the medical devices. Healthcare organizations should consider taking advantage of technology to track safe administration of medication by patients after hospital discharge and monitor patient progress so as to adjust medications accordingly, thus prevent risk of errors.

Staff-led Preventive Strategies

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC health services research, 19(1), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4481-7

Medical errors are common in intensive care units. This is due to the nurse’s lacking knowledge on the medication they are delivering to their patients. In addition, the ICU nurses might lack adequate training, which leads to avoidable medical errors. The nurses on the ICYU have to be trained and have adequate knowledge of the medication they are administering to their patients. Nurses with high knowledge of the medication they are offering commit medication errors. Training and education to understand the medication is necessary to prevent medical errors in an ICU unit in a hospital. Therefore, it is critical for healthcare organizations to design regular training programs for nurses on the various available and emerging therapies and their safe administration.

Al-Ghabeesh, S. H., & Qattom, H. (2019). RETRACTED ARTICLE: Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of health policy research, 8(1), 1-9. https://ijhpr.biomedcentral.com/articles/10.1186/s13584-019-0314-8

Workplace bullying has a significant negative effect on the morale of nurses and their performance on the job. The decreased nurse morale and stress negatively impacts their accuracy, thus increasing the risk of medication errors. Bullying in the emergency department will negatively affect the mood and commitment of nurses and increase the risk of mistakes during clinical practice. Changing the work environment to be conducive and where every nurse is feeling appreciated will be effective in improving the morale and performance of the nurses in the emergency department. Creating a positive work environment will improve the safety of the emergency department and decrease cases of medical errors as the morale and productivity of nurses improve.

Rutledge, D. N., Retrosi, T., & Ostrowski, G. (2018). Barriers to medication error reporting among hospital nurses. Journal of clinical nursing, 27(9-10), 1941-1949. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14335

Despite the increasing cases of medication errors, the cases of self-reporting and whistle blowing among nurses is still low. Nurses are afraid to make reports concerning medical errors fearing punitive actions by management of the hospitals. The lack of reporting leaves the causes of the medical errors unaddressed, and the problem continues to persist in the hospital. There is a need for proper and clear guidelines concerning reporting of medical errors. The approach will lead in early identification of preventable causes of medication errors, such as nurse incompetency and fatigue. When these factors are determined, corrective measures will be taken, and the problem of medical errors will be resolved as safety is prioritized.

Best Practices for Reporting and Improving Environmental Safety Issues

Van de Vreede, M., McGrath, A., & de Clifford, J. (2018). Review of medication errors that are new or likely to occur more frequently with electronic medication management systems. Australian Health Review, 43(3), 276-283. https://www.publish.csiro.au/ah/AH17119

The purpose of the study was to examine the medication errors associated with the electronic medication management system. The management system has been known to reduce medication errors, but new medication errors have been identified from the management system. Healthcare facilities should not assume that their electronic medication systems are perfect and effectively handle all medication errors. There is a need to scrutinize the systems and correct any medical errors caused by the electronic medical system. Many hospitals believe that electronic systems solve all problems regarding medical errors. Having regular review is important as a safety quality and ensure that the errors caused by the electronic management system is solved. In addition, staff training on how to use the system helps reduce medication errors resulting from poor technical knowledge on how to use the system.

van Ewijk, B. (2018). Medication Error Prevention: Improving Patient Health Outcome. https://repository.usfca.edu/thes/1112/

Medical administration errors are reported to have an error rate of 60% resulting from wrong dosage, wrong timing, and dosage amount. Nurses need to be aware of these errors and be keen when they administer doses. Nurses have to be aware of the wrong dosage as one of the leading causes of medical errors. When the nurses understand the leading causes of medical errors, they will be more careful when administering doses to avoid committing errors that are most common. Nurses are trained to be alert and careful not to administer wrong does and ensure that they keep time when administering does. Considering these factors leading to medical errors in a medical setting and making a report to the nurse will improve safety as the nurses will be aware of the mistakes, thus will avoid repeating them. Therefore, it is critical for healthcare organizations to regularly conduct a root cause analysis of medication errors, and make a report for nurses to refer to during their practice.

Gohal, G. (2021). Models of teaching medical errors. Pakistan Journal of Medical Sciences, 37(7), 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613064/

Medication errors are the leading cause of adverse drug events in many healthcare organizations. Health care organizations should come up with educative strategies and teaching models to ensure that their healthcare workers understand the problem of medication errors. Teaching the nurses to understand the extent to which their behaviors contribute to medication errors and the consequences of this issue to healthcare stakeholders will motivate them to adopt quality improvement interventions. Therefore, healthcare institutions should review the rate and causes of medication errors regularly and prepare reports to train their staff on how to reduce the identified leading causes.

 

 

References

Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of health policy research, 8(1), 1-9. https://ijhpr.biomedcentral.com/articles/10.1186/s13584-019-0314-8

Amiri, M., Khademian, Z., & Nikandish, R. (2018). The effect of nurse empowerment educational program on patient safety culture: a randomized controlled trial. BMC medical education, 18(1), 1-8. https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1255-6

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC health services research, 19(1), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4481-7

Gharaveis, A., Hamilton, D. K., & Pati, D. (2018). The impact of environmental design on teamwork and communication in healthcare facilities: a systematic literature review. HERD: Health Environments Research & Design Journal, 11(1), 119-137. https://journals.sagepub.com/doi/abs/10.1177/1937586717730333

Gohal, G. (2021). Models of teaching medical errors. Pakistan Journal of Medical Sciences, 37(7), 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613064/

Ibrahim, M. I. M., & Izham, N. F. F. M. (2021). Medical Devices to Improve Medication Adherence. In Medical Devices for Pharmacy and Other Healthcare Professions (pp. 39-54). CRC Press. https://www.taylorfrancis.com/chapters/edit/10.1201/9781003002345-6/medical-devices-improve-medication-adherence-mohamed-izham-mohamed-ibrahim-fatin-farhani-mohamed-izham

Kaboodmehri, R., Hasavari, F., Adib, M., Khaleghdoost Mohammadi, T., & Kazemnejhad Leili, E. (2019). Environmental factors contributing to medication errors in intensive care units. Journal of Holistic Nursing and Midwifery29(2), 57-64. http://hnmj.gums.ac.ir/browse.php?a_id=722&slc_lang=en&sid=1&ftxt=1&html=1

Mieiro, D. B., Oliveira, É. B. C. D., Fonseca, R. E. P. D., Mininel, V. A., Zem-Mascarenhas, S. H., & Machado, R. C. (2019). Strategies to minimize medication errors in emergency units: an integrative review. Revista Brasileira de Enfermagem, 72, 307-314. https://www.scielo.br/j/reben/a/gMgPrcLkFvyq3VvCz6KJhKH/abstract/?lang=en

Rutledge, D. N., Retrosi, T., & Ostrowski, G. (2018). Barriers to medication error reporting among hospital nurses. Journal of clinical nursing, 27(9-10), 1941-1949. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14335

Van de Vreede, M., McGrath, A., & de Clifford, J. (2018). Review of medication errors that are new or likely to occur more frequently with electronic medication management systems. Australian Health Review, 43(3), 276-283. https://www.publish.csiro.au/ah/AH17119

van Ewijk, B. (2018). Medication Error Prevention: Improving Patient Health Outcome. https://repository.usfca.edu/thes/1112/

Wu, A. W., & Busch, I. M. (2019). Patient safety: A new basic science for professional education. GMS Journal for Medical Education, 36(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446473/

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