NURS FPX 4020 Assessment 1: Enhancing Quality and Safety Enhancing Quality and Safety

 

Patient safety and quality care are two of the most significant challenges faced by health care facilities, nurses, physicians, and other health care professionals. Poor quality and issues to patient safety will lead to morbidity, mortality, increased cost of care and hospital stay, lower patient satisfaction, and job satisfaction, and other issues. Some of the most common patient safety issues are medication administration errors, poor patient handling, delayed care, hospital-acquired infections, patient falls, and other issues. The purpose of this paper is to analyze the medication administration issue relating to patient safety, best evidence-based practices, and analyze coordination between nurses and stakeholders.

Patient-safety risk focusing on medication administration

Medication administration is a critical process where nurses play a key role. However, stakeholders such as physicians, pharmacists, informatics nurses, and other health care professionals contribute to it as the process includes medication prescription, dosage calculation, medication dispensing, and error monitoring. Error in any of the stages will lead to medication administration errors. This will result in adverse events. For example, the prescription error rate varied from 6% to 77.2% (Korb-Savoldelli et al., 2018), dispensing errors varied from 1.2% to 46% (Kumar et al., 2019), and wrong dosage and omission error varied from 8% to 26% in health care (Palese et al., 2019). Suclupe et al. (2020) found in their study that 6–25% of errors were caused by nurses. This indicates that human errors are a major factor.

Another factor is interferences during medication administration. Interferences from patients or their families disturb the normal work process, which results in medication mix-up and delayed administration. Thomas et al. (2017) pointed out that nurses feel excessive cognitive load when there are distractions and interruptions. Frequency interruptions reduce throughput and efficiency, which culminates into errors. Also, conversations with other nurses during administration increase the risk of medication errors (Huckels-Baumgart et al., 2017). For example, nurses discussing about other patients during administration can lead to confusion.

Nurse to patient ratio is another major factor as an increased number of patients per nurse increases burnout in nurses. Burnout leads to lower cognitive functioning and leads to poor decision-making and errors (Montgomery et al., 2020). Another major factor is poor communication between nurses, physicians, informatics nurses, and pharmacists as misinformation regarding dosage or wrong patient records in EHRs result in medication errors. These can result in adverse effects (Tsegaye et al., 2020). In their study, Tsegaye et al. (2020) found that the prevalence of administration errors was due to wrong assessment (27%), wrong evaluation (26.7%), and wrong time (38.7%). A significant relationship between lack of training, failure to adhere to administration rights, unavailability of guidelines, and medication errors was observed (Tsegaye et al., 2020). For example, the use of abbreviations, no knowledge regarding change of packaging and FDI regulations, and guidelines by IOM and QSEN result in medication errors (Montgomery et al., 2020).