Class 3 Redo Assessment 1

Please read everything. I got a 70% percent on this assessment. Attached are instructions, assessment and teacher comment from assessment. 

due 1 Nov 2pm cst 

I received a 70% on this assessment, so please read

Scenario

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Instructions

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For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.

Scenario

Consider the hospital-acquired conditions that are not reimbursed under Medicare/Medicaid, some of which are specific safety issues such as infections, falls, medication errors, and other concerns that could have been prevented or alleviated with the use of evidence-based guidelines.

Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.

For this assessment:

· Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.

Instructions

The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care settings from organizations such as QSEN and the IOM. Looking through the lens of these professional best practices to examine the current policies and procedures currently in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote medication administration safety in the context of your chosen health care setting.

Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.

· Explain factors leading to a specific patient-safety risk focusing on medication administration.

· Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.

· Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.

· Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.

· Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

· Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.

· APA formatting: References and citations are formatted according to current APA style.

I received a 70% on this assessment, so please read ALL teacher comments as she has given me feedback on assessment.

Teacher Comment: I appreciate your efforts here in identifying the factors that lead to a specific patient-risk concern with med errors. This can be expanded upon for a higher performance score. While you provided some basic details of a risk concern, a more thorough description is needed to achieve a higher performance level here. Are there authors you might cite, who can provide supporting evidence from the literature for some of your observations? If you have any questions, please let me know. Thanks!

Teacher Comment: Thank you for identifying an evidence-based and best practice solution, however, a greater explanation of the strategies is required along with a connection med errors and how cost is impacted. Parts of this section were unclear due to lack of citations to support your discussion. For a higher performance level, be sure to support your discussion with relevant literature.

Teacher Comment: You identified how nurses can help with coordinating care to increase patient safety and reduce costs; however, a further explanation was required with examples of how a medication administration safety issue could be addressed with cost savings being impacted. Please review the grading rubric criteria to identify missing information. 

Teacher Comment: You broadly identified the stakeholders in the paper; however, they were not named, explicitly rather it was inferred. You wrote that patients on surgical units require special attention but did not explain how. This would have been helpful for the reader to understand who the specific stakeholders were this was not explained. A deeper discussion on how their role impacts the ability to drive and change policy in which quality and safety enhancements to reduce med errors can be delivered was unclear. The next step would be to review the scoring guide to see what information was not addressed and to be sure to address all areas thoroughly on future submissions.

Teacher Comment: I like that I could follow your main theme, however there were many grammatical errors and incomplete sentences, such as the second line after initiating an QI process there should be evacuated over time to assess its suitability. The sentence is not clear about its meaning or purpose. The next statement states there is a need for full integration but the reader hasn’t been told what integration is or its purpose here. I recommend careful proof-reading before submitting for a grade.

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Capella University

October, 2020

Enhancing Quality and Safety

The Processes of quality improvement are often initiated to improve outcomes, especially in healthcare. Therefore, after initiating a quality improvement process, there should be evaluated over time to assess its suitability. The evaluation process can be through the following: For quality improvement processes (QIP) to work out effectively, there is a need for full integration into a healthcare system together with all its procedures (Adane et al., 2019).

Companies use Root Cause Analysis (RCA) to establish the instances, whereby it draws divergent opinions that result in poorer integration. Therefore, integration levels can be a good judge of an RCA approach (Charles et al., 2016). One of the ways this could be useful is in analyzing medical errors. Addressing medication errors requires a continuous improvement process. This is to ensure the provision of quality patient care in medical and surgical practice. It will define measures that intervene for planned success in patient safety and the success of the RCA.

Potential Evidence-based and Best-practice Solutions for Solving Medication Administration Errors

Medication administration errors are a threat to the safety of patients, and they are costly as well. Nurses have to interpose any medication errors to enhance the safety of patients before the medications reach the patient. They can do this by sticking to the six medication administration rights and reporting any medication errors they encounter. Besides, they must find the best solutions to prevent them (Latimer et al., 2017). The most important thing when deciding on the solutions is that they must be adequate, simple, and economical. The six medication rights that nurses must adhere to are “the right patient, the right drug, at the right time, the right route, right dose, and right documentation.”

Additionally, hospital and nursing managers should lessen the nursing workforce overworking, offer regular training programs on the appropriate and safe medication administrations, and establish an atmosphere that is conducive for reporting errors (Latimer et al., 2017). One of the best approaches to enhance patient safety and reduce the extent of drug administration errors is to recognize and intervene with the contributing factors of medication administration errors. In cases of prescription errors, computerized physician order entry is the best to employ to reduce the incidence of prescription errors. By prescribing electronically and connecting it to the pharmacy directly is effective in reducing oral errors, standardizes the order, and enhancing the legibility of the prescriptions.

A clinical decision support system is another evidence-based practice that has been used to reduce medication administration errors. It helps in alerting and aiding prescriber decisions regarding therapeutic management, frequency, dose, length of medication therapy, side effects, and allergies, laboratory test values, and drug and food interaction. Using modified medication and prescription charts also help reduce medication administration errors. These charts have a drug name, form, dose, strength, route, refill, frequency, amount, indications, and other directions on drug administration. Incorporating automated drug dispensing machines, using barcoding, and using robots can also reduce the common dispensation errors. Medication administration errors can be prevented by utilizing “smart devices” when performing an intravenous administration.

Medication Administration Errors in Healthcare Setting

The primary cause of preventable patient harm and death within the healthcare setting across the globe is unsafe medication habits. The most significant percentage of which arises during the administration of medication (Wondmieneh et al., 2020). Medication administration errors such as prescription errors, exclusion, incorrect time, unlawful drug administration, incorrect dose, incorrect dose prescription, incorrect dose preparation, and administrations errors are the most common kinds of medical errors presenting risky effects for patients, health institutions, and health professionals.

Nurses devote up to forty percent of their time administering medications to patients since it is their responsibility. They symbolize the final safety assessment in the string of proceedings in the process of drug administration and are the final safety measure of patient health (Hammoudi et al., 2018). Medication errors can arise at any of the medication use phases, i.e., at some stage in prescribing, transcription, dispensation, and administration. However, most medication errors most commonly happen during the phase of administration.

These errors usually occur due to factors such as insufficient nurse education regarding the safety and quality of patients care, inadequacy in staffing, indecipherable provider handwriting, issues with drug labelling, faulty dispensing systems, staff fatigue, and extreme workload (Hammoudi et al., 2018). Besides, issues such as drugs with similar names or same packaging, drugs not regularly prescribed, frequently used drugs to which many patients are allergic. Besides, medications, which need testing to guarantee the maintenance of suitable therapeutic levels, continuously challenge nurses to make sure that the patients get the correct medication at the correct time. Medications that look the same or have names that sound the same can cause medication errors and misreading the names of medications, which look the same, is a frequent mistake nurses face when caring for their patients.

The Role of Nurses and other Stakeholders in addressing the Issue of Medication Administration Errors

Nurses play a huge role in enhancing quality care in hospitals. They engage directly with patients across all units. They play an important role in critical care. Most of the time, they require nurses and specialized personnel to help the recovery in the ICU before they are transferred to the common wards. Measures have to be developed to ensure that their safety is heightened in addressing medical errors (Scott & Henneman, 2017). Most of the surgical units’ patients require special attention, which the nurses are mandated to oversee. It lies up to them to liaise with other health professionals in ensuring that patients recover and leave the hospital. This does, however, put them at risk. They often carry the liability of medical error. This does also put them at pressure since they are often overworked affecting their emotional and physical strength (Dall’ Ora et al., 2016).

Health care facilities continue to ensure that nurses are trained in how best to handle patient safety. The nursing profession has clear guidelines for patient’s safety. A case of negligence on their part could result in the suspension of their licenses or even revocation of their practicing license (Hammoudi et al., 2018). As a result, they have to continue training their nurses on how best to improve their skills for patient safety. With medical errors being a common issue in the healthcare setting, nurses have to be trained on their contribution towards reduced medical errors.

Hospitals have to ensure that they schedule their shifts accordingly to prevent them from work overload. In order to meet their role in patient safety, nurses have to coordinate their roles with those of the clinicians, supervisors, and ancillary staff. Their coordinated efforts help facilitate improvement measures towards reduced medical errors. They also need to coordinate their roles to reduce workload and improve communication to reduce interruptions that lead to human error. Through interdisciplinary actions, they carry out Root cause analysis and facilitate corrective action to meet patient safety needs.

As mentioned earlier, nurses play a vital role in ensuring patient safety by reducing medication administration errors. Other stakeholders such as the pharmacists, physicians, the patient, the government, legislative bodies, researchers, and accrediting agencies also have a significant role to play in reducing medication administration errors. Nurses use their knowledge top to deliver nursing care that is important to patient safety and wellbeing. The government and legislative agencies establish practice rules, acts, and regulations regarding medication administration. Patients should mention their allergies, physicians should write legible prescriptions, and accrediting agencies should only accredit healthcare facilities based on their merits (Garfield et al., 2016).

Conclusion

Quality improvement tools are vital to healthcare organizations. They, however, need constant evaluations to assess their effectiveness. Through a focused audit, developmental, and multiple case studies, there can be an evaluation of the QIP. Also, through assessment of integration levels, data, and evidence-based assessment, evaluation can be achieved. Medical errors need joint collaboration between the hospitals and their health professionals to ensure patient safety is enhanced. This will help hospitals cut down on the cases reported as a result of medical errors in the surgical and transplant department and across all units. Patient safety and quality of care are essential when administering medications. It is, therefore, important for all the stakeholders to prevent any medication errors that might harm the patient or cause death.

References

Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, 12, 67-73. doi:10.2147/rmhp.s179259

Berlin, L. (2017). Medical errors, malpractice, and defensive medicine: An ill-fated triad. Diagnosis, 4(3), 133-139. doi:10.1515/dx-2017-0007

Charles, R., Hood, B., Derosier, J. M., Gosbee, J. W., Li, Y., Caird, M. S., . . . Hake, M. E. (2016). How to perform a root cause analysis for workup and future prevention of medical errors: A review. Patient Safety in Surgery, 10(1), 20-20. doi:10.1186/s13037-016-0107-8

Dall’Ora, C., Griffiths, P., & Ball, J. (2016). Twelve-hour shifts: Burnout or job satisfaction? Nursing Times (1987), 112(12-13), 22-23.

Garfield, S., Jheeta, S., Husson, F., Lloyd, J., Taylor, A., Boucher, C., . . . Franklin, B. D. (2016). The role of hospital inpatients in supporting medication safety: A qualitative study. PloS One, 11(4), e0153721-e0153721. doi:10.1371/journal.pone.0153721

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.

Latimer, S., Hewitt, J., Stanbrough, R., & McAndrew, R. (2017). Reducing medication errors: Teaching strategies that increase nursing students’ awareness of medication errors and their prevention. Nurse Education Today, 52, 7-9. doi:10.1016/j.nedt.2017.02.004

Scott, S. S., & Henneman, E. (2017). Underreporting of medical errors. Medsurg Nursing, 26(3), 211.

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, addis ababa, ethiopia. BMC Nursing, 19(1), 4-4. doi:10.1186/s12912-020-0397-0