Culture of Care and Respect to reduce Medication Errors

       I have always been the meticulous one when it comes to medicating patients. Even when I was working as a staff nurse in a tertiary hospital, I made it a point to always apply the 3 checks principle and the Rights of Drug administration. I have been trained not to do short-cuts even when others are doing it. Sometimes, it takes real guts to be "the different one" when it comes to an environment where some people around you are not doing the ideal standard procedure. You have to be strong enough to stand firm in the face of ridicule and gossips. But then again, each one of us nurses are uniquely imperfect as human nature defines us all. There is always that experience when you look back and smile at your own human flaws. We make mistakes but it is always good to learn from them and not repeat them. Medication errors scare me and I have to admit that when it comes to medication administration, I strive harder than hard to be perfect.

         Medication errors, still one of the leading threats to patient safety, contribute to more than 7,000 inpatient deaths per year in the United States (Flynn, Liang, Dickson, Xie, & Suh, 2012). Medication Errors are preventable events that are caused by inappropriate medication use and can lead to patient harm under the responsibility of healthcare professionals, or under the control of patients or consumers (Mrayyan, 2012). All healthcare providers dealing with medication administration are prone to commit medication errors as human nature is never perfect. Medication errors can possibly lead to Adverse Drug Events (ADE). When the use of medication at any dose, a medical device, or a special nutritional product result in an adverse outcome in a patient, this can lead to an incident called ADE. Approximately 10 % of emergency department visits and up to 17% of hospital admissions have been reported by studies as results of ADEs (Hayes, Klein-Schwartz, & Gonzales, 2009).

        Research has demonstrated that it is the registered nurses who are most likely able to identify and do something about medication errors even if these can originate at the prescribing, transcribing, dispensing, or administration stage (Flynn, Liang, Dickson, Xie, & Suh, 2012). Although Medication Errors may easily be identified by nurses, the challenge lies in the system of documentation and reporting. A study that examined the relationship between incidence and report of medication errors as well as working conditions emphasized that the establishment of an efficient reporting system, documentation of errors and removal of barriers to reporting may result in decreased frequency of medication errors (Joolaee, Hajibabaee, Peyrovi, Haghani, & Bahrani, 2011). This means that there must be a work atmosphere in which nurses feel more comfortable at reporting medication errors and decreasing work tensions to help properly identify the factors that lead to the errors and eventually create strategies to prevent these unwanted incidents. 

        A culture emphasizing quality of care, with the participation of the entire healthcare team, could reduce the incidence of medication errors in the future. A multidisciplinary collaborative effort is a must and required for a successful utilization of tools and policies to detect and prevent medication errors. It is also important to have a supportive practice environment because studies show that it is associated with a higher quality of nursing care. Thus, healthcare administrators are challenged to consider carefully available strategies that create a comfortable work atmosphere encouraging nurses to identify Medication Errors quickly, document them and report immediately so that proper interventions can be done. 

References:

Flynn, L., Liang, Y., Dickson, G., Xie, M., & Suh, D., 2012, Nurses' Practice Environments, Error Interception Practices, and Inpatient Medication Errors, Journal of Nursing Scholarship, 44, 2, pp. 180-186, viewed 21 November 2012.

Hayes, B., Klein-Schwartz, W., & Gonzales, L., 2009, Cause of Therapeutic Errors in Older Adults: Evaluation of National Poison Center Data, Journal of the American Geriatrics Society, 57, 4, pp. 653-658, viewed 21 November 2012.

Joolae, S., Hajibabaee, F., Peyrovi, H., Haghani, H., & Bahrani, N., 2011, The Relationship Between Incidence and Report of Medication Errors and Working Conditions, International Nursing Review, 58, 1, pp. 37-44, viewed 21 November 2012.

Mrayyan, M.T., 2012, Reported Incidence, Causes, and Reporting of Medication Errors in Teaching Hospitals in Jordan: A Comparative Study, Contemporary Nurse: A Journal For the Australian Nursing Profession, 41, 2, pp. 216-232, viewed 21 November 2012.