Approaches To Prevent Medication Errors

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Approaches to Prevent Medication Errors

Introduction

Medication errors are among the leading causes of morbidity and mortality among the medical

blunders reported in many countries including the United States. The Institute of Medicine

(IOM) indicates that medication errors have adverse effects on more than 1.8 million individuals

in the U.S (Anderson and Townsend 24). Besides, there are many costs associated with

medication errors including production, lost incomes, and unnecessary health care spending. The

incidents of medication errors vary broadly from one facility to another. Nevertheless, a growing

body of pharmacological research indicates that at least a single medication error occurs in every

health center per day (Lavon, Ben‐Zeev, and Benton 288). These errors have far-reaching

adverse effects on the patients, health care professionals, and the organization. This paper delves

into the issue of medication errors to define it, examining causes, reasons for its occurrence and

suggests some strategies for prevention.

A medication error is a failure occurring during treatment that injures or is capable of harming a

patient. Medication administration is an all-encompassing process that embodies several steps

including prescription, transcription, dispensing, and administration of drugs and monitoring of

patients’ response (Lavon, Ben‐Zeev, and Benton 288). Medication errors can occur at any of

steps mentioned above. The leading medication errors occur during administration contributing

approximately 30% to the incidence in the United States. It is fatal and usually not intercepted

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easily (Keers et al. 1050). Researchers argue that the prescription stage presents a higher chance

of medication errors. However, the medical staff such as pharmacists and nurses intercepts errors

emanating from drug prescription. Most of the prescription errors result in the wrong dosage,

where the patient gets too little or excess of the recommended dose (Anderson and Townsend

27). Additionally, incorrect transcription and labeling can cause serious undetectable

consequences. Also, those errors can involve a mix-up of drugs, patients themselves or a wrong

application route.

Medication errors occur on wide-ranging grounds as underpinned by several factors. According

to the Institute of Safe Medicine (ISMP), ten key elements influence medical practice (Anderson

and Townsend 25 They include patients’ education, competency of the medical staff, and the

storage of medications, environmental aspects, drug packaging, and labeling among (Idemoto et

al. 1481). Mistakes that occur when handling any of these elements result in medication errors

(Lavon, Ben‐Zeev, and Benton 288). Correct identification of a patient is the first step of the

medication process. Nurses who fail to identify the right patient’s information are likely to

administer erroneous drugs. Patient’s profile shows age, gender, birth date, and weight.

Moreover, allergies, current lab results, and accurate diagnosis are crucial sources of information

to guide nurses when administering treatment. Medication errors occur when the medical staff

overlooks any components of patient’s information.

One of the most threatening causes of medication errors is poor packaging, labeling, and

nomenclature. Failure to distinguish between similarly packaged or labeled drugs can endanger

patients. The harm can be more threatening if the drugs mistaken belong to the high-alert groups

(Fall 360). Moreover, look-alike or sound-alike medications can be easily confused, hence

resulting in errors. Drug storage, stock standardization, and distribution present another area of

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medication errors. Availing a floor-stock of medicines can easily lead to confusion among

nurses, particularly when high-alert drugs are stacked together. Staff education and competency

have a strong correlation with the incidence of medication errors. Lack of teaching nurses on the

use of newly introduced drugs can pose a risk of mistakes (Keers et al. 1050). When nurses and

pharmacists fail to update themselves on changes regarding medication-related policies,

procedures, and protocols, they use old administration methods that can be detrimental to

patients.

Some patients use medication at home away from the caregivers. If they lack adequate

information regarding those drugs, errors such as overdose, underdose, or even confusion of

look-alike drugs are likely to occur (Keers et al. 1050). Experts hold that some environmental

factors create room for medication errors. These conditions include poor lighting, cluttered work

environments, increased patient acuity, and distractions when preparing drugs or administration.

Dispensing errors usually occur at the pharmacies or at the hands of health care professionals

who administer medications (Anderson and Townsend 25). These errors comprise negligence or

mistakes that lead to the dispensing of incorrect drugs or doses and doing a wrong entry in cases

where pharmacists use computer software. Researchers refer to theses occurrences as errors of

commission (Fall 359). Errors of omission entail the failure to counsel patients, use of

ambiguous language, and lack of engaging them in interactive sessions (Idemoto et al. 1482).

Additionally, errors of omission imply a failure to include a prescribed dose of the patients’

medication or not following the instructions on time for drug administration.

An additional cause of medication errors is poor communication between nurses and patients.

Sometimes patients may fail to take instructions carefully or are unaware of errors that can occur.

Also, medication errors can spring from inadequate monitoring of complex processes or devices.

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For instance, the removal of patients from one bed to another, mishandling of devices can lead to

overdose. Various parties including manufacturers, pharmacists, nurses, and patients can cause

medication errors. Manufacturers who label different drugs similarly or package them in

identical containers contribute to medication errors. Nurses are responsible for medication errors

too. Factors inherent in nursing that contribute to errors include personal neglect, heavy

workload, unfamiliarity with new medication, new nursing staff, complicated orders initiated by

doctors, unfamiliarity with the patients’ condition, and inadequate training (Lavon, Ben‐Zeev,

and Benton 288).

Other elements that cause errors amongst nurses include solving other problems while

administering drugs to other patients, stress and burnout, the length of nursing shift, duration of

hospital stay, and poor quality checking for damaged or expired medication (Lavon, Ben‐Zeev,

and Benton 288). Pharmacists are responsible for all errors emanating from dispensing errands.

Sometimes poor communication between pharmacists and patients result in errors. Particularly,

pharmacists are responsible for dispensing errors. On the other hand, patients are accountable for

medication errors, especially those that involve failure to adhere to doctor’s prescription

(Idemoto et al. 1482). For instance, patients can make decisions that contradict orders including

under-dose, over-dose or ignoring to take drugs altogether.

Medication errors result in adverse effects on patients. As such, when they occur prompt

reporting should follow for timely corrective action. Interception for some medication errors is

possible when there is timely reporting. Medical professionals do not commit errors deliberately

(Idemoto et al. 1482). However, the occurrence of medication errors sometimes puts those

responsible in undesired circumstances. In other instances, blame game erupts where the

professionals are unwilling to admit responsibility (Roy, Gupta, and Srivastava 62). Some

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punishment processes serve as disciplinary action on the irresponsible professionals. An

investigation should be launched to analyze the delivery channels of the particular drug and its

use in the healthcare organization. When errors occur, the quality department should initiate an

evaluation process to prevent future incidences. Healthcare agencies should strive to create a

non-threatening, non-punitive, and confidential environment that allows medical professionals to

report medication errors voluntarily and timely for an immediate interception.

Medication errors in the United States are on the rise leading to unanticipated health effects such

as deaths, illnesses, costs, and high rates of co-morbidity. As such, the entire health care system

should lead the way in formulating strategic solutions. The system should seek to identify the

key areas from which errors emanate (Anderson and Townsend 26). First, providing patient

education on the adherence to medications can prevent errors. In fact, proper education and

information can ensure that patients play an integral part in promoting safety prescription

correctness. Patient education entails proper identification of the information given by

pharmacists, proper drug use, safe storage of medications to avoid contamination, checking

expiry dates, and taking recommended doses. Additionally, prior authorization programs play a

vital role in providing quality care and enhancing cost-effectiveness in prescription. The

programs can reduce errors through ensuring that particular patients do not take specified

medications.

Electronic Bar Coding Technology is a preventive measure of medication errors. The medication

bar device ensures that patients receive the right amount of a particular drug amount that

corresponds to the identified condition. Information regarding dose, medication and the patient

conditions should appear on the medication bar tool to help in proper administration (Roy,

Gupta, and Srivastava 63). An electronic prescription record (EPR) is software that contains data

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including labeling, dispensing, and payment such that patients pay for the right medicine. It helps

in preventing dispensing errors. Also, E-prescribing can reduce all errors that stem from the

prescription processes. With the advancement in technology, pharmacists rely on the Internet to

carry out drug utilization reviews (DUR (Roy, Gupta, and Srivastava 63). Other prevention

strategies include providing medical education and training for new staff before job placement

(Fall 361).

Conclusion

Medication errors claim lives of many patients around the globe besides resulting in many

effects. As such, drug handlers and medical practitioners should employ proactive strategies to

ensure flawless medication processes. Researchers suggest several measures including

immediate reporting of medication errors and adequate training of medical professionals on a

timely interception. Moreover, proper labeling of drugs can help to prevent errors emanating

from look-alike or sound-alike drugs. Ensuring the right documentation and the patients’ right to

refuse medication are additional ways of preventing errors. Also, health physicians and

pharmacists should exercise fair evaluation and monitoring to identify practices or incidences

that are likely to result in medication errors. Proper staffing practices such as an appropriate

number of nurses per bed and room prevent burnout and overload-related medication errors. Last

but not least, the advancement in technology including Electronic Bar Coding Technology and

E-prescribing is gradually improving medication processes such as labeling, prescription, and

administration.

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Works Cited

Anderson, Pamela, and Townsend. "Medication errors: Don't let them happen to you." American

Nurse Today 5.3 (2010): 23-27. Print.

Fall, Bruce. "The Academy of Managed Care Pharmacy's concepts in managed care pharmacy:

prior authorization and the formulary exception process." Journal of Managed Care

Pharmacy 11.4 (2005): 358-361. Print.

Idemoto, Lori, Barbara Williams, Joan Ching and Craig Blackmore. "Implementation of A

Custom Alert To Prevent Medication-Timing Errors Associated With Computerized

Prescriber Order Entry." American Journal of Health-System Pharmacy 72.17 (2015):

1481-1488. Print.

Keers, Richard, Steven Williams, Jonathan Cooke and Darren Ashcroft. "Causes of Medication

Administration Errors in Hospitals: A Systematic Review of Quantitative and Qualitative

Evidence." Drug Safety 36.11 (2013): 1045-1067. Print.

Lavon, Ben‐Zeev, and Benton. "Medication errors outside healthcare facilities: a national poison

center perspective." Basic & Clinical Pharmacology & Toxicology 114.3 (2014): 288-

292. Print.

Roy, Vijay, Puneet Gupta, and Shouryadeep Srivastava. "Chapter-14 Medication Errors: Causes

& Prevention." Health Administrator 19.1 (2006): 60-64. Print.

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