Essay on Medication Errors in ICU

Health care organizations are continuously paying attention to the provision of quality care and ensuring the safety of the patient. This is following the increasing cost and incidence of medication errors (Grundgeiger, Sanderson, MacDougall &Venkatesh, n.d). Whereas great attention has been given to the myriad effect of these events in the healthcare on patients who have fallen victims of medication errors there has not been enough consideration of the practitioner involved especially in relation to the intensive care unit (ICU) (Gokhman, Seybert, Phrampus, Darby, & Kane-Gill, 2012). It should be noted that these errors have the potential to affect both professional and personal performance of the practitioner. PICOT statement: For patients in the intensive care unit (ICU), how does barcode medication administration (BCMA) compared to not using a BCMA system affect the rate of medication administration error as recorded by direct observation and data review over a period of implementation lasting three months?

System factors have been credited as a crucial source of medication errors especially within the ICU. The nursing professional plays a vital role as a primary member of the multidisciplinary bedside team. It is important to examine how systems such as barcode medication administration (BCMA) can be used to eliminate medication errors as compared to other methods including but not limited to regulatory approach, pharmacy intervention, and CPOE (computerized physician order entry) (Seibert, Maddox, Flynn & Williams, 2014). Reduction in medication errors will result in decreased patient injury and positive quality outcomes.

Evidence-Based Solution

According to Keers, Williams, Cooke and Ashcroft (2013), understanding the main cause of medical errors is essential in developing the right intervention measures. Arguably, barcode medication administration can be used effectively to reduce cases of medication errors in the hospital and more specifically in the intensive care unit. In their study, Seibert, Maddox, Flynn & Williams (2014) found that use of barcode medication administration technology increased accuracy by between 92 to 96 percent and no new types of error arose.

Nursing Intervention

The nurse plays a vital role in ensuring that patient safety while in the ICU is maintained. In their study Dimitrios, Martha, and Theodore (2012) observes that each clinical interaction presents a possibility of an error as a result of work load, frequent interruptions, and burnout. A good intervention measure in this case is to achieve 100% compliance with BCMA to help in reducing medication errors.

Patient Care

Dimitrios, Martha, and Theodore (2012) note that about nine out of ten nurses have made medication errors at one point in time while providing patient care. These errors are characterized by prescription of wrong drugs and administration of medication at the wrong time as well as other contributing factors. Some of the events have significant effects on patient safety besides imposing high economic costs on the health system.

Health Care Agency

Keers, Williams, Cooke, & Ashcroft (2013) emphasize the importance of system factors in terms of contributing toward medical errors. The author notes lapses and slips among medication administrators as the most common causes. Other factors include miscommunication, inadequate supply and storage of medicines, and staff health status. In line with this, it is the responsibility of health care agencies, such as The Joint Commission, to ensure that all protocols are followed and that there is a clear definition of roles and responsibilities.

Nursing Practice

There is a need for education and systematic changes to prevent medication errors during medical emergencies as an effort to avoid harm (Kiekkas, Karga, Lemonidou, Aretha & Karanikolas, 2011). Nurses should also be provided with official record of errors in a bid to sensitize them on the importance of managing such errors. Educating nurses on the importance of minimizing medical errors is crucial for ensuring the safety of patients in the ICU.

Barriers to barcode medical administration.

The primary barrier to this approach in eliminating medication errors lies on the suitability. Like any other technology, barcode technology is more suited to some products as opposed to others. This makes it less effective and difficult to implement in other medications. For instance, using barcodes is easy among the injectable medications as opposed to the oral medication. This is because the syringe pumps connected to patients makes it easier for identification of infusion drugs as opposed to manually administered. This technology has also proved difficult to cut some steps to make the workflow easily when administering oral medications.

To solve this problem the nursing homes and hospitals need to employ more nurses to cater for all steps. Besides, this approach should be equally employed in both medication approaches. This way it will be easy to establish various ways easy steps to use the approach in all medication types. Finally, nurses should be vigilant and strive to carry on research on new ways that all forms of medications should be integrated to the barcode system. With these strategies, it will be viable to overcome this barrier.

Another barrier is an incorrect use of the technology to administer drugs to patients. Whereas Barcode technology is very effective in eliminating errors occurring in medication, some instances may make the technology fail. The failure is attributed to the factor that some settings are needed to run the technology appropriately. When any error is made on the set stage, the error will replicate to the type, amount and the frequency the patient will get the medication. Thus even with appropriate technology the patients will end up getting a wrong medication. The solution to this barrier is proper education to nursing staff on the new technology. With adequate education and keenness, the barrier could be eliminated. Furthermore, nurses should be keen when administering drugs and avoid relying on the barcode technology alone. With these strategies, it will be viable to overcome this barrier.

References

Dimitrios, M., Martha, K., & Theodore, K. (2012). Factors which affect the occurrence of

nursing errors in medication administration and the errors' management. Rostrum Of

Asclepius / Vima Tou Asklipiou, 11(2), 293-312.

Gokhman, R., Seybert, A. L., Phrampus, P., Darby, J., & Kane-Gill, S. L. (2012). Clinical paper:

Medication errors during medical emergencies in a large, tertiary care, academic medical

center. Resuscitation, 83482-487. doi:10.1016/j.resuscitation.2011.10.001

Grundgeiger, T., Sanderson, P., MacDougall, H., & Venkatesh, B. (n.d). Interruption

Management in the Intensive Care Unit: Predicting Resumption Times and Assessing

Distributed Support. Journal Of Experimental Psychology-Applied, 16(4), 317-334.

Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Causes of medication

administration errors in hospitals: a systematic review of quantitative and qualitative

evidence. Drug Safety, 36(11), 1045-1067 23p. doi:10.1007/s40264-013-0090-2

Kiekkas, P., Karga, M., Lemonidou, C., Aretha, D., & Karanikolas, M. (2011). Medication errors in critically ill adults: a review of direct observation evidence. American Journal of Critical Care, 20(1), 36-44. http://dx.doi.org/doi: 10.4037/ajcc2011331 Am J Crit Care January 2011 vol. 20 no. 1 36-44Seibert, H. H., Maddox, R. R., Flynn, E. A., & Williams, C. K. (2014). Effect of barcode

technology with electronic medication administration record on medication accuracy

rates. American Journal Of Health-System Pharmacy, 71(3), 209-218 10p.

doi:10.2146/ajhp130332