Medication Errors in Nursing Practice

The Definition of Medication Errors

In spite of the fact that the United States spends more on healthcare than any other developed nation, the quality of health care remains low. One of the areas of concern is patient safety and the impact of prescription errors. In order to understand the impact of such errors, it is important to define the concept of “medication error” and related terms.

A medication is a medicinal product with a defined biological effect on an individual’s health and which is intended to be administered by an individual for preventative and diagnostic purposes or as a part of the treatment of a disease (Aronson, 2009, p. 601).

Medication may also be a product with no biological effect used as a placebo. A type of medication used in the practice of medicine to induce a state of unconsciousness or to provide pain relief is called anesthesia. Medication has an active compound which is responsible for interfering with physiological or biochemical function of an organism (Aronson, 2009, p. 601). Due to this fact, medication should only be administered for the prescribed purposes and in a correct dosage. A failure to administer medication in accordance with the instruction may result in side-effects or negative outcomes.

In the context of this paper, a medication error can be defined as “a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient” (Aronson, 2009, p. 601). In other words, a medication error is a mistake which occurs during the compounding, prescribing or administering of a medication which results in a treatment failure. The definition does not clarify who is responsible for the occurrence of medical errors but highlights the fact that a medication error results in a sub-par level of treatment and negative health effects.

The Impact of Medication Errors

Medication errors have been thoroughly studied as one of the major factors contributing to the lower quality of care and unfavorable patient outcomes.

A paper by John James seeks to evaluate the number of deaths associated with medication errors. The author conducted a comprehensive literature search, which included scientific studies published between 2008 and 2011. The studies included statistics on mortality rates associated with medication errors (James, 2013, p. 122). The lower limit turned out to be 210,000 deaths per year, and it was estimated that at least 400,000 patients die prematurely due to medication errors, such as medication stop orders (James, 2013, p. 122).

A study by van Doormaal et al. examined the impact of medication errors in a hospital setting. The data on medication errors and their effect on patient outcomes and hospital stay was collected during a 5-month period (van Dormaal et al., 2009, p. 22). The researchers examined the impact of various types of medication errors, including prescribing and transcribing errors (van Dormaal et al., 2009, p. 22).

The study highlighted the fact that the majority (60%) of medication errors contained at least one such error. The analysis performed by the researchers suggests that out of 592 hospital admissions, 103 resulted in negative patient outcomes due to medication errors. In most of the cases, harm was temporal and sometimes, resulted in a prolonged hospital stay. In two cases patients’ lives were in danger, and one patient died because of a medication error (van Dormaal et al., 2009, p. 22).

In addition to patient outcomes, it is important to consider the economic effects of medical errors. The research team headed by Van Den Bos uses an actuarial approach to project the costs associated with improper medical management (Van Den Bos et al., 2011, p. 596). The researchers estimate that the annual cost of medical errors was $17.1 billion in 2008 (Van Den Bos et al., 2011, p. 596). The research shows that it is important to consider improving patient safety as a part of the strategy to minimize rising healthcare expenditures.

The Causes of Medication Errors

There is a growing understanding that medication errors are the result of organizational factors and poor design of work processes.

Research suggests that organizational factors do influence patient safety and that a change in organizational conditions can contribute to the reduction of medical errors. A study done by Nieva and Sorra explores the role of organizational factors in patient safety. The researchers evaluate the potency of safety culture assessment as a part of patient safety improvement strategy (Nieva & Sorra, 2003, p. 17). The authors conclude that safety culture assessments can be used to find out what organizational conditions contribute to medical errors and as a tool for change initiatives evaluation (Nieva & Sorra, 2003, p. 21).

A research paper by Pascale Carayon, et al. uses human factors system approach to addressing the issue of healthcare quality and patient safety. In the paper, “the Systems Engineering Initiative for Patient Safety” model is proposed as a solution to the concerns of quality improvement through work systems redesign (Carayon et al., 2014). The researchers evaluate the effects of work systems design on the quality of care and conclude that while multiple system elements have implications for patient safety, the ambiguity in current patient care guidelines affect compliance with them (Carayon et al., 2014).

Medication Errors and the Role of the Nurse Practitioner

The issue of medication errors has a profound impact on the role of the nurse practitioner. In order to address this issue, the medical community has to unite their efforts and use leadership, safe practices, and technology to transform healthcare. This fact emphasizes the need of nurse practitioners to develop leadership attributes, make informed diagnostic and treatment decisions using best clinical evidence, and be a vocal supporter of the implementation of technology in healthcare.

Today people recognize the role of leadership in achieving organizational goals (Buckbinder & Shanks, 2001, p. 25). Nursing leaders are the driving force behind the continuous process of improving the quality of health care services.

It is important that nurse practitioners apply their expertise to inspire other health care professionals to deliver superior performance. In order to address the issue of medication errors in the increasingly complex healthcare settings, nurse practitioners are expected to possess the attributes of leadership and be aware of leadership practices related to their field. It is true for nurses in administrative positions, but it is also true for nurses who are at the beginning of their careers since they also have to guide for students and healthcare assistants.

The increasing awareness about the issue of medical errors and the destructive effect they have on the delivery of medical care expands the role of the nurse practitioner to include leadership practices as the foundation of their work. The role of the nurse practitioner emphasizes using leadership to unite people in an attempt to minimize medication errors and improve the quality of care. Leadership education in the context of healthcare is, therefore, important, since leaders have to possess certain knowledge and qualities to be successful.

Another important area to consider is the fact that nurse practitioners have to use best clinical evidence to make informed decisions about the application of medication, in particular, high-risk ones. In order to establish safe practices, nurse practitioners have to be careful when administering medications, be aware of their adverse effects, and carefully monitor patient’s condition. Nurse practitioners have to understand the consequences medication errors and always make their judgments using best clinical evidence.

In addition, the role of the nurse practitioner now emphasizes their committed to further advancing medical science by conducting research and implementing research evidence in their work. This fact means that nurse practitioners have to conduct research on the impact of medical errors and their causes, and use the evidence-based approach to propose effective intervention and prevention programs aimed at overcoming this important issue.

Medication errors can be minimized by using the latest technology, such as computerized order prescription systems and digital patient records. Such technology allows for an information flow between different practitioners which is especially important in today’s complex healthcare settings. Therefore, the role of the nurse practitioner now implies that the nurse practitioner is fully capable of using such technology to advance medical care. Medical errors are contributing to the need of nurse practitioners to be advanced users and vocal supporters of the adoption of medical technology in healthcare settings.

References

Aronson, J. (2009). Medication errors: definitions and classification. British Journal of Clinical Pharmacology, 67(6), 599-604. Web.

Buckbinder, S., & Shanks, N. (2012). Introduction to Health Care Management. Burlington, United States: Jones and Bartlett.

James, J. (2013). A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Journal of Patient Safety, 9(3), 122-128. Web.

Nieva, V., & Sorra, J. (2003). Safety culture assessment: a tool for improving patient safety in healthcare organizations. Quality & Safety in Health Care, 12(2), 17-23. Web.

Van Den Bos, J., Rustagi, K., Gray, T., Halford, M., Ziemkiewicz, E., & Shreve, J. (2011). The $17.1 Billion Problem: The Annual Cost Of Measurable Medical Errors. Health Affairs, 30(4), 596-603. Web.

Van Doormaal, J., Van Den Bemt, P., Mol, P., Egberts, A., Haaijer-Ruskamp, F., & Kosterink, A. (2009). Medication errors: the impact of prescribing and transcribing errors on preventable harm in hospitalized patients. Quality & Safety in Health Care, 18(1), 22-27. Web.