In the early forenoon hours of a 12-hour dark displacement. a nurse gives the patient an wrong medicine. The acetylsalicylic acid given was ordered for the patient in the following room. Medicine mistakes are common in the infirmary scene and particularly by a nurse who is fatigued from working a 12-hour displacement. In the state of affairs described. should the nurse study the mistake or presume that the incident is non deserving describing since it was merely aspirin? Surprisingly. harmonizing to Covell and Ritchie ( 2009 ) most medication mistakes are merely unmarked. “Nurses estimate that merely between 25 % and 63 % of medicine mistakes are really reported” ( p. 287 ) .
This appraisal may look low to some ; nevertheless. other research workers estimate that the voluntary coverage of medicine mistakes may be even lower. In 2009. Jones and Treiber found that less than 5 % of medicine mistakes are reported. Medicines are typically ordered by doctors. but it is finally the nurses’ duty to administrate the right medicine. There are several stairss in this procedure and unluckily when one measure is altered. a medicine mistake can happen.
Preventing mistakes has been and continues to be an of import facet of nursing. I believe that in order to supply patients with the best possible attention it is of import for nurses to understand the common reported causes of medicine mistakes. jobs in describing mistakes. and their function in medicine bar and coverage. Throughout this paper I will discourse the medicine mistake issues described above and their importance and impact on the nursing profession. Subjects discussed in this paper include the common causes of medicine mistakes. perceived jobs with describing medicine mistakes. and the importance of medicine mistakes to the profession of nursing. Common Causes of Medication Mistakes
Nurse Correlated Causes
Even though preventive steps are taken. nurses are frequently still the cause of medicine mistakes. Medication disposal is a major intercession in nursing and when distracted or fatigued it is easy for simple errors to happen that usually would non hold happened. The five rights are taught to all nurses at some point in their instruction as the basic technique to assist cut down the happening of medicine mistakes ; nevertheless. many nurses fail to systematically and accurately use these steps. Harmonizing to a survey of 775 nurses conducted by Jones and Treiber ( 2010 ) . 79 % of participants believed that failure to follow the five rights of medicine disposal causes the bulk of medicine mistakes.
Other nurse-correlated causes identified by Jones and Treiber ( 2010 ) include distractions and breaks of the nurse. high patient nurse ratios. and deficiency of proper instruction along with weariness and exhaustion. Types of factors that are straight related to nurses are considered internal causes of medicine mistakes. However. literature shows that a combination of internal and external variables within the nursing environment contribute to medicine mistakes. Unfortunately. actions by nurses and failures to follow common nursing protocols straight place the duty of medicine mistakes on the nursing profession. Other Associated Causes
It is besides of import to see causes of mistakes other than the common internal causes straight correlated to nurses. A common external cause of medicine mistakes is miscommunication. Miscommunication can happen in several different ways. but it frequently involves miscommunication from the initial prescription by doctors. Brady. Malone. and Fleming ( 2009 ) found that. “ineffective written and verbal communicating in relation to prescriptions lend to medication mistakes. peculiarly between nurses and physicians” ( p. 692 ) . Quite frequently. handwriting is non legible when prescriptions are written which consequences in medicine mistakes.
Since many drugs look and sound similar. it is easy for nurses to confound script. An illustration involves the medicines. Vioxx. Ziox. and Zyvox. These medicines sound really similar ; nevertheless. they are used for really different interventions. Confusion by the nurse in composing a verbal order or in reading the order related to one of these three medicines could ensue in huge effects. In a study of 983 registered nurses. Brady et Al. ( 2009 ) likewise concluded that hapless handwriting ranks among the top three causes of medicine mistakes.
In add-on. there are many other factors that have been shown to lend to medication mistakes including uncomplete patient information. usage of abbreviations. unavailable drug information. deficiency of appropriate packaging and labeling of Master of Educations. and environmental factors such as bad lighting. Understanding the cause of medicine mistakes is an of import measure to diminish the happening and prevent future mistakes from happening. Unfortunately. coverage of mistakes is still a big job among the nursing profession. Perceived Problems with Reporting
Barriers to Reporting
Most nurses would hold that medicine mistakes should be reported when they occur. yet medication mistakes are still underreported. A study conducted by Jones and Treiber ( 2010 ) found that among nurses. “94 % either strongly agreed or agreed that medicine mistakes should be reported even when no injury resulted to the patient ( p. 243 ) . ” Based on these findings. it is obvious that there is some incompatibility between existent happening and coverage. These findings besides suggest that there may be barriers to describing. Barriers to describe can be broken down into four major groups harmonizing to research from both Koohestani and Baghcheghi ( 2009 ) and Covell and Ritchie ( 2009 ) . The major groups are unequal definition. fright. coverage procedure. and administrative procedure.
Surveies conducted by Covell and Ritchie ( 2009 ) . determined that fright ranked as the highest barrier to describing since “participants indicated that they were most fearful of inauspicious effects from describing medicine errors” ( p. 289 ) . Findingss by Koohestani and Baghcheghi’s ( 2009 ) sing barriers to coverage by nursing pupils besides demonstrated fright as the strongest sensed barrier. Their research indicated that among nursing pupils the fright of. “decreasing rating mark and presenting educational problems” along with “instructor’s reprimand” ranked as the highest barriers ( p. 70 ) . Surprisingly. both surveies ranked the procedure of describing. clip to make full out proper signifiers and clip to reach physician. as holding the least impact on describing. Increased Coverage
The big figure of medicine mistakes and the deficiency of describing suggest a demand for alteration among the nursing profession. Harmonizing to research findings from a survey conducted by Drach-Zachavy & A ; Pud ( 2010 ) . “Approximately every 3rd patient. on norm. is exposed to some kind of divergence from the ordinances when having medicine. Yet. when nurses were confronted with these findings. they tended to disregard their gravitation and argued that they were fiddling in the infirmary context” ( p. 801 ) . One manner to better the job of medicine mistakes is to pull attending to the issue.
This can be done by increased coverage of mistakes among the nursing profession. However. due to the barriers of describing described by nurses. set uping a concrete system to better coverage has been hard. Most nurses are cognizant that underreporting of medicine mistakes does occur ; nevertheless. they still fail to describe. Education about proper coverage and consciousness of the issue has been shown to increase coverage among nurses. Research shows that the major barrier to describing medicine mistakes is fear ; hence. cut downing fright is a major constituent to increase coverage. Schemes to cut down fear include processs to. “ensure that the procedures used for describing medicine mistakes are respectful” ( Covell & A ; Ritchie. 2009. p. 295 ) . It is besides of import for decision makers and nursing directors to make a on the job environment conducive to coverage. one that encourages and supports coverage of mistakes ( Koohestani & A ; Baghcheghi. 2009. p. 73 ) .
Another scheme to better coverage trades with the procedure of describing. Although the procedure of coverage was considered the lowest barrier to coverage. research still suggests that bettering this procedure can take to better coverage of results. Brady et Al. ( 2009 ) suggest that electronic describing systems improve coverage. This type of system improves the coverage procedure by doing it easier. There is significantly less paperwork required. and the fright associated with coverage is significantly reduced. In order to alter the deficiency of coverage of medicine mistakes. the sensed jobs with describing demand to be improved. The first measure in this betterment starts within the nursing profession. Acknowledging that nurses play an active function in forestalling and describing medicine mistakes will assist to diminish the figure of mistakes. However. the distinguishable function of nurses in describing medicines mistakes needs farther treatment. Importance to the Nursing Profession
Role of Nurses
The major function of nurses in the procedure of medicine mistakes is first and first bar. To assist prevent mistakes. nurses must foremost acknowledge why medicine mistakes occur and make an attempt to extinguish the beginning. They must besides endeavor to actively follow implemented guidelines and processs. For illustration. systematically practising the five of rights of medicine disposal has been shown to diminish the happening of mistakes. Harmonizing to Brady et Al. ( 2009 ) the major function of nurses is to. “take appropriate stairss to develop and keep competency in relation to all facets of medicine management” ( p. 694 ) .
Education plays a cardinal function in keeping nursing competency ; hence. it is imperative to stay up to day of the month with current cognition. grounds based pattern. and accomplishments. Once a medicine mistake occurs. the most of import function of the nurse is to describe. Brady et Al. ( 2009 ) concludes that. “reporting medicine mistakes is polar in bettering the medicine direction process” ( p. 694 ) . Reporting is critical for nurses because it is a legal and ethical concern in the nursing profession. Nurses must systematically describe all mistakes and besides promote other wellness attention professionals to describe every bit good. Overall. the most of import functions among nursing professionals are to administrate medicines safely and accurately. study mistakes systematically. and adhere to the American Nurses’ Association Code of Ethics.
Reconsider the medicine mistake discussed at the beginning of this paper. As the nurse in the state of affairs. I might non hold ab initio reported the medicine mistake. I might hold merely informed the charge nurse of my error. After researching this subject. my positions on medicine mistakes and describing have changed. I now have a greater apprehension of the impact that an active nursing function can hold in cut downing medicine mistakes. I believe that the deductions of medicine mistakes are of import because medicine disposal is a cardinal nursing function. Throughout my nursing calling I will administrate medicines to 1000s of patients. Unfortunately. I will probably be the cause of at least one medicine mistake.
Harmonizing to the literature. medicine mistakes do occur. Therefore. it is of import to acknowledge causes so that stairss can be made toward forestalling medicine mistakes. I believe that steps such as proper preparation and extra instruction are the best methods to forestalling medicine mistakes. It is besides really of import for nurses to actively pattern safe medicine disposal by taking a “back to basics” attack and utilizing simple techniques such as the five rights. Furthermore. I believe that the best manner to better coverage is to cut down the fright environing coverage. One manner to make this would be to originate on-line describing systems. In my hereafter nursing pattern. it will finally be my duty to administrate the right medicine to patients. In order to supply patients with the best outcomes. it is of import for nurses to understand the deductions of medicine mistakes.
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