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Medication errors > literature review

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Medication Errors: A Literature Review American Medical system can hold the tag of being the best medical system in the world, with its effective personnel including nurses as well as advanced medical technologies and treatments. However, despite its efficiency, human-made medical errors are one of the prominent problems. As stated by Brailer (2005), the staffs and medical technology that go into American medicine may be the best in the world, but the care that comes out the other side is beset by enough mistakes to make medical error the third leading cause of death, behind heart disease and cancer” (qtd. in businessweek. com). Among the various medical errors, Medication errors are one of the most threatening problems. National Coordinating Council for Medication Error Reporting and Prevention defines as, “ A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional…Such events may be related to professional practice…including prescribing, administering….” (nccmerp. org). Acquired competency in drug administration is one of the integral criterions for registered nurses. However, nurses due to oversight or inefficiency could falter during drug administration, leading to major medication errors. While, acknowledging that administration of medicines needs attention, Scott (2002) notes that a lack of stringent management on drug policy in recent years has led to a relaxed attitude amongst those nurse professionals who administer drugs.
Medication errors happens at various nodes or parts of the medication process, and is caused by some faults in the working conditions. Medication process includes the different nodes like prescribing, documenting, transcribing, dispensing, administering, and monitoring. (Chilton, 2007). In these related chains of various nodes, prescribing the wrong drug, dosage, or route contributes to 48% of medication errors, secondly transcription errors account for 11% of all errors, dispensing errors comprise 14% of all medication errors, and finally Administration errors account for 28% of all errors, with no way to intercept during the monitoring after the medicine has been given. (Chilton, 2007). These errors mainly occur due to some faulty or unfavorable working conditions, caused by doctors’ miscommunication, hospitals mismanagement as well as inefficiency by the nurses themselves. A scholarly research conducted by two nurses and published in the Journal of Nursing Care Quality lists out the working conditions that may cause medication errors. Reasons for medication errors includes illegible or unclear handwriting from a physician (86%), high patient-nurse ratio (71%), unclear verbal orders (68%), insufficient staffing (68%), nurse incompetence (66%), Packaging errors (60%) and poor training (56%). (Cited in healthcarepackaging. com, 2010)
From the above mentioned causes, it is clear that to prevent medication errors nurses have to play Two roles. As Pepper (2006) states, (1) they must check to see that other healthcare providers have not made any errors in any part of the medication order chain; and (2) they must ensure that they themselves do not make an error. (Cited in Chilton, 2007). Although checking others’ errors and preventing it is crucial, it is more important on the part of the nurses to ensure they do not commit medication errors themselves. For that, Nurses should first follow the “ 5 Rights” to safe medication taught during their academics. These include: right drug; right patient; right dose; right route; and the right time (Chilton, 2007). To follow these key criterions aptly, Nurses has to be first fully focused and aware of their responsibilities to the patient and hospital settings. Nurses could also prevent errors by using safety checklists formulated by their departmental heads. If there are anything unclear particularly prescription details and other drug related information, then the nurses without assuming on their own should take the initiative to clarify the doubts with the doctors, superiors and also with the hospital management.
businessweek. com. (2005). This Man Wants To Heal Health Care. Retrieved on November 8,
2010 from
http://www. businessweek. com/magazine/content/05_44/b3957113. htm
Chilton, L. L. (2007). Medication Error Prevention for Healthcare Providers. Retrieved on
November 8, 2010 from
http://cme. medscape. com/viewarticle/550273
healthcarepackaging. com. (2010). Nurse medication errors and the role of packaging. Retrieved
on November 8, 2010 from
http://www. healthcarepackaging. com/archives/2010/06/nurse_medication_errors_and_th. php
nccmerp. org. What is a Medication Error? Retrieved on November 8, 2010 from
http://www. nccmerp. org/aboutMedErrors. html
Scott, L. (2006) Effects of critical care nurses work hours on vigilance and patients safety.
American Journal of Critical Care. 15(1): 30-7.

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