NURS FPX 4020 Assessment 1- Enhancing Quality and Safety

NURS FPX 4020 Assessment 1- Enhancing Quality and Safety

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NURS FPX 4020 Improving Quality of Care and Patient Safety

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Enhancing Quality and Safety

Patient safety uses the technique of safety science to build a dependable healthcare delivery system (Brigitta & Dhamanti, 2020). Medication administration errors (MAEs) can endanger the patient’s life and if not always fatal tend to cause losses in terms of treatment leading to a longer patient’s stay in the hospital. This, in turn, leads to a reduced patient’s trust towards healthcare systems and practitioners, as well as a rise in the treatment cost. The purpose of this study is to analyze the factors contributing to MAEs and discuss the strategies that can be employed to improve the quality of patient care.

Factors Leading to Patient Safety Risks

Before analyzing the primary elements that contribute to patient safety risks at healthcare institutions, a medication error incident that happened in a hospital will be discussed here. In a bustling hospital, Nurse Ella was responsible for the care of diabetic patients in their ward. The patient Mr. Wallace was diagnosed with Diabetes type 2 and was prescribed two insulin pens, one containing rapid-acting insulin to be administered before meals and the other containing long-acting insulin to be administered once daily. Despite her best intentions Ella mistakenly administered rapid-acting insulin, with a higher-than-normal dose, to Mr. Wallace instead of a once-daily dose of long-acting insulin. After some time the patient started to develop symptoms of hypoglycemia. Upon noticing the symptoms, the nurse realized her mistake and notified the charge nurse and the physician. They quickly intervened to address Mr. Wallace’s symptoms. 

Nurses being responsible for drug administration are the key to providing safe and accurate treatment services to the patients. Being the front line in patient care, nurses are often the most common source of medication administration errors as well.  In an institutional-based, cross-sectional study the prevalence of MAEs was found to be 57.7% among the participant nurses and 30.4% of them made it more than three times (Tsegaye et al., 2020). The main factors leading to medication administration errors by nurses include lack of adequate training, prescribing errors, stress, burnout, and communication gap between healthcare professionals.

Lack of Knowledge and Training

Lack of experience and inadequate knowledge about drug doses, interactions, contraindications, and potential adverse effects is a leading factor of medication administration errors. Research suggests that 78.7% of medication errors are due to poor training of nurses (Hassen et al., 2022). Nurses possessing advanced pharmaceutical knowledge and subsequent training are less likely to make medication administration errors.

The Communication Gap Between Healthcare Professionals

Lack of communication and collaboration between the healthcare staff i.e. the pharmacist, physician, and nurses can lead to medication errors. A study suggests a higher incidence of medication administration in hospitals where there is a communication gap between the healthcare staff (Ghasemi et al., 2022). 

Prescribing Errors

Prescription errors occur when healthcare professionals inaccurately prescribe medications leading to incorrect dosage, inappropriate instructions, and other potentially serious issues. In a study, it was found that incompletely written prescriptions accounted for 71% of the total prescription-related errors while errors during transcription of the prescription contributed to the remaining 29 % of the errors (White et al., 2019).

Stress, Burnout, and Mental Health Challenges Among Healthcare Workers

Owing to excessive workloads, long shifts, moral dilemmas, perceived job stability, and a lack of social support, the elevated stress level among the nurses often results in psychological distress which can lead to burnout, depression, anxiety disorders, and other illnesses. In a study conducted to assess the correlation of registered nurses’ burnout with the quality of patient care it was found that 30% of the registered nurses exhibited high levels of burnout, and nurses with burnout were 5 times more likely to cause patient care and medication errors (White et al., 2019). 

Evidence-Based Best Practices Solutions

To accomplish the objectives of enhancing patient safety and lowering costs in the administration of medications, evidence-based and best practice solutions are essential. Here are several techniques backed by academic or professional sources:

• The QSEN (Quality and Safety Education for Nurses) approach focuses on six fundamental skills of patient-centered care, teamwork, evidence-based approach, focus on quality improvement actions needed, patient safety, and the use of informatics and technology in healthcare provision. Quality and safety education for nurses is found to have been improved by up to 75% by including QSEN competencies in the nursing curriculum (Watanabe et al., 2021).
• By implementing medication reconciliation procedures which entail contrasting a patient’s present pharmaceutical regimen with what had been prescribed for them, patient safety during care transitions can be dramatically improved (Koprivnik et al., 2020).
• Using Computerized Physician Order Entry (CPOE) systems, healthcare professionals can electronically submit medicine orders, lowering the chance of adverse drug events (Skalafouris et al., 2022).
• Barcode Medication Administration systems ensure correct medication delivery by the use of patient identification and barcoded labels on pharmaceuticals, thus enhancing patient safety by preventing drug errors (Ye, 2023).
• Clinical decision support system (CDSS) offers suggestions based on research to healthcare practitioners right at the point of care. To prevent negative outcomes, these systems can notify healthcare professionals about possible medication combinations, dosage mistakes, or allergies. 
• Value-based formulary management strategies help keep healthcare quality high while cutting expenditures related to pharmaceuticals. This methods entails choosing medicines based on their clinical potency, cost-effectiveness, and safety (Weinmeyer et al., 2021).

Nurse-Led Coordination to Optimize Patient Safety

The medication administration can be significantly improved via coordination of nurses with other healthcare administrators. In the medication administration error discussed above the nurses’ coordination with physicians, pharmacists, charge nurses, and IT personnels of the hospital setting can significantly decrease the chances of error in healthcare settings. The clear communication between nurses and physicians with special emphasis on the treatment regimen required and the guidelines to be followed results in enhanced accuracy during administration of the drugs. Double checking by the nurses themselves or charge nurse creates an environment where the probable causes of adverse events can be prevented (Alrabadi et al., 2021). The prevention of adverse events by using these interventions in turn reduces the cost incurred  on hospitals and patients by the long stay of patients at the hospitals. Nurses can work in collaboration with pharmacists to reduce the errors of prescription transcribing and filling thus ensuring the five rights of medication administration (Koprivnik et al., 2020).

Enhancing Quality and Safety

Nurses can help in improving cost effectiveness at hospitals by collaborating with pharmacists in the development of value based formulary (Weinmeyer et al., 2021). The mutual working of nurses and IT personnel of hospital staff can result in the effective use of technology tools such as CPOE, BCMA and CDSS to prevent MAEs to occur (Ye, 2023). These interventions could have prevented Ella from administering wrong insulin to Mr. Wallace. Holistic care approach promoted by working with interdisciplinary teams and in accordance with regulatory requirements reduces risk of errors and thus ensuring patient safety and cost effectiveness in halthcare.

Nurses’ Coordination with other Stakeholders 

To improve medicine delivery, nurses collaborate with physicians, pharmacists, patients, and nursing leadership. The quality improvement teams and nursing staff can work together to effectively evaluate the challenges arising in healthcare settings and implement suitable strategies and processes in action. NURS FPX 4020 Assessment 1- Enhancing Quality and Safety. The correct use of informatics requires efficient collaboration between nurses and IT personnel within the organizations. Better adherence and patient satisfaction can be enabled by involving patients and their families. Patient safety is prioritized at the organizational level by the involvement of medication safety officers and administrators. Professional associations offer crucial tools for advancing medical practices continuously. 

Conclusion

Medication administration errors are potentially fatal errors that pose a risk to the patient and increase the cost of the treatment as well. However, these errors can be prevented by identifying the factors contributing to medication administration errors by the nurses and putting suitable remedial plans into action. NURS FPX 4020 Assessment 1- Enhancing Quality and Safety. The best practice solutions that can be used for this purpose include the use of medication reconciliation, benefitting from technological advancements in healthcare systems, incorporation of teamwork in healthcare setups, and by using value-based approaches. Incorporation of the QSEN approach in nurses’ training also reduces the risk of medication administration errors by giving quality patient care practice skills to the nurses. Efficient collaboration between nurses and other stakeholders such as clinicians, pharmacists, and IT personnel significantly enhances the quality of patient care provided by the nurses.

References

Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Abu Farha, R., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/jphsr/rmaa025 

Ghasemi, F., Babamiri, M., & Pashootan, Z. (2022). A comprehensive method for the quantification of medication error probability based on fuzzy SLIM. PLOS ONE, 17(2), e0264303. https://doi.org/10.1371/journal.pone.0264303 

Hassen, A., Abozied, A., Mahmoud, E., & El-Guindy, H. (2022). Mental health nurses’ knowledge regarding patients’ rights and patients’ advocacy. NILES Journal for Geriatric and Gerontology, 5(2), 307–324. https://doi.org/10.21608/niles.2022.243510

Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., Taboada-López, R. J., & Rodríguez-Penín, I. (2020). Improving patient safety through a pharmacist-led medication reconciliation program in nursing homes for the elderly in Spain. International Journal of Clinical Pharmacy, 42(2), 805–812. https://doi.org/10.1007/s11096-020-00968-8 

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309 

NURS FPX 4020 Assessment 1- Enhancing Quality and Safety

Skalafouris, C., Reny, J.-L., Stirnemann, J., Grosgurin, O., Eggimann, F., Grauser, D., Teixeira, D., Jermini, M., Bruggmann, C., Bonnabry, P., & Guignard, B. (2022). Development and assessment of PharmaCheck: An electronic screening tool for the prevention of twenty major adverse drug events. BMC Medical Informatics and Decision Making, 22(1). https://doi.org/10.1186/s12911-022-01885-8 

Watanabe, Y., Claus, S., Nakagawa, T., Yasunami, S., & Teshima, M. (2021). A study for the evaluation of a safety education program for nursing students: Discussions using the QSEN safety competencies. Journal of Research in Nursing, 26(1-2), 97–115. https://doi.org/10.1177/1744987121994859 

NURS FPX 4020 Assessment 1- Enhancing Quality and Safety

Weinmeyer, R. M., McHugh, M., Coates, E., Bassett, S., & O’Dwyer, L. C. (2021). Employer-led strategies to improve the value of health spending: A systematic review. Journal of Occupational & Environmental Medicine, 64(3), 218–225. https://doi.org/10.1097/jom.0000000000002395 

Ye, J. (2023). Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Perioperative Medicine, 6(1), e34453. https://doi.org/10.2196/34453