Pennsylvania Nurse 2019 Pennsylvania Nurse 74.1 - Page 17

of healthcare. Abubakar, Chedi, Simbak, and Haque (2014) stated that the cost of medication errors in the healthcare system was almost US$4 billion per year. The growing potential of these errors poses seri- ous consequences for patient safety and quality of care. There is a necessity to act to reduce the inci- dence of this problem. Wang et al. (2015) described medication errors as a failure in the treatment process posing a danger to the health status of the patients. Medication errors may take place in all phases of treatment, including prescribing, copying, medication checking, preparing, administration, and observing (Wang et al., 2015). Almost 38% of medication errors happened during the administration of the medication, which was the greatest percentage among the types of medication errors (Vazin et al., 2014). RNs are more involved in medication errors as they are the last staff deal- ing with medications and administering them to the patients (Wang et al., 2015). Healthcare professional and system failures can lead to medication errors. Hence, RNs should have an active role in addressing the problem. Healthcare Professional Failure: Unsafe Acts The attitudes of RNs and other healthcare profession- als are fundamental to the prevention of medication errors. Keers, Williams, Cooke, and Ashcroft (2013) noted that complacency and carelessness are among the most common cause of medication errors. How- ever, they are usually short term and easy to identify. Typically, multiple circumstances result in one unsafe act. When multiple conditions are an issue, sorting out the reasons for the occurrence of a medication error becomes more challenging. In some cases, patient and/ or drug misidentifications underlie the occurrence of a medication error (Keers et al., 2013). These misiden- tifications include administering a wrong dose due to calculation errors, misreading a medication label/pre- scription, and/or confusing look-a-like or sound-a-like medication names or medication packages (Abubakar et al., 2014; Anderson & Townsend, 2010 ; Kruer et al., 2014). These may result in administration of the wrong medication. In some cases, the nurse may be unfamiliar with a given medication or have poor drug knowledge, especially with high-alert medication groups, such as cardiovascular, electrolytes, and fast This article will discuss healthcare professional and system failures that lead to medication errors. It will suggest guidelines and prevention strategies to help registered nurses (RNs) and nurse managers develop a plan to decrease the seriousness of the problem in their settings and guarantee quality assurance. bolus intravenous administration (Keers et al., 2013 ; Wang et al., 2015). It also includes improper acquisi- tion, use, and monitoring of drug delivery devices (Anderson & Townsend, 2010). In the absence of adequate training regarding medi- cation preparation and administration, medication errors are likely to increase, especially among novices (Wang et al., 2015). Moreover, problems like lack of concentration, fatigue, stress, and sleep depriva- tion can influence medication errors (Anderson & Townsend, 2010). These factors may be exacerbated by long working hours, double shifts, being busy, and lack of breaks or food (Keers et al., 2013). Fatigue and sleep loss may diminish a nurse’s ability to recognize subtle patient changes due to an adverse reaction to a drug (Anderson & Townsend, 2010). Many medication errors stem from miscommunica- tion among physicians, pharmacists, and nurses (Abubakar et al., 2014). Written communication characterized by unclear script and abbreviations in- stead of full names of drugs serve to confuse medica- tion orders (Anderson & Townsend, 2010). Problems with the pharmacists’ labeling of medication were also reported as a factor leading to medication errors (Vazin et al., 2014). System-Level Failures Keers et al. (2013) noted that unsafe acts and behav- iors are usually associated and influenced by factors raised from a failure in the local work environmental system. System failures include poor hospital and ward environments, bureaucratic operation systems, ineffective means of communication, and inadequate staff and equipment (Abubakar et al., 2014). Lack of access to suitable medication administration proto- cols and policies, such as basic information about Issue 74, 1 2019 Pennsylvania Nurse 15