Pennsylvania Nurse 2019 Pennsylvania Nurse 74.1 - Page 18

mixing and administering intravenous medications or checking policies, may lead to medication errors (Keers et al., 2013). This factor takes many forms. The policies and protocols do not exist, are poorly de- signed, or not communicated to the staff (Anderson & Townsend, 2010: Kruer et al., 2014). The patient care delivery model may affect the pos- sibility of medication errors, especially in settings using a functional nursing model where one nurse is responsible for administering all medications (Vazin et al., 2014). Moreover, policies on scheduling medication administration with other ward activities and error feedback mechanisms affect the level of medication errors in the setting (Keers et al., 2013). However, implementing policies may take time because they are related to managerial decisions (Keers et al., 2013). Understaffing and heavy workloads are important contributors to medication errors (Keers et al., 2013). Risk grew with increased patient acuity and during the end of the shift/patient transfer (Anderson & Townsend, 2010). Organizational culture (i.e., values, attitudes, and behavioral patterns) is another factor in medication errors (Keers et al., 2013). Any inter- ference with the nurse’s job might distract the per- formance, especially during medication preparation and administration (Vazin et al., 2014). In addition, nurses can pass on bad practices, including admin- istering without a prescription. A nurse may receive pressure from other staff, especially between senior staff and novice nurses, to administer drugs quickly without a safety check (Keers et al., 2013). Environmental factors can promote medication er- rors and distraction. Examples include ward rounds, face-to-face or telephone conversations with cowork- ers/patients, and noise (Anderson & Townsend, 2010; Keers et al., 2013). Moreover, problems with medicine supply and storage can lead to errors. This usually involves availability and functionality of the equip- ment used to aid drug administration, such as infu- sion pumps, gloves, and syringes (Keers et al., 2013). The pharmacy department also contributes to errors through delayed deliveries, incorrect dispensing, and unavailable stock (Abubakar et al., 2014). As nurses are the majority involved in medication er- rors, nurses and nurse managers should identify and understand the reasons and circumstances surround- ing medication errors in their institution. The causes Issue 74, 1 2019 Pennsylvania Nurse 16 can highlight possible solutions to decrease medica- tion errors and design more applicable and effective interventions (Keers et al., 2013; Wang et al., 2015). Prevention Strategies and Recommendations Although medication errors cannot be eliminated, there are reduction strategies (Wang et al., 2015). The literature provides valuable information to ad- dress factors influencing the occurrence of medica- tion errors. These strategies incorporate the intro- duction of technologies to the units and changes in policies and protocols. Also, increasing healthcare providers’ knowledge about medication administra- tion will reduce the percentage of medication errors (Abubakar et al., 2014). By applying these strategies, nurses and nurse managers can reduce the incidence of medication errors, promote the level of care in their units, and enhance patient safety. In addition, the process is more effective when all healthcare pro- viders are involved. Wang et al. (2015) claimed that a multidisciplinary collaboration among physicians, pharmacists, nurses, and hospital administrators is more effective in reducing errors. Technology Computerized physician order entry (CPOE) in- volves the use of computers by the physicians to send prescriptions to the pharmacy (Abubakar et al., 2014). According to Marquis and Huston (2012), the CPOE reduced medication errors by 50%, especially in problems associated with physicians’ handwriting and communication between healthcare professionals (Vazin et al., 2014). CPOE also reduces prescription errors because it is designed to send notifications about allergies, drug interactions, and medical his- tory (Abubakar et al., 2014; Anderson & Townsend, 2010). However, nurses should not completely depend on CPOE to prevent all errors because the program can also contribute to the occurrence of potential er- rors (Vazin et al., 2014). Barcode scanning is another verification technique. Each patient is assigned a distinctive barcode. The pharmacist dispenses the patient’s medication ac- cording to this code. This ensures that the right patient receives the right drug. After that, the nurse scans the patient’s armband barcode to confirm iden- tity and consistency of the medication (Abubakar et al., 2014; Anderson & Townsend, 2010). Data show