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Assessment 1: Enhancing Quality and Safety
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Student Name
Capella University
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Course Name
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Prof Name
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FEB 24, 2024
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Improving Healthcare Quality and Safety
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Ensuring patient safety, deeply rooted in principles of safety science, serves as a cornerstone in
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establishing reliable healthcare systems (Brigitta & Dhamanti, 2020). Medication administration
errors (MAEs) represent significant hazards to patient well-being, potentially causing setbacks in
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treatment and prolonging hospital stays. This research explores the underlying factors
contributing to MAEs and suggests strategies to fortify the quality of patient care.
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Identifying Factors Influencing Patient Safety Risks
A real-world incident involving Nurse Ella's inadvertent administration of rapid-acting insulin to a
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diabetic patient underscores the intricate nature of medication errors within bustling hospital
environments. Studies reveal that insufficient training, prescribing inaccuracies, communication
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breakdowns, stress, and burnout significantly contribute to MAEs among nurses (Tsegaye et al.,
2020).
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1. Knowledge and Training Deficiencies:
Inadequate grasp of drug dosages, interactions, and adverse effects, compounded by
insufficient experience, substantially fuels medication errors. Research indicates that nearly
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80% of such errors stem from deficient nurse training (Hassen et al., 2022).
2. Communication Gaps Among Healthcare Professionals:
Inadequate communication and collaboration among healthcare personnel, including nurses,
physicians, and pharmacists, exacerbate medication errors (Ghasemi et al., 2022).
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3. Prescribing Errors:
Erroneous prescriptions, resulting in incorrect dosages and instructions, emerge as major
contributors to medication errors. Incomplete or inaccurately written prescriptions pose particular
challenges (White et al., 2019).
4. Stress, Burnout, and Mental Health Struggles:
Heightened stress levels among nurses, compounded by factors such as excessive workloads
and ethical dilemmas, markedly elevate the likelihood of medication errors (White et al., 2019).
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Implementing Evidence-Based Interventions
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To mitigate patient safety risks and curb medication administration costs, evidence-based
interventions are imperative. Key strategies include:
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- QSEN Approach: Emphasizing patient-centered care, teamwork, evidence-based practice, and
patient safety significantly enriches nurses' education on quality and safety (Watanabe et al.,
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2021).
- Medication Reconciliation Procedures: Aligning patients' current medications with prescriptions
during care transitions enhances safety (Koprivnik et al., 2020).
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- Computerized Physician Order Entry (CPOE) Systems: Electronically submitting medication
orders diminishes the risk of adverse drug events (Skalafouris et al., 2022).
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- Barcode Medication Administration (BCMA) Systems: Utilizing barcoded labels on medications
bolsters safety by averting errors (Ye, 2023).
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- Clinical Decision Support System (CDSS): Furnishing research-based recommendations at the
point of care aids in preventing medication-related issues.
- Value-Based Formulary Management: Selecting medications based on efficacy,
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cost-effectiveness, and safety ensures high-quality care while managing costs (Weinmeyer et
al., 2021).
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Nurse-Led Coordination for Enhanced Patient Safety
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Nurses, alongside other healthcare professionals, wield substantial influence in enhancing
medication administration accuracy. Transparent communication and collaboration among
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stakeholders mitigate error risks. Interventions such as double-checking and collaboration with
pharmacists enhance safety and cost-effectiveness (Alrabadi et al., 2021).
Collaborative Efforts for Enhanced Quality and Safety
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Effective collaboration among nurses, physicians, pharmacists, patients, and nursing leadership
is pivotal for refining medication delivery and patient safety. Quality improvement teams, in
conjunction with nursing staff, can identify challenges and implement efficacious strategies.
Collaboration with IT personnel ensures optimal utilization of informatics, augmenting
adherence and patient satisfaction. Patient safety remains a paramount concern at the
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organizational level through the involvement of medication safety officers and administrators
(White et al., 2019).
In Conclusion
Medication administration errors pose substantial risks to patients and escalate treatment costs.
By identifying contributing factors and deploying evidence-based strategies, healthcare systems
can prevent these errors and elevate the quality of patient care. Effective collaboration among
nurses and other stakeholders is indispensable for realizing improved healthcare outcomes.
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References
Alrabadi, N., Shawagfeh, S., Haddad, R., et al. (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
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quantification of medication error probability based on fuzzy SLIM. PLOS ONE, 17(2),
e0264303. https://doi.org/10.1371/journal.pone.0264303
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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
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Gerontology, 5(2), 307–324. https://doi.org/10.21608/niles.2022.243510
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Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., et al. (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- vi
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Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult
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medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1),
1–29. https://doi.org/10.1177/2042098620968309
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Skalafouris, C., Reny, J.-L., Stirnemann, J., et al. (2022). Development and assessment of
PharmaCheck: An electronic screening tool for the prevention of twenty major adverse drug
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events. BMC Medical Informatics and Decision Making, 22(1).
https://doi.org/10.1186/s12911-022-01885-8
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Watanabe, Y., Claus, S., Nakagawa, T., et al. (2021). A study for the evaluation of a safety
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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
Weinmeyer, R. M., McHugh, M., Coates, E., et al. (2021). Employer-led strategies to improve
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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
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