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Summary Walden University NURS 6050 Medication Errors 2022
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Walden University NURS 6050 Medication Errors 2022
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Running head: MANAGEMENT OF MEDICATION ERRORSManaging Adverse Drug Events through Change Management
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,MANAGEMENT OF MEDICATION ERRORS 2
Managing Adverse Drug Events through Change Management
Incessant demands for quality care and concerns over patients’ safety means
that healthcare administrators must wake up and smell the coffee of change. Under the
new dispensation, there is no room for administrators to hold onto their status quo. At
the current trajectory, medication errors have finally moved to the top of agenda for
nursing administrators. The significance of medication errors is based on the realisation
that these errors are preventable and yet, they precipitate into adverse drug events. It is
against such a backdrop that effective management and leadership is needed
strengthen error reporting systems
Research findings have shown that the failure of nurses to report medication
errors is the root cause of adverse drug events (Kaldjian et al., 2008). This is because
reporting errors provides crucial information for averting future errors and subsequent
harm to patients (Holden and Karsh, 2006). In light of these findings, effective nursing
leadership skills and sound management techniques are at the core of managing
medication errors (Gifford et al., 2007). Indeed, growing evidence indicates that nursing
administrators hold fundamental role in the management of medication errors
(Athanasakis, 2012)
Head nurses in various nursing departments have strong authority over nurses’
actions regarding medication administration. These head nurses can influence nurses’
positive behaviour and attitudes towards responsible and honest reporting of medication
errors (Ferner, 2009). Nursing administrators can also play a crucial role in creating a
culture of safety for hospitalised patients. This will entail maintaining vigilance and
promoting conditions that support effective drug administration (McBride, 2006).
,MANAGEMENT OF MEDICATION ERRORS 3
Therefore, the position of management and leadership becomes very apparent when
one considers the extent of medication errors within the NHS.
Medication Errors within the NHS
The National Patient Safety Agency, NPSA (2009) broadly defines medication
errors as any incident involving an error in the process of prescribing, preparing,
dispensing, administering and monitoring medications or providing advice on
medication, irrespective of whether harm occurred or not. Medication incidents results
into different clinical outcomes; adverse drug events and near misses. Adverse drug
events refer to the actual harm from medication errors. NPSA (2009) posits that 62% of
incidents leading to adverse drug events and death results from intravenous medication
errors.
Near misses constitute the largest proportion of medication errors. NPSA (2009)
has observed that all near misses are preventable but practitioners rarely report near
misses. Near misses serve as useful tools for learning and that is why it is crucial to
report such events (Tighe et al., 2006). NPSA (2009) intimates that one in ten
hospitalised patients encounters medication-related harm. However, most of these
events go unreported because nurses do not realise that an error actually occurred
(Spinewine et al., 2013).
In 2007, NPSA reported that 80% of patients from the reported 60,000 incidents
were not harmed, while the remaining either died or suffered severe harm. Children and
patients with allergies are the most vulnerable casualties of adverse events. The risk in
children is three times higher than in adults since they require complex dose
, MANAGEMENT OF MEDICATION ERRORS 4
calculations. NPSA also found out that the National Health Service (NHS) incurs costs
of more that £750M per annum to treat adverse drug events (NPSA, 2009).
In the United Kingdom, medicines are regulated under the Medicines Act (1968).
The Nursing and Midwifery Council has underscored administration of medicines as a
critical aspect of nursing practice (NMC, 2008a). Section 4 of NMC (2010) standards for
medicines management outlines standards for practice of administration of medicines.
Standard 24 requires registrants to take immediate, corrective measures for adverse
event. Such corrective measures include preventing potential harm to the patient,
reporting the incident to relevant authority and documenting actions taken.
Nevertheless, Standard 25 requires registrants to take any possible action to
remedy a patient from adverse drug reactions. Such actions should be recorded in the
patient’s records, as well as reported to relevant authority (NMC, 2010). In light of these
standards, nurses are legally and ethically bound to maintain high standards of
professionalism in all aspects of clinical practice since they owe patients a duty of care
(NMC, 2008c)
Causes of Medication Administration Errors
Factors that cause adverse drug event include individual staff characteristics,
ineffective communication, policy- and procedure-related issues and system issues
(Robb, 2004). Individual staff characteristics encompass limited knowledge of correct
administration procedures (Wright, 2008). Other individual characteristics include poor
medication calculation skills (Wright 2007), limited knowledge on the proper use of
intravenous infusion devices/pumps and confusing IV lines for nasogastric tubes
(Athanasakis, 2012).
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