Nursing Essay Example: Anxiety and Medication Errors

Phase I, Problem or Need for Change/Practice Change

In recent decades, concerns have been raised concerning the increased cases of medication error mostly by nurses. Medication error is an event that results from incorrect medication procedure or use. Such incidences happen about the healthcare products, professional practice, system, and procedures, prescription process, improper labeling, ineffective communication when ordering drugs, error during distribution and dispensing, error in labeling of medical products and even drug abuse (Fish J. 2002). Medication errors by the nursing team are common in the hospital set up and can result in severe patient injury and death, but are preventable. There is a need to promote the process of medication administration and also, it is the responsibility of the rest of medical practitioners to become extra vigilant to reduce the errors that occur. This paper will identify the causes of these errors and propose ways to prevent them. This paper will use studies published between the years 2013-2016 that identified the causes of medication errors by the nurses. The following are the factors were identified as causes of medication errors:

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Transcriptional errors and fatigue from the workload

Infusion rate errors and duplication of doses.

Errors among student nurses were the miscalculation of dosages whereas, among the registered .nurses, fatigue from workload was a major cause.

Anxiety had a positive correlation with medication errors.

Phase II - Validation of the evidence found.

There has been an increase of concern in the recent decades concerning the medication errors mainly done by the nurses. According to the research conducted, nurses spend nearly 40% of their overall time administering drugs. Correct medication administration is an essential part of patient safety. Some of the major causes related to medication errors include:

Medication errors have been related to anxiety aiming the nurses.

Transcriptional errors and fatigue from the workload

According to Shahrokhi, Ebrahimpour, and Ghodousi, (2013), the nurse-related issues are the main influential ones in the medication errors. Environment-related and management errors, as well as management, were less effective as compared to the nursing-related elements in regards to the medication errors. The study demonstrated nurse-related factors as the most real factors on the medication errors, though, nurses are part of the healthcare members; therefore their performance needs to be perceived into the framework of the health-care structure such as rules and regulations, force condition, manufacturing of drugs that might affect the nurses' performance. Most prevalent source of errors in the three categories was tiresome workload, improper transfer of patients' medication schedule form kardex to the medicine card and inattention among the nurses.

Infusion rate errors and duplication of doses:

The study by Ehsani et al. (2013) shows that the most prevalent medical errors were linked to wrong infusion rates as well as giving two doses of medication rather than one. Infusion and duplication of doses have been linked to lack of pharmacological information among the nurses and lack of sufficient nurses to give and administer medicine to the patients. Infusion error was identified as an error of commission or omission in context of IV drug therapy that affects the patient's condition

This study showed that the risk of medication errors among nurses is high and medication errors are a major problem of nursing in the emergency department. We recommend increasing the number of nurses, adjusting the workload of the nursing staff in the emergency department, retraining courses to improve the staff's pharmacological information, modification of the education process, encouraging nurses to report medical errors and encouraging hospital managers to respond to errors in a constructive manner in order to enhance patient safety.

Identified drug infusion as per the research conducted is as follows:

Wrong intervention rate: It involves administering of the drug at speed other than recommended one.

Wrong mixture: using of diluent/solvent/additive that was inappropriate.

Wrong volume" using the inappropriate volume of diluent/solvent/additive to prepare an injectable medication other than the one preferred.

Drug incompatibility: Administering one drug provided with the other solution or drug through the same bag or intravenous infusion that is not recommended for compatibility.

Miscalculation of dosages

A miscalculation in medication may be prompted by various causes based on the knowledge and experience of the registered nurse. Miscalculation of drugs to be administered has been on the rise especially among the inexperienced nurses or registered nurses. In that case, fatigue among the nurses that is led by work overload is cited to be one of the factors that lead to the miscalculation of drugs. Those factors are affiliated with others such as failure to read labels on medicines, confusion on patients, failure to record medication administered on the medication chart and irregular administration of medication by different nurses. Some nurses also, have some limited understanding of the numerical skills.

Anxiety had a positive correlation with medication errors.

The research conducted by Khorshid and Telli, (2016) noted that there is a direct connection between the medication error and states of anxiety. It was noted that the day shift nurses were identified to be having a higher rate of anxiety standing at 59% while the ones working on the night shift had a reduced state of anxiety standing at 49%. It means that the pressure in work during the day shifts elevates the anxiety state of the nurse hence making them make medication errors, while those working on night shift, experience low anxiety rate hence there are minimum medication errors,

Phase III: Resolution Strategy

The fit of setting: According to the evidence provided regarding the issues with medication errors, they are fit to bring change into the nursing practice. The evidence supports the major causes of medication errors and also providing practical situations on how the issues affect the practice.

Viability: The evidence used for the research on medication errors are authentic and credible based on based on evidence-based practices in nursing. The sources were journals and therefore they passed through a rigorous evaluation and information presented was evaluated before being published in nursing journals.

Substantiating evidence" the evidence was substantiated since the clinical research was conducted, data collected evaluated and concluded to arrive at the position of the matter being discussed.

Current practice: The evidence provided support the current practice in the health system, the information that is presented is practical in the real world of nursing health care system.

Phase IV: Implementation Plan

Since the evidence is sufficient to recommend a change in practice, we will proceed to the next step which is to pilot the change based on the knowledge gathered from the literature on phase II. We will then evaluate whether the change is appropriate for adoption. The process will consider the use of evidences a described in Phase III. We will then use formally, whee the pilot test will be conducted. The implementation process will be based on reducing the medication errors in the health systems. In regards to the above discussed impediments in the health system among the nurses. The implementation plan involves:

Enhance information on medicines

Promotes interprofessional communication

Improve pharmaceutical awareness

Proper calibration of medication administering apparatus

Enhance labor forces.

Phase V: Evaluation

The tupe of evaluation that will be used at this step is to use the research evidence formally, the goal for each use of the implementation plan is a s follows.

Enhance information on medicines. Study shows that, promoting the information on medicine can be done through collaboration among the colleagues in terms of dosage and type of timing. Technology is essential at this part since it will play role at reducing errors.

Promotes inter-professional communication: Communication among the professions in the medical field is essential since it promotes health safety of the patients. Cooperation among the nurses to reduce the chances or errors. Such barriers should run through all the medical practitioners in the health organization

Improve pharmaceutical awareness: Pharmaceutical awareness can be enhanced by sensitizing the patient on how to ensure that proper medication is being administered to them. Also, nurses are educated in the ways to reduce the miscalculation of the medication.

Proper calibration of medication administering apparatus: the nurses need to be properly informed on the use of the apparatus used to reduce the chances of infusion errors

Enhance labor forces: Since anxiety has been identified as one of the cause that lead to the medicine error, the number of nurses working per shift has to be improved in order to promote the ratio of nurses working on the patient.