NURSE DISTRACTION

Nurse Distraction Related To Medication Administration Errors

Nurse Distraction Related To Medication Administration Errors

A review of the literature of nurse distraction related to medication administration error shows that Interruptions during any step in the medication-use process can have devastating consequences. In one example, an emergency department patient died after receiving a 10-mg dose of Hydro-morphone when morphine 10 mg was ordered. As the ED nurse was selecting the drug, she was temporarily distracted by another of her patients who was attempting to climb off the end of the stretcher. She quickly placed a vial of Hydro-morphone in her pocket while she attended to the second patient, interrupting her normal routine of checking the medication and documenting the signout on the narcotic record. After settling the agitated patient, she resumed medication administration to the first patient, inadvertently omitting the step of signing out the narcotic. After receiving 10 mg of Hydro-morphone, when 2 mg is the usual intramuscular dose, the patient was discharged. He subsequently suffered a respiratory arrest in the family car and could not be resuscitated. (Westbrook, 2010)

A medication error as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”. Medication errors are common occurrences in the health care setting, causing injury to over 1.5 million patients and accounting for 7,000 preventable deaths in the United States each year; other potential consequences of medication errors are staff distress and legal ramifications. Medication errors occur at a median rate of 106:1,000 patient-days in adult intensive care units (ICUs) and account for 78% of serious adverse events in medical and coronary ICUs. (Biron, 2009)

Eileen (2010) states in his research paper that “The impact of a set of interventions..” that a medication error results in an average increase in a patient's length of hospital stay by 4.6 days, and the annual cost of medication errors in hospitals is estimated to be between $3.5 billion and $29 billion. Medication errors can occur at any point during medication use—including prescribing, transcribing, dispensing, administering, and monitoring—but a disproportionately large number of errors occur during medication administration, one of the most frequent activities performed by nurses. (Eileen, 2010)

Research Question

The research question is clear: What are the causes and effects of nurse distraction related to medication administration errors. The hypothesis is: There is a relationship between Nurse distractions and medication administration errors.

Medication administration, a risky procedure requiring mental focus, is one of the most frequently interrupted nursing care activities; distractions (i.e., events that draw or direct a health care provider's attention somewhere else) and interruptions (i.e., events that stop the health care provider's current action) have been identified as important contributors to medication errors. Rates of medication errors are higher in environments with higher levels of distraction and interruption. (Theresa, 2003)

Nurses are interrupted 3-14 times per hour, making it difficult to complete a nursing care activity, including medication administration, without being ...