NURSING MEDICATION ERRORS

Nursing Medication Errors

Nursing Medication Errors

Literature review

The debate on preventing medication errors made national public headlines after the National Institute of Medicine released their landmark findings in two separate reports titled; To Err is Human, Building a Safer Health System and Crossing the Quality Chasm: The IOM Health Care Quality Initiative (Institute of Medicine, 2005). These reports identified real and potential adverse outcomes that occurred yearly from medication errors. Following this report, medication errors were then linked with flawed healthcare systems within practice settings. However, regardless of the system issues, the attention quickly shifted to mathematical competence of professional nurses. If professional nurses were targeted, there was a natural pathway paved toward targeting entry-level nursing education about medication administration. As a result, nursing faculty had additional pressure beyond the examination, yielding tremendous pressure to stop medication errors.

Johnson and Johnson (2002) suggested a unique model to address four components which the authors identified as essential for calculation of medication dosages. The four processes, 1) compute, 2) convert, 3) conceptualize, and 4) critically evaluate, were incorporated into a singular comprehensive teaching model for students. Scaffolding, a learning process whereby students build on previously learned material, was considered to be the underpinnings of the model. By building a foundation specifically for medication calculations, the authors identified greater collaboration between faculty and students.

Rice and Bell (2005) also cited problems in practice with substandard abilities of nurses to calculate medication dosages. Calculation of medications was an essential step in safe medication administration, and was necessary to safeguard patients. The authors referenced the American Society of Health-Systems Pharmacist system which identified nine categories that contribute to medication errors.

Rice and Bell (2005) also discussed nursing students as classified poor performers in mathematics, expended high anxiety levels when dealing with calculations, and exposed to inconsistent teaching strategies in medication calculations. Mathematical formulas have been identified as problematic due to misapplication of formulas or miscalculations. Best teaching practices have been elusive and results for nursing students were dismal.

Burke (2005) identified seven significant barriers to safe medication administration. Lack of interdisciplinary teamwork and efforts, fluctuation in staffing patterns, and use of abbreviations were identified within the seven barriers. Delays in responding to safety concerns and systems flaws within healthcare environments also influenced safe medication administration practice. Burke also identified recent research that has examined the negative impact of nursing staff working over 12 hour shifts or 40 hours per week and the increase risk of medication errors.

In summary, the majority of the literature reviewed examined the teaching strategies of medication administration and mathematical competency of nursing students. However, there was identification within the literature of system flaws that influence risk factors for medication errors.

Medication Administration Policy

This medication administration policy and procedure was a revision in 2002 to an existing policy for medication calculation testing of nursing students. The significant revision was to assess nursing students' ability to calculate medication dosages every semester as opposed to sporadically throughout the curriculum. Secondly, failure to meet standards resulted in academic ...