Posted: May 13th, 2023

Reducing Medication Errors in Medical Surgical Units Essay

Reducing Medication Errors in Medical Surgical Units by Use of Computer Technology Student’s Name University Name
Abstract The research focuses on exploring reduction of medication errors in the surgical units through the use of computer technology. The study emphasizes on the use computer technology in physician order entry together with clinical decision support and how they are useful in controlling adverse drug events.
The roles and responsibilities of nurses and their significant impacts on the reduction of medication errors and the relationship to the use of technology are discussed. The peer reviewed resources used in the study are obtained from PubMed.
The retrieval of the information is followed by the extraction of the results from these articles for analysis. The deduction from the study is that the use of computer technology leads to reduction of medication errors and as a result reduce the deaths and injuries that results from adverse drug events.
Computerization of the system work in conjunction with creating conducive and favorable environment that enables the nurses to perform their pivotal role in the system effectively. Reducing Medication Errors in Medical Surgical Units by Use of Computer Technology
Research questions The questions guiding this study are as follows · The potential causes of medication administration errors and interventions to curb the implications · What are the barriers of implementing computerized systems within health care facilities
· Is computerization of hospital and health facilities worth or use in reducing adverse drug event · Frequency of voluntary reporting medication administration errors · Why is the voluntary reporting medication error not effective
· What is the mortality rate due to adverse drug events The research questions are intended to be answered by the study and literature review. The hypothesis of the study is that the use of computer technology reduces medication errors in surgical units through employing CPOE with CDS and involving the workforce of nurses. The aim of the research is thus to bring out clearly the means of realization of reduction in medication error. The study is important due to the fact that there is no priority more important than achieving the safety of patients in health care facilities.
Literature review Daniels (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap), states that medication errors constitute a major problem in the health sector. MEDMARX, the United States Pharmacopeia’s voluntary medication error tracking system, registered 198,024 incidents of medical error in 2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers. Computerization order entry is among the steps being taken in mitigation of medical error incidence. It is obvious that safety is the priority in any medication administration. The key objective of implementing safe medication practices is to reduce and if possible eliminate the adverse drug events (ADEs). Therefore, the use of technology is a viable way out of the quagmire. Nevertheless, diligent nursing care is essential in limitation of medical errors. Nursing education programs deliberate the five rights of medication administration. The five rights are right patient, right drug, right dose, right route, and right time.
Documentation is as well considered to be among the rights by some sources. Fact is with no rise documentation, adverse medication error may results. Nurses are supposed to have the information at their finger tapes to avoid risking the lives of patients (Daniels, 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap).
According to Anderson (2005), the United States annual expenditure on mortality and morbidity resulting from medication errors is roughly $76.6 billion. Khoumbati (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer), states that 75% (an estimate) of a million people die or get injured yearly from the ADEs.
One of the studies on medication errors in 36 health facilities in Colorado and Georgia found that 19% of the doses were in error. 7% of the errors could have led to ADEs.
Medical errors and the associated adverse drug events raise the cost of hospitalization to roughly $4,700 per incident. And the increased cost for a 700-bed hospital as a result of ADEs was estimated to consume $2.8 million on a yearly basis.
Most errors that occur in healthcare facilities are not reported hence rendering the difficulty of ascertaining the exact rate of medical errors. The major method used in reporting medical errors is the voluntary reporting method. It is not efficient in detecting and reporting errors and may only account for 10% of the ADEs that occur in the hospitals. A study found that 84 errors were reported under the anonymity of questionnaires, and 36 errors on incident reports within a period of 59,470 patient days. It is surprising that the estimation of the errors involving administration and dispensing of was at 51,200 in that period (Khoumbati, 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Most states in the United States have mandated certain form of medication error reporting. However, the effectiveness of the reporting systems in mitigating medical report errors together with the adverse drug events is not yet realized.
The use of information technology or computerization of hospitals is under adoption to detect the ADEs and medication errors. For instance, clinical laboratory data and pharmacy data stored in electronically is screen-able for ADEs. One of researches conducted found that computerization of hospital systems in monitoring medical errors realized a total of 89% of ADEs. Application of information technology in detection of ADEs at LDS Hospital in Salt Lake City, Utah was programmed to produce a list of ADEs on a daily basis, from the data within the integrated hospital computerized system. In a period of 18 months, 631 out of 731 verified adverse drug events were detected through automatic system as opposed to 9 ADEs that were recorded from the voluntary reporting system (Khoumbati, 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
Khoumbati (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer), states that around 50% of medical error arises due to lack of information regarding the patient at the moment when a medic or a nurse is ordering the drugs.
Another source of error is the transcription process. Researchers have found out that information technology or computerization of the system and decision support can lead to reduction of errors. It is probably right that computerized systems application will minimize the chances of errors more effectively than the individuals based applications.
As cited by Khoumbati (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer), in 2003, Kaushal, Shojania and Bates reviewed five trials which assessed the impacts of computerized physicians order entry (CPOE) and another seven trials that performed the assessments on the clinical decision support systems (CDSS).
The researchers made a deduction that the use of CDSS and CPOE can tremendously reduce medical errors. For instance, the implementation of CPOE has the potentiality of reducing medication errors in the range of 55% to 83% based on the degree of decision support.
Information technology decision support systems have also prove being effective in remediating medication errors. A research conducted by Evans, Classen and Penstotnik among others realized that the utilization of a computerized system in anti-infective program in handling drug management led to a 70% reduction in ADEs that resulted from anti-infective drugs. Computer alerting system also has a role to play in the system. The alert systems reduces rate of errors, reduction of delays in treatment, as well as cost and hospital length of stay. The HELP system based in situated in LDS Hospital in Salt Lake City automatically detect patient who are at risk for ADEs through electronic monitoring of patient stored data. Alerts enable the staff to take proper actions and interventions whenever potential ADEs are detected (Khoumbati, 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
In 2002, Anderson and others developed a computer simulation model in investigating computerized medical delivery system. The parameters used in the model were estimates from a research of prescription errors of two medical facility surgical units, and applied the parameters as baseline run.
Four stages (prescribing, transcribing, dispensing and administration of drugs) of the medication delivery systems were modeled. The interventions that are supported by other studies to reduce rates of error were simulated (Anderson, 2005).
The results showed that a computerized system that noticed 26% of medication errors and a well prohibited the associated adverse drug effects would save around 1,226 days of hospital stays and $1.4 million in hospital yearly.
Therefore, the study confirmed that the clinical computerized systems are of great potential and cost-effective means of combating adverse drug events in hospital. That research also focused on the significance of viewing medication errors from a system perspective (Khoumbati, 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
Research design and methodology The methodology of this paper is based on the secondary sources that are already researched. The evidence on precise health computer technology safety topics were collected from MEDLINE searches.
Medical subject headings (MeSH) terms in conjunctions with proper keywords were employed to generate relevant studies. The key terms that were used in search are ‘electronic health records’ and ‘medical information’ and role of nurses in safe medication safety practices.
Relevant studies were identified from the searches and picked to enter the next step of study. A total of five articles of peer reviews were selected. The information from these articles was picked to form the part of the study.
The peer reviewed articles of handling the same topic are analyzed together. The analysis or discussion was framed in a manner that the research questions were addressed. The most important part is that the discussion of the result was directed in answering the topic of study, that is, reduction of medication errors (in surgical units) by using computer technology.
Variables and measures The main variables of the study are divided into independent and dependent variable. The independent variables include use of information technology in CPOE and CDS in health care facilities, and roles of nurses. The dependent variable is adverse drug events and its implications. The independent variables are measured through recording the reporting rates of incidences of medication errors. The dependent variables are measured through the lives saved by employing interventions to prevent ADEs on realizing a medication error.
Results and data management Graber, Johnston and Bailey (2016: 2024 – Do my homework – Help write my assignment online) analyzed Pennsylvania patient safety authority database to measure the significance of electronic health records (EHR) regarding adverse drug events. From the results obtained they realized that safety events reduced by 27% once the EHR implementation was executed.
The reduction included 30% reduction in medical error and 25% reduction in reports on complication of treatment. It is recorded that the previous study involving from database identified roughly 3,100 EHR related event within the period of 2004 and 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap.
The harm scores and vent types were classified. The classification realized that 89% of the cases caused no harm, 15% resulted into unsafe conditions, less than 1% led to temporary harm, and negligible percentage caused significant harm.
Also, majority of the EHR related medication errors was calculated at 81% related to dose (missed, under or over), and 13% was all about errors relating to procedures or treatment or testing.
And the rest were grouped under miscellaneous. A quantitative research conducted by RAND Health, ECRI institute and staff members from Baylor College of Medicine and University of Texas carried out a field research based on the information technology safety interventions projects in 11 institutions. Four out of the 11 institutions were ambulatory care and the rest were hospitals. The conclusion derived from the study was that change and improvement is not easy within a short period of time thus explaining the complexity and challenges in influencing technology, culture, workflow, and user behavior at the same moment (Graber, Johnston & Bailey, 2016: 2024 – Do my homework – Help write my assignment online).
Wolfstadt et al. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers) conducted a research on CDS and CPOE in relation to the ADEs. The studies were grouped both into ambulatory and hospitals. From the statistical analysis CPOE with CDS contributed to decline in ADEs in 50% of the studies, 40% recorded non-statistical decrease in ADEs, and 10% showed no change in the rates of ADEs. The study proposed that for evaluation of efficacy of CPOE with CDS, a study needed to be conducted across various clinical set up.
Mrayyan (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap) reported a research conducted in wards and intensive care units of Jordanian teaching hospitals. The survey consisted of 212 nurses from four teaching hospitals. The mean for medication errors incidence report was 35%, for ICUs generated a result of 36.4% and wards recorded a result of 33.8%. Poor quality or damaged labels on medications were noted as the major cause of error. Nurses failed in reporting medication of errors based on the fear that they will face disciplinary actions.
Discussion and analysis From results of Graber, Johnston and Bailey (2013) and Wolfstadt et al. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers), proper application use of computer technology in health facilities reduces ADEs to a greater percentage.
The same argument is echoed by Keane (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay) who states that prevention of medication errors is the most prioritize in every health care facility. Technological advancement like handheld computers is decreasing the incidence of medication errors.
Electronic physician ordering, medication bar coding and electronic documentation are turning to norms rather than the exception. Staudinger, Höss and Ostermann (2009), has supported the idea of using handheld computers as a way of improving though the information is descriptive based but not evidence based.
A careful adoption of new technologies to practice enhances opportunity for nurses to transform nursing practice, improving lives of patients and promote patient safety. The use of computer technology in recording data regarding patients is essential in reducing the errors.
CPOE will reduce the chances of giving wrong medication and when integrated with the CDS will enable proper flow of information. Therefore, capturing incidences of errors will be spontaneous and accurate.
It simply means proper actions will be taken in time to reduce the occurrence of ADEs. Developing system is the only way to mitigate the medication errors. A system acts as a complete unit thus its transformation needs a complete transformation including culture, technology and proper training of staff members in adopting the changes in the system.
The results from all sources of study and literature review has supported that the application of technology in the surgical units and other departments in the health facilities will reduce the medication sources of errors.
The traditional methods of reporting medication errors have a lot of limitations because nurses only report incidences cases of errors at their will. Advancement in technology should thus be call upon to reduce the rate of deaths that arises from ADEs due to medication errors.
Mitchell (2013) states that implementing planed change face a lot of challenges. However, using a framework like Lippitt’s may assist in elimination of certain potential problems. Emphasis on selection of the right theory or approach to use when implementing technological advancement and modification of culture may enable those affected by the changes to be receptive to the change.
Implications for nursing practice Nurses have critical role to play in health care facilities since they are in direct contact with patients most of the time. Some aspects of nurses are described. The roles and responsibilities of nurses in medication safety is the first aspect. All nurses have a sense of responsibility when it comes to handling patients and administering of the medication. Being alert and precise working in handling medication is a key characteristic that nurses should uphold and practice. Another aspect is the ability to work safely. This entails risk awareness and circumstances in which the nurses operate. Lastly, the aspect of nurse acceptance of safety practices. Nurses play pivotal role in Medication administration errors. To play the role effectively, safety practices that are feasible, appropriate and evidence based should be set in place to ensure that favorable working environment is created (Smeulers et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay).
According to Jones (2009), improvement in medication administration errors is met through covering the sources of errors. Some of the ways to seal the sources of errors include evaluation of e-learning programs with the aim of improving mathematical skills of nurses to avoid giving wrong medication dosage; use of visual prompts and checklist in monitoring adherence to protocols and evaluating the effective use of protected administration times. Therefore, it is fact that nurses are bringing a lot on the table and implementing the use of technology without involving with in the program may not yield good results.
In conclusion, the hypothesis of the research is achieved. It is thus stated categorically that from both the literature review and results of the peer reviewed articles, the computer technology reduces medication errors through reducing the adverse drug events (ADEs). The result is realized through adoption of CPOE with CDS and incorporating nurses into the system to play the pivotal role in the surgical units.
ReferencesTop of Form Anderson, J. G., & Aydin, C. (2005). Evaluating the Organizational Impact of Health Care Information Systems. New York: Springer.Top of Form Daniels, R. (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Contemporary medical surgical nursing. Clifton Park, NY: Delmar, Cengage Learning.
[bookmark: _GoBack]Graber, M. L., Johnston, D., & Bailey, M. R. (2016: 2024 – Do my homework – Help write my assignment online). Report of the Evidence on Health IT Safety and Interventions. Jones, S. W. (2009). Reducing medication administration errors in nursing practice. Nursing Standard, 23(50), 40-46.Top of Form
Keane, K. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Reducing medication errors by educating nurses on bar code technology. MedSurg Nursing, 23(5), S1-S1. Khoumbati, K. (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Handbook of research on advances in health informatics and electronic healthcare applications: Global adoption and impact of information communication technologies. Hershey PA: Medical Information Science Reference.Top of Form
Mitchell, G. (2013). Selecting the best theory to implement planned change: Improving the workplace requires staff to be involved and
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Mitchell, G. (2013). Selecting the best theory to implement planned change: Improving the workplace requires staff to be involved and
innovations to be maintained. Gary Mitchell discusses the theories that can help achieve this. Nursing Get research paper samples and course-specific study resources under   homework for you course hero writing service – Manage ment, 20(1), 32-37.
http://home.nwciowa.edu/publicdownload/Nursing DepartmentNUR310Selecting the Best Theory to Implement Planned Change.pdf 80%
innovations to be maintained. Gary Mitchell discusses the theories that can help achieve this. Nursing Get research paper samples and course-specific study resources under   homework for you course hero writing service – Manage ment, 20(1), 32-37.
Mrayyan, M. T. (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Reported incidence, causes, and reporting of medication errors in teaching hospitals in Jordan: A comparative study. Contemporary nurse, 41(2), 216-232. Staudinger, B., Höss, V., & Ostermann, H. (2009). Nursing and clinical informatics: Socio-technical approaches. Hershey, PA: Information Science Reference.
Wolfstadt, J. I., Gurwitz, J. H., Field, T. S., Lee, M., Kalkar, S., Wu, W., & Rochon, P. A. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers). The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: a systematic review. Journal of general internal medicine, 23(4), 451-458.
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