NRSG 314 Unit 2 – Individual Project

NRSG 314 Unit 2 – Individual Project

NRSG 314 Unit 2 – Individual Project

Medication Errors

Health care facilities should be safe settings for patients and health care practitioners. At the administrative level, organizations’ leaders should ensure health care staff is adequately facilitated and workplace issues are addressed timely and satisfactorily. Besides, patient safety, care quality, and efficient processes should be prioritized. Although many organizations apply diverse measures to enhance patient safety, many adverse events still occur. Nurses should be adequately aware of the causes of adverse events and their role in reducing them. The purpose of this paper is to describe medication errors as a leading adverse event and appropriate measures for reducing errors.

Cause and Incidence Rate of Medication Errors

After joining a facility, new nurses look forward to cooperation with experienced colleagues, management support, and leaders’ continuous guidance. Providing the necessary support and guidance requires health care organizations to have adequate nurses and nurse leaders. However, this is not the case due to the prevalence of the nursing shortage, which is among the leading causes of medication errors. Salar et al. (2020) explained that most medication errors happen due to the nursing shortage, which increases the nurses’ ratio to patients. A nursing shortage increases fatigue and workplace stress among nurses. As a result, they cannot concentrate fully as the practice requires; thus, they are highly likely to administer drugs without confirmation or erring in reading labels. The incidence rate of medication errors varies across organizations and health care professionals. Salar et al. (2020) found that 39% of medication errors are caused by general practitioners and nurse-specific incidences ranging between 16-27%. The high prevalence poses a significant to patient safety and quality care hence the need for practical and lasting interventions.

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Continuous Quality Improvement

Health care organizations should embrace quality improvement and support quality improvement initiatives. Continuous quality improvement (CQI) involves asking what is being done in patient care delivery and what is needed to achieve excellence (Tibeihaho et al., 2021). Due to its benefits, nurse leaders and staff identify performance gaps and their causes and intervene appropriately. An effective CQI initiative for addressing a nursing shortage is supporting nurses to cope with the shortage. Generally, health care facilities do not have adequate financial resources to support the continuous recruitment and training of nurses. Enabling nurses to cope through training, empowerment programs, and self-care opportunities could play a vital role in preventing nurse burnout. Preventing nurse burnout reduces nurses’ chances of committing medication errors since they are not fatigued, stressed, or dissatisfied. The first part of the initiative should be identifying the causes of medication errors and the relationship with a nursing shortage. Next, the most appropriate coping strategy should be implemented depending on the magnitude of the problem. Outcome measures include a progressive reduction in medical errors, engaging in teamwork, and participating in activities that foster health and well-being.

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The rationale for Reducing Medication Errors

Reducing medication errors implies a proportional increase in positive outcomes. In the United States, approximately 7000-9000 people die due to medication errors (Tariq et al., 2018). The number could be higher considering that a significant proportion of patients do not report adverse reactions related to medication complications. As a result, reducing medication errors is instrumental in reducing deaths and health complications related to medication errors. Tariq et al. (2018) added that medication errors lead to patient dissatisfaction and low trust in health care professionals. It is crucial to prevent such outcomes to promote progressive organizational growth. Reducing medication errors also increases nurses’ self-confidence and ensures they are not victims of the second-victim syndrome, which is typical among nurses who commit errors leading to death and health complications.

Nurses’ Actions to Reduce Medication Errors

Nurses have a personal and professional responsibility to reduce medication errors. One of the nurses’ actions that can assist in preventing medication errors is timely reporting of incidences. Reporting is founded on the precept that erring is human, as underscored in the Institute of Medicine (IOM) Report (Afaya et al., 2021). Timely reporting encourages a collaborative approach to solution implementation as nurses learn from their mistakes to prevent a recurrence. Nurses should also embrace teamwork to learn from experienced colleagues about medication administration. Teamwork also gives nurses the needed support to confirm drugs before administering them to patients. Above all, nurses should embrace technology to reduce medication errors. For instance, barcode scanning is effective in confirming drugs hence reducing possible errors.


Whether new or experienced in practice, nurses are likely to commit medication errors more than other practitioners. Causes vary depending on the facility and the type of patient activities that a nurse is allowed to undertake in an organization. As explained in this paper, the nursing shortage is a leading cause of medication errors. Exhaustion and stress stemming from a high workload prevent nurses from concentrating fully and delivering care as expected. As a result, a CQI initiative focusing on addressing the nursing shortage can help to reduce medication errors. Nurses should also embrace teamwork, timely reporting, and technology in patient care to prevent errors.

NRSG 314 Unit 2 – Individual Project References

Afaya, A., Konlan, K. D., & Kim Do, H. (2021). Improving patient safety through identifying barriers to reporting medication administration errors among nurses: An integrative review. BMC Health Services Research21(1), 1-10.

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences13, 100235.

Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2018). Medication dispensing errors and prevention.Statpearls [Internet].

Tibeihaho, H., Nkolo, C., Onzima, R. A., Ayebare, F., & Henriksson, D. K. (2021). Continuous quality improvement as a tool to implement evidence-informed problem solving: experiences from the district and health facility level in Uganda. BMC Health Services Research21(1), 1-11.

Assignment Description

Medication errors are the number one patient safety issue at most medical facilities.

You are a member of the risk management team at a medical facility. You have been assigned to develop a professional paper that will assist nurse managers in reducing the number of errors made by new employees concerning medication. Your paper should include all of the following:

  • Discuss the most frequent cause and incidence rate of medication errors at a medical facility.
  • Incorporate the continuous quality improvement (CQI) process into the identification, implementation, and measure of the plan to reduce the medication errors.
  • Discuss the rationale for reducing the errors.
  • Give at least 2 actions that the nurse should take to assist with the reduction of errors.
  • Cite at least 3 scholarly sources. Two of the sources must be recent (within the past 5 years), and the third source must come from an Institute of Medicine (IOM) report that is related to medication errors.

Please click on this APA Style for CTU Students link for help with APA formatting. Use the CTU Writing Style Guide (templates provided)—not the Introductory Writing Style Guide.

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A primary concern in health care is patient safety; it can be addressed in many ways, and those who need around-the-clock care have found that bedside report (BSR) helps ease their mind. Medication errors, unfortunately, happen too often, putting patients’ safety at risk. In a unit that used to work, we had a near-miss incident with a chemotherapy infusion.  The chemo drug was hanging but was left clamped, causing the medication not to infuse. On another occasion, the provider ordered a normal saline bolus for a diabetic patient with a blood sugar of > 400, the nurse administered D5W instead. These incidents happened within a week of each other.

The implementation of BSR was applied and enforced in the unit. Sherwood and Barnsteiner (2021) describe how this process happens. First, the oncoming RN is introduced by the leaving RN. Both RNs go over critical issues like checking IV lines, type of medication being infused, fall prevention equipment, and goals for the day. In the hospital where I work, besides the leaving and oncoming RNs, a physician, a pharmacist, and a social worker are part of the rounding team. BSR has helped reduce the number of medication errors because it increases the accuracy of care and reduces the amount of time spent trying to figure out or fix an easily avoidable mistake (McAllen et al., 2018).

Even though BSR has helped decrease the number of medication errors, they are still happening. Besides the implementation of BSR, a detailed log with the number of medication errors, the nature of the errors, and the adverse effect the medication error inflected on the affected patient would help increase the nurses’ awareness. Another tool that could be added to the BSR is auditing. By auditing one -another’s work, there is a less likely chance of having medication errors. Audits can help evaluate and analyze the effectiveness of the future changes that would be required to decrease the nurse error in medication faults.

NRSG 314 Unit 2 – Individual Project References:

McAllen, E. R., Stephens, K., Biearman, B. S., Kerr, K., & Whiteman, K. (2018). Moving shift

report to the bedside: An evidence-based quality improvement project. Online Journal of

Issues in Nursing, 23(2), 1.

Sherwood, G., & Barnsteiner, J. (2021). Quality and Safety in Nursing (3rd ed., pp.119). Wiley Global Research (STMS).

Working in the emergency department we see a range of patients from pregnant mothers in labor to the sick and dying. The learning in the emergency department is awe inspiring and ever changing although that does come with its struggles. Being a facility that has new medical residents we see many new physicians come in to learn emergency medicine and to be able to do their patient care as smooth as possible.

In one instance I myself was a float nurse who was assisting with nursing tasks, break relief for my fellow coworkers and all around resource for the department. We received a patient that was having an allergic reaction to pine nuts that was hidden in the cookies that he was given. Upon presentation the emergency department we rapidly bedded the patient and proceeded with general procedures as one would expect. Cardiac monitor, vital signs, establishing an IV, fluids primed and have medications ready preemptively until the physicians are there for the actual orders. Understandably, epinephrine given intramuscularly remains the mainstay of treatment for this condition also additionally other second-line therapies such as H1 or h2 blockers and steroids. (Cheng, 2011).

As soon as the resident came in I was able to tell her the background of the patient and that I have already pulled the medications and have everything established I asked what the resident would like for medications she proceeded to tell me for a verbal order read back, 50 mg Benadryl IV, 150 mg Solu-medrol IV, and 0.4 mg epinephrine IV. I questioned the order about the epinephrine IV and received push back from the resident with her quoting “it’s alright it’s just a small dose”. I proceeded to ask the resident if they would like the epinephrine around route, possibly IM and was revoked. I prepared the medications, with no intention of giving the epinephrine IV, to have ready at bedside after the supervising physician was at bedside.

Once the supervising physician walked in I asked the resident to repeat the orders. The resident was corrected by the physician, the patient was treated as well as discharged later that day. As Sherwood goes on to say that discussions of near misses usually do not generate the defensive reactions (Sherwood, Barnsteiner 2021) this was an episode in which I was placed in a position in which it was. The resident responded in a defensive way and had a thought process of explaining to me that “it’s just a small dose”.

After my encounter with the residents in my department the education team increased their rounding and actually brought up encouraging nurses to speak up about not only medication errors, but about advocating for patients and appropriate medications but to speak up to residents. As Sherwood & Barnseiner go on to explain facilitating and harboring a culture of safety we should not let our egos get in the way of patient care when in critical situations, or ever.

NRSG 314 Unit 2 – Individual Project References:

Cheng A. (2011). Emergency treatment of anaphylaxis in infants and children. Paediatrics & child health, 16(1), 35–40.

Sherwood, G., & Barnsteiner, J. (2021). Quality and Safety in Nursing (3rd Edition). Wiley Global   Research (STMS).

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