One of the most common hazards that every nurse must avoid in her work is administering the incorrect prescribed medication to patients in their care.
The most frequent medicinal errors concern incorrect dosages and drugs, the strength or frequency of the medicine or even the failure to administer medication entirely.
Unfortunately, medication mistakes like the above are not rare incidents. As a result, national research has shown that almost one in 10 patients experienced harmful affects following these lapses with varying degrees of severity – including death. Given the sometimes dire consequences of these lapses, the need for proper documentation and eradication of medication errors is imperative.
So here are Search Medical’s Top 8 ways for nurses to avoid medication errors whilst in work.
1. Ensure the five rights of medication administration are followed.
It isn’t adequate to simply transcribe the medication as prescribed. Always take into account the five R’s checklist before you do anything:
- The right patient,
- The right drug
- The right dosage
- The right time
- The right route
2. Repeat the orders back
Read back an order to the prescribing physician to ensure the ordered medication is transcribed correctly so any mistakes can be easily rectified. You can also involve another a second opinion from another nurse to ensure accuracy but do not check medicines and their dosages verbally in tandem with other staff to avoid talking each other through mistakes. Do it separately.
3. Improve the clarity of initial orders to avoid confusion
Mistranscribed information is one of the main causes of medication errors so communicating ways to clarify data is essential. Consider using name alerts to clear up commonly confused errors e.g. Whyte and White and place zeroes in front of decimal points to avoid situations like mixing up 0.25mg with 25mg.
4. Turn drug administration into protected time and learn organisation’s medication procedure
Ensure that any time needed to complete and administer medication to patients is protected and not compromised by other commitments or pressure from staff so that your full attention can be focused on correctly ordering the prescribed drugs. Also, in order for you to follow an institution’s medication policy, you must become completely familiar with it’s content.
Make sure that you learn as much as possible from the institution’s education/training department as these policies often contain vital information regarding the institution’s practices on medication ordering, transcription, administration, and documentation.
Hospitals have also introduced red tabards with a "Do not Disturb, Drug Round in Progress" written on the front and back so patients and staff know not to interrupt these specific nurses. This has lead to a significant fall in medication errors recording in these wards and institutions.
5. Only complete the process with your full attention
In the high pressure and combustible environment of nursing, stress, tiredness and diverted attention are regrettable fixtures of your work. As with anything in this industry, a rushed process can be life threatening so do not view this primarily administrative process as a lesser task. If you feel that your full attention is slipping, step away from the task and only resume when your concentration is at 100% or your unrelated conversation has been completed.
6. Ensure proper storage of medications for proper efficacy
You do not need to unnecessarily add to the risk of administrative errors by ordering from a disorganised and scattered drug storage unit. Store all your medications in their correct storage facilities and adhere to the temperature guides that all drugs should display. If a multidose vial is used, it must be labelled to ensure it is not used beyond its expiration date from the date it was opened. This will streamline the entire process allowing you more time to concentrate on transcribe and administer the correct order rather than worry about the actual quality of the drug in question.
7. Question if unsure
A junior or newly arrived nurse might feel uncomfortable questioning whether a prescription is right. Ultimately, treating your patient should always be your number one priority and it is in the interests of patient safety to categorically confirm the medication being provided is what was originally intended.
8. Record more ‘near miss’ medication errors.
Whilst the ‘adverse errors’ are far more serious by their nature, ‘near misses’ cause no harm to the patient but usually are caused by the exact same procedural mistakes as the former. Unlike adverse errors, which are consistently documented, many ‘near misses’ go unreported as staff often do not realise a fault has even occurred.
These kinds of mistakes are considered by all as free passes to learn from and are valuable resources for all nurses to review. But because of a fear of reprisal organisations do not report these enough. If errors are not reported, patients will not receive the additional treatment they might require and the danger that the same error could occur again increases due to the root cause of the problem not being addressed.
Search Medical is a specialist in not only sourcing and placing nursing jobs but also guiding our workers through some of the most important issues surrounding the profession. If you have any questions regarding the medication errors please contact a member of the Search Medical team in your nearest England office.
By John Murphy