Term Paper on "Medication Errors"

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Without proper error reporting it is impossible to assess the true extent, causes and possible preventions of medication errors. However, nurses often do not report medication errors due to fear of punishment or being fired. Although it is known that errors in administering medication stem from system-wide problems, nurses feel personally responsible for medication errors. Drach-Zahavy and Pud feel that focusing on deviations from procedures and policies rather than the outcome of such deviation will help relieve the reluctance that nurses feel towards error reporting. Also, Dickens found that work environments with an open and communicative work atmosphere lead to increased error reporting.

Several possible solutions to the problem of medication errors exist. Each solution focuses on different steps in the process of giving a medication to a patient and has different attributes and drawbacks. The solutions that I will focus on are: decreasing distractions, using barcodes, and using computerized medication software programs.

Although it has previously been denied that work load and long hours affect healthcare worker performance Kozer found a positive correlation between hours worked and medication errors. Also, personal negligence due to distractions and heavy work load were the top two reasons that lead to medication errors according to a group of nurses (Tang). One study suggests creating interruption free zones such as around the medication cart or while a nurse is giving out medications, denoted by wearing a red vest, would be a possible solution (McGillis Hall). Interruptions by coworkers are a significant source of distractions for nurses while trying to concentrate on medications. This solution would clearly decrease that problem. However, this method has not been tested. More studies would be needed to determine how viable this method is and if reducing distractions does lead to a decrease in medication errors.

It is known that errors in administration of medications occur when the five rights have not been fully verified. Several reasons exist for why the five rights might not be completed such as distractions, interruptions, personal negligence, and rushing due to high patient work loads. One solution for this problem would be to use bar codes at the patient's bedside to verify the five rights. Use of barcodes would increase speed and efficiency, which would decrease the likelihood that distractions and interruptions would affect nurses. Also, nurses would have more time to prepare and recheck complicated medications if they spent less time determining the five rights. Studies have shown that use of barcodes does in fact decrease the occurrence of medication errors (Lafleur). However, this method only works as well as the training that those using it have received (Hidle). Also, over reliance on a barcode system could circumvent a nurse's own intuition and expertise. Another drawback is cost. It is… READ MORE