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Capella 4000 Assessment 4

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    Capella 4000 Assessment 4

    Capella 4000 Assessment 4 Analyzing a Current Health Care Issue

    Student Name

    Capella University

    NHS-FPX 4000 Developing a Health Care Perspective

    Prof. Name


    Analyzing Current Health Care Problems or Issues

    Healthcare systems often encounter health-related issues that require effective measures to resolve those issues. These problems have a negative impact on an individual’s health. Wondmieneh et al. (2020) have highlighted that medication error poses a significant threat to the patient’s health and affects their overall health. The current assessment aims to highlight medication error issues within the healthcare practice. The goal is to highlight the causes of medication error, its negative effects, strategies to manage, and the ethical association of those strategies.  

    Medication Errors – Healthcare Problem

    Medication error is a harmful adverse event that may result from negligence in the medication use process, including prescribing, dispensing, transcribing, and administration (Agency for Healthcare Research and Quality, 2019). These errors often have long-lasting effects on a patient’s health and well-being as well as affects the organization’s and professionals’ reputation, making patient lose their trust in the care practices. Escriva Gracia et al. (2020) have identified medication errors as one of the serious healthcare issues leading to fatal consequences for patients. Medication error is recognized as an adverse event that causes harm and a reported case of 1 death every day, affecting approximately 1.3 million people (World Health Organization, 2020).

    Medication errors have a significant impact on individuals as they tend to reduce the patient’s immunity, leading to a medicinal reaction that may lead to rehospitalization, post-application complications, and, even worse, death. Research has shed light on the contributing factors that may take part in medication error and highlighted that cognitive burden, fatigue, staff deficiencies, knowledge gaps, lack of competency and expertise, and distraction are contributing factors that increase the risk of medication error (Balchaites et al., 2020). Thus, these human factors significantly affect the administration of medication and can contribute to negligence that poses a significant threat to the care practices and overall health of the patient.

    Capella 4000 Assessment 4

    Therefore, many healthcare organizations focus on the medication processes being computerized and stress the need for healthcare professionals to be vigilant while administering the medication. The reasons for choosing these scholarly articles are their nature, their relevance to the topic at hand, the information they provide regarding medication errors, and how much they impact the population. The shared information is from the past five years of scholarly journals that highlight the latest trends and statistics on medication errors. All of the aforementioned data comes from reliable, up-to-date sources, such as official government portals or scholarly peer-reviewed journals. They help identify the issues that may cause medication errors while also providing an overview of the strategies that have been proven effective for individuals.

    Analyzing the Issue of Medication Error

    Medication error is one of the most critical issues in healthcare, especially when it comes to medication administration in hospital settings.  It is a preventable event that happens during any stage of the medication use process as a result of a mistake in prescribing, dispensing, transcribing, or administering. Being a nurse, this issue holds critical importance to me and I aim to provide better care facilities. It is concerning for me in regards to patient safety and healthcare outcomes. Medication errors have a harmful effect on patients seeking health care services and can have significant effects on healthcare outcomes. 

    People Involved

     People who are part of the healthcare care process, such as healthcare providers, pharmacists, patients and their caregivers, and the organization, are involved in such errors. The providers are responsible for prescribing, administering, and monitoring aspects of medication. At the same time, pharmacists are responsible for dispensing medication and verifying the medication against barcodes to ensure accuracy. At the same time, the patient and their caregiver are responsible for the administration, dosage management, following instructions, and reporting the adverse impact. While the institution holds an important role in creating systems that ensure accurate dispensing and transcription of medication,

    Cause of the Medication Error

    Medication errors can be attributed to many factors; however, a few of the highlighted ones are human errors, communication issues, write-up issues, and a lack of standardization. From the perspective of human error, healthcare providers are susceptible to making mistakes due to factors such as burnout, fatigue, or lack of training that alter their ability to actually diagnose their patients and provide medication. Human errors such as fatigue and burnout significantly affect the professional’s ability to accurately assess the patient and provide an accurate dosage of medicine (Sameera et al., 2021).

    Similarly, communication issues can lead to misunderstandings and incomplete information sharing among the patient and their care provider, leading to either overestimation or underestimation of the problem and prescribing medication as per the communication. Studies have shown that human flaws like confusion and taking the incorrect medication increase the risk of medication errors, and the writing and naming of medications make these risks worse (Bryan et al., 2021). Unreadable handwriting or similar-sounding medication may also get misinterpreted, which leads to medication errors.

    Solution for the Medication Errors

    The telehealth integrated systems would be required for providing an electronic prescribing system that allows healthcare professionals to utilize technology help in the medication prescribing, providing medication reconciliation as the time of discharge or utilizing the barcoding or scanning system. Some of the solutions proposed by the studies are:

    • Electronic Medication Prescribing System: Having an e-prescribing system can help reduce errors related to illegible handwriting and improve communication between the provider and the pharmacists while limiting the risk of taking the wrong medication. Also, these electronic systems can send dosage and timing alerts. Fei et al. (2019) reported that electronic medication systems are effective and safe for patients as they allow proper prescription of the medication, reducing human errors. The pros and cons of this strategy are that it reduces the risk of human error in medication prescription while increasing patient safety and care. However, data entry errors may pose a threat to accurate e-prescription.  

    Capella 4000 Assessment 4

    • Medication Reconciliation: Another strategy is to conduct medication reconciliation when the patient shifts from the hospital to the home care setting and to ensure that accurate dosage, timing, and medication are recorded. The verification of medication before discharge helps reduce the risk of medication error (Rasool et al., 2020). Reconciling a patient’s medications before discharging them allows for faster responses to feedback and, if necessary, more rapid adjustments to treatment plans. However, medication reconciliation does not provide guarantee regarding accurate prescribing and administration in the first place. 
    • Barcoding and Scanning: Another strategy is to use barcoding and scanning for medication administration, as it can help reduce errors while ensuring that the right patient receives the right medication against their barcode at the right time. The pros of using the barcoding and scanning system are that it prevents the wrong selection of patient for the medication, but it can interrupt the nurses workflow or may increase their work demands. 

    However, the consequences of not addressing these issues can affect patient healthcare outcomes and lead to reputational damage to the organization. Also, it can increase the risk of a lack of standardization processes in the organization, increase the risk of rehospitalization, increase the ratio of adverse events, and increase lawsuit claims. This also effects the organization’s ability to take effective measures and evaluate the organization’s performance and standards. Therefore, addressing these issues can help develop effective strategic plans that can increase healthcare outcomes for patients. 

    Ethical Implications of the Recommended Solutions

    Ethical principles are significant in healthcare systems. These principles are autonomy, beneficence, nonmaleficence, and justice. The solutions proposed are interlinked with these ethical principles.

    • The principle of benefit ensures that healthcare professionals act in the best interest of the patient while promoting their well-being. Implementing electronic prescribing exemplifies beneficence with the aim of reducing the risk of medication error. Research highlights that e-medication provides real-time alerts about the drugs and their harmful effects and dodge monitoring while reducing writing errors (Fei et al., 2019), as it helps to tone down the potentially dangerous medication combination while helping the providers monitor the progress of patient care. This also serves the ethical principle of nonmaleficence.
    • The principle of autonomy is catered to through education for the patient, giving the patient the right to make informed decisions through medication reconciliation, where the patient knows regarding their medication, times, and dosage and can make a fully informed decision based on the information that is being provided to him. Reverification of medication helps the patient trust their caregiver and their recommendations while empowering them to have enough information for their decision-making process (Rasool et al., 2020). The verification process also serves the ethical principle of beneficence, as the provider ensures to provide safe medication for the patient during the transition phase as well.
    • The principle of fidelity is the provider’s duty to maintain the trust of the patient. The barcoding and scanning ensure that the patient’s trust in their provider is intact and has not been affected by medication errors. The barcoding ensures that the patient gets the right medication, which also tends to satisfy the patient regarding the care that is being provided to them.


    In conclusion, medication error poses a significant threat to the healthcare practices of the patient, which needs to be addressed effectively. Evidence-based research and ethical care standards support the use of solutions like e-prescribing, medication reconciliation, and barcode scanning to manage medication errors.


    Agency for Healthcare Research and Quality, (2019). Medication errors and adverse drug events 

    Balchaites, A., McCarthy, S., & Fleming, A. (2022). Exploring the human factors of medication errors in community pharmacy: A mixed methods study. International Journal of Pharmacy Practice, 30 (Supplement_1), i39–i40.

    Bryan, R., Aronson, J. K., Williams, A., & Jordan, S. (2021). The problem of look‐alike, sound‐alike name errors: Drivers and solutions. British Journal of Clinical Pharmacology, 87(2), 386–394. 

    Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1), 640.

    Fei, L., Robinson, J., & Macneil, A. (2019). Case study: Using electronic medication administration record to enhance medication safety and improve efficiency in long-term care facilities. Canadian Journal of Nursing Leadership, 32(2), 102–113.

    Mutair, A. A., Alhumaid, S., Shamsan, A., Zaidi, A. R. Z., Mohaini, M. A., Al Mutairi, A., Rabaan, A. A., Awad, M., & Al-Omari, A. (2021). The effective strategies to avoid medication errors and improving reporting systems. Medicines, 8(9), 46.

    Rasool, M. F., Rehman, A. ur, Imran, I., Abbas, S., Shah, S., Abbas, G., Khan, I., Shakeel, S., Ahmad Hassali, M. A., & Hayat, K. (2020). Risk factors associated with medication errors among patients suffering from chronic disorders. Frontiers in Public Health, 8. 

    Sameera, V., Bindra, A., & Rath, G. P. (2021). Human errors and their prevention in healthcare. Journal of Anaesthesiology, Clinical Pharmacology, 37(3), 328–335. 

    World Health Organization (2020). Medication without harm. World Health Organization 

    Wondimeneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 4. 

    Capella 4000 Assessment 4