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NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

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    NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

    Student Name

    Capella University

    NURS FPX 4020 Improving Quality of Care and Patient Safety

    Prof. Name

    Date

    Improving Quality and Safety in Patient Care

    The enhancement of patient safety involves applying safety science principles to establish a reliable healthcare delivery system (Brigitta & Dhamanti, 2020). Medication administration errors (MAEs) pose a significant threat to patient well-being, potentially leading to life-threatening situations and, even when not fatal, contributing to prolonged hospital stays and increased treatment costs. This study aims to investigate the factors influencing MAEs and propose strategies for elevating the quality of patient care.

    Factors Contributing to Patient Safety Risks

    Before delving into the primary elements contributing to patient safety risks in healthcare institutions, let’s examine an incident involving a medication error in a hospital setting. In a busy hospital, Nurse Ella, responsible for diabetic patient care, mistakenly administered rapid-acting insulin, in an elevated dose, to Mr. Wallace instead of the prescribed once-daily long-acting insulin. This error resulted in symptoms of hypoglycemia, necessitating prompt intervention by the healthcare team.

    Nurses, being at the forefront of drug administration, play a crucial role in delivering safe and accurate treatment services. An institutional-based cross-sectional study revealed a 57.7% prevalence of MAEs among participant nurses, with 30.4% making errors more than three times (Tsegaye et al., 2020). Key factors contributing to these errors include inadequate training, prescribing errors, stress, burnout, and communication gaps among healthcare professionals.

    Lack of Knowledge and Training

    Insufficient experience and knowledge regarding drug doses, interactions, contraindications, and potential adverse effects contribute significantly to medication administration errors. Research indicates that 78.7% of medication errors result from inadequate nurse training (Hassen et al., 2022). Nurses equipped with advanced pharmaceutical knowledge and comprehensive training are less prone to making medication administration errors.

    Communication Gap Between Healthcare Professionals

    Poor communication and collaboration among healthcare staff, including pharmacists, physicians, and nurses, can lead to medication errors. Studies suggest a higher incidence of medication administration errors in hospitals with communication gaps among healthcare staff (Ghasemi et al., 2022).

    Prescribing Errors

    Prescription errors occur when healthcare professionals inaccurately prescribe medications, leading to incorrect dosages, inappropriate instructions, and other serious issues. Incomplete prescriptions accounted for 71% of total prescription-related errors in a study, with the remaining 29% attributed to errors during prescription transcription (White et al., 2019).

    Stress, Burnout, and Mental Health Challenges Among Healthcare Workers

    Elevated stress levels among nurses, stemming from excessive workloads, long shifts, moral dilemmas, job instability, and lack of social support, contribute to psychological distress, burnout, and potential errors. A study found that nurses with burnout were five times more likely to cause patient care and medication errors (White et al., 2019).

    Evidence-Based Best Practices Solutions

    To achieve the goals of enhancing patient safety and reducing medication administration costs, evidence-based and best practice solutions are imperative. Several techniques supported by academic or professional sources include:

    1. QSEN Approach: The Quality and Safety Education for Nurses (QSEN) approach focuses on six fundamental skills, improving patient-centered care, teamwork, evidence-based practice, quality improvement, patient safety, and the use of informatics and technology in healthcare (Watanabe et al., 2021).
    2. Medication Reconciliation: Contrasting a patient’s current pharmaceutical regimen with the prescribed medications significantly improves patient safety during care transitions (Koprivnik et al., 2020).
    3. Computerized Physician Order Entry (CPOE): Electronic submission of medication orders through CPOE systems reduces the likelihood of adverse drug events (Skalafouris et al., 2022).
    4. Barcode Medication Administration (BCMA) Systems: These systems ensure correct medication delivery by using patient identification and barcoded labels on pharmaceuticals, preventing drug errors (Ye, 2023).
    5. Clinical Decision Support System (CDSS): These systems offer research-based suggestions to healthcare practitioners at the point of care, preventing negative outcomes by notifying about possible medication combinations, dosage mistakes, or allergies.
    6. Value-Based Formulary Management: Choosing medicines based on clinical potency, cost-effectiveness, and safety helps maintain healthcare quality while reducing pharmaceutical expenditures (Weinmeyer et al., 2021).

    Nurse-Led Coordination for Optimal Patient Safety

    Coordination among nurses and other healthcare administrators significantly improves medication administration. The incident discussed earlier underscores the importance of clear communication between nurses, physicians, pharmacists, and IT personnel, reducing the likelihood of errors. Nurses collaborating with pharmacists can also minimize prescription transcribing and filling errors, ensuring the five rights of medication administration (Koprivnik et al., 2020).

    Nurses’ Collaboration with Other Stakeholders

    Collaboration between nurses, physicians, pharmacists, patients, and nursing leadership, along with the involvement of quality improvement teams, is crucial for evaluating and addressing challenges in healthcare settings . Efficient collaboration between nurses and IT personnel is essential for the effective use of technology tools such as CPOE, BCMA, and CDSS, preventing MAEs (Ye, 2023).

    Conclusion

    Medication administration errors pose significant risks to patient safety and contribute to increased treatment costs. Identifying factors contributing to these errors and implementing suitable remedial plans, such as evidence-based best practices and nurse-led coordination, can prevent such errors. Incorporating the QSEN approach in nurses’ training, utilizing technological advancements, promoting teamwork, and adopting value-based approaches contribute to enhancing patient safety and cost-effectiveness in healthcare.

    References:

    Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Abu Farha, R., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/jphsr/rmaa025

    Ghasemi, F., Babamiri, M., & Pashootan, Z. (2022). A comprehensive method for the quantification of medication error probability based on fuzzy SLIM. PLOS ONE, 17(2), e0264303. https://doi.org/10.1371/journal.pone.0264303

    NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

    Hassen, A., Abozied, A., Mahmoud, E., & El-Guindy, H. (2022). Mental health nurses’ knowledge regarding patients’ rights and patients’ advocacy. NILES Journal for Geriatric and Gerontology, 5(2), 307–324. https://doi.org/10.21608/niles.2022.243510

    Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., Taboada-López, R. J., & Rodríguez-Penín, I. (2020). Improving patient safety through a pharmacist-led medication reconciliation program in nursing homes for the elderly in Spain. International Journal of Clinical Pharmacy, 42(2), 805–812. https://doi.org/10.1007/s11096-020-00968-8

    Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309

    Skalafouris, C., Reny, J.-L., Stirnemann, J., Grosgurin, O., Eggimann, F., Grauser, D., Teixeira, D., Jermini, M., Bruggmann, C., Bonnabry, P., & Guignard, B. (2022). Development and assessment of PharmaCheck: An electronic screening tool for the prevention of twenty major adverse drug events. BMC Medical Informatics and Decision Making, 22(1). https://doi.org/10.1186/s12911-022-01885-8

    Watanabe, Y., Claus, S., Nakagawa, T., Yasunami, S., & Teshima, M. (2021). A study for the evaluation of a safety education program for nursing students: Discussions using the QSEN safety competencies. Journal of Research in Nursing, 26(1-2), 97–115. https://doi.org/10.1177/1744987121994859

    NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

    Weinmeyer, R. M., McHugh, M., Coates, E., Bassett, S., & O’Dwyer, L. C. (2021). Employer-led strategies to improve the value of health spending: A systematic review. Journal of Occupational & Environmental Medicine, 64(3), 218–225. https://doi.org/10.1097/jom.0000000000002395

    Ye, J. (2023). Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Perioperative Medicine, 6(1), e34453. https://doi.org/10.2196/34453