Target High Risk Areas for Medication Errors Medication errors are among the biggest issues in health care settings today. The effect of managed care is one of the causative factors. The need to contain costs has invariably doubled the nurses' workload making them less efficient as caregivers. Example of problem is the high incidence of medication errors. Nurses' workload has increased tremendously regardless of the fact that most of these patients are of great acuity, thereby predisposing them to a greater risk of medication errors. Medication giving include five basic rights: Right patient, Right medication, Right route, Right dose, and Right time.
Contrary to the above is medication errors. Most medication errors reported involve patient allergies, insulin administration, heparin, opiates, patient controlled analgesia and potassium concentrates. Most errors with PCA devices are with rate, mis programmed dose, wrong concentration and device malfunction errors. However, lack of basic knowledge and poor performance have also caused these errors. Another area of great concern with medication error is order transcription. Poor Transcription or orders have resulted in wrong information passed on to a patient Whether n a discharge or as an in patient.
Clarification in the case of doubt is a weapon against order transcription error. Most nurses have poor concentration due to the amount of their work load that they could hardly call back the doctor to clarify either the order clearly written or an illegible order, then arriving to their own assumption. Administering medication later than specified time ordered or missed medication is an area of issue. Some prophylactics given before or after according to specified order are lifesavers. When a patient is scheduled for a surgery, prophylactic anticoagulant is administer e to prevent clots and perhaps continues post-op. If such a patient is not given his / her medication as ordered he could break a clot resulting to embolism.
Incorrect patient history has resulted to medication errors. It is obvious that nurses' workload permits them with a limited time that a complete or basic issue in patient history is neglected resulting to a serious health crisis or ever death and lawsuits. Poor documentation is among the biggest issue with nurses. It has been said," if you don't chart is you didn't do it." Documenting properly bails you from a lawsuit.
Most nurses are quite busy especially with another patient of a high acuity and have no time to see the other patient frequently as suppose or may not even been in the room for hours. A patient may die between this time, yet the nurse may document that patient was resting quietly. Also is the need in documenting why a medication or care is not given to a patient at the scheduled time. While the workload issues with nurses are increasing, it is still nurses Responsibility to be accountable for their actions. Bibliography The Essentials of Pediatric Nursing-Mosby pp. 1103-08, 1262-75 Medical-Surgical Nursing-Pulaski pp.
98-116, 172-185, 665-667.