Please use the link to do the reading for this assigments and read the attachemnt.
https://web-s-ebscohost-com.cosc.idm.oclc.org/ehost/detail/detail?vid=0&sid=a691fcfe-1d6e-4c81-899e-163a66e19952%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=132181877&db=hch
https://web-s-ebscohost-com.cosc.idm.oclc.org/ehost/detail/detail?vid=0&sid=a691fcfe-1d6e-4c81-899e-163a66e19952%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=132181877&db=hch
https://allnurses.com/nurse-gives-lethal-dose-vecuronium-t692463/
https://www.ncbi.nlm.nih.gov/books/NBK499956/
How do we improve patient safety? A look at the issues and an interview with Dr. Britt
Please read and answer to two classmates and include reference seperately for each response.
Classmate 1
Medical Errors by Nurses
As a newer nurse, one of the biggest fears experienced is making some type of error that could cause harm to the patient or that could result in the loss of my nursing license. Two common errors made by nurses are charting and documentation errors and infection issues.
Charting and documentation errors are often made by nurses. There is so much that needs to be charted on the patients, making nurses overwhelmed and increases the chance of a mistake being made. As nurses we not only have to chart patient assessments, but we have to chart things like IV access attempts, calls to the doctor, and education. A time-motion study was conducted and found that 33% of a nurse’s shift was spent interacting with some kind of technology documentation compared to the 22% of time actually spent with the patient (Trainer, 2023). Nurses are spending more time documenting than they are with the patients due to not wanting to make errors and cause liabilities. Working on a cardiology floor, the nurses often get feedback about not appropriately charting I&O’s for patients on Lasix. It is vital to document patient medication effects because the output determines the appropriate dose for the patient. Incomplete and inaccurate documentation leads to miscommunication and wrongful collaboration with other healthcare professionals (Limandri, 2021). To prevent charting and documentation errors, frequent education and feedback regarding documenting should be given to nurses. At my place of work, nurses are
now required to ask admission questions that involve housing conditions and financial stability. These questions would be more appropriate if done by a case manager or social worker. Having the proper department ask questions like that would lighten the responsibility of the main nurse.
Another issue made my nurses is making mistakes with infection issues. The CDC estimates that each year, about 1 in 25 patients in the hospital get diagnosed with a healthcare associated infection (HAI) (Lamphier, 2022). Patients who are at most risk are patients associated with prolonged stays, foley catheters, and central lines. Nurses often make mistakes by not cleaning these areas with the proper solution and technique. Ways to prevent infection issues in the hospital are having infection disease nurses who audit and monitor charts to ensure that patients are getting appropriate treatments. My hospital incorporated scanning in chlorhexidine bottles to ensure that patients with central lines are getting cleaned properly. The most effective way to prevent infection issues is to wash hands before and after entering a patient’s room. A study monitoring ICU units showed that handwashing with the alcohol-based sanitizers reduced HAI by 29% (Bello et al., 2020). Taking the time to use infection prevention techniques will reduce the risk of infection issues.
Though nurses do not intentionally make mistakes, it does happen. It is important for nurses to take all the steps and education needed to prevent any errors from happening to keep patients safe. How has your healthcare facility made changes to prevent errors from happening?
References
Bello, S., Bamgboye, E. A., Ajayi, D. T., Ossai, E. N., Aniwada, E. C., Salawu, M. M., & Fawole, O. I. (2020). Handwash versus hand-rub practices for preventing nosocomial infection in hospital intensive care units: A systematic review and meta-analysis. Canadian Journal of Infection Control, 35(2), 82–90. https://doi- org.cosc.idm.oclc.org/10.36584/cjic.2020.009
Lamphier, I. (2022). A day in the life of an Infection Preventionist. Infection Control Today, 26(9), 24–26.
Limandri, B. J. (2021). Efficient and Effective Documentation in Nursing Care. Oregon State Board of Nursing Sentinel, 40(3), 4–7.
Trainer, N. (2023). Documentation and Nurses’ Time Caring for Patients. Critical Care Nurse, 43(1), 10–11. https://doi-org.cosc.idm.oclc.org/10.4037/ccn2023527
Classmate 2
Nursing Errors
As a new nurse I remember in nursing school watching videos of nursing errors or reading articles. That was enough to scare me in ever making that mistake. It is important for nurses to ensure they are using the 6 rights to medication safety which include the right patient, right medication, right dose, right route, right time, and right documentation (Morouse, 2023). Skipping any of these steps puts the patient’s safety at risk and also the nurses license.
At my job a common error I see with patient safety is nurses do not scan medications they manually input it into the patient’s chart after they have given the medication. Not scanning the medication can cause an error because we can miss an alert by the system. For example, a lab value or an allergy. Although, Morouse (2023) suggests, “Providing the technology to improve
safety does not remove all risks” (pp. 2). So, it is essential to use the 6 rights of medication when the nurse is in the med room and before medication administration. We must find out why this problem is happening and why nurses may be skipping steps.
A second error that happens is when providers do not put orders in the patient’s chart. Many times, they will give verbal orders to the nurse, but fail to put them in the system. This makes it difficult for nurses to carry through with the orders. Even though medication errors can
occur at any stage of the medication administration process, the nurses are the last link to stop
them before occurring and reaching patients (Athanasakis, 2021, pp. 2). Nurses and providers should have the proper education and training for medication administration to prevent these errors. Nurses should also speak up if they are questioning the order and clarify.
References:
Athanasakis, E. (2021). Medication safety practices in clinical nursing: nurses’ characteristics, skills, competencies, clinical processes, and environment. International Journal of Caring Sciences, 14(3), 2019–2028.
Morouse, K. M., & Tyler, D. D. (2023). Medication administration: Using technology to promote patient safety. Journal of Informatics Nursing, 8(1), 6–10.
