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Assessment 1: Enhancing Quality and Safety

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Student Name

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Capella University

Course Name
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Prof Name

FEB 24, 2024

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Enhancing Quality and Safety in Medication Administration: A
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Comprehensive Approach

Introduction:
Patient safety within healthcare systems hinges on the application of robust safety science
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principles to ensure reliability and effectiveness (Brigitta & Dhamanti, 2020). Medication
administration errors (MAEs) represent a significant threat to patient well-being, potentially
leading to adverse outcomes and increased healthcare expenditures. This study seeks to
explore the factors contributing to MAEs and investigate evidence-based strategies to bolster
patient care quality.
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Factors Contributing to Patient Safety Risks:

A case study spotlighting a medication error incident involving Nurse Ella and patient Mr.
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Wallace underscores the intricate nature of patient safety risks within healthcare institutions.
While nurses serve as frontline caregivers in medication administration, factors such as
inadequate training, communication breakdowns, prescribing errors, and stress contribute to
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MAEs.

1. Lack of Knowledge and Training:

Inadequate grasp of drug doses, interactions, and adverse effects, compounded by insufficient
training, significantly contributes to medication errors. Research indicates that a notable portion
of medication errors stems from inadequate nurse training (Hassen et al., 2022).

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2. Communication Gap Among Healthcare Professionals:
Ineffective communication and collaboration among healthcare staff, including nurses,
pharmacists, and physicians, can precipitate medication errors. Institutions experiencing
communication gaps among staff members witness heightened rates of MAEs (Ghasemi et al.,
2022).

3. Prescribing Errors:
Inaccurate prescription practices, such as incomplete or illegible prescriptions, substantially
contribute to medication errors. Evidence suggests that poorly written prescriptions are a

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primary cause of prescribing errors (White et al., 2019).

4. Stress, Burnout, and Mental Health Challenges:

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Elevated stress levels among nurses, stemming from workload pressures and burnout, elevate
the likelihood of medication errors. Nurses experiencing burnout are more susceptible to patient
care and medication errors (White et al., 2019).

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Evidence-Based Best Practices Solutions:
To fortify patient safety and diminish medication errors, evidence-based solutions and best
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practices are imperative. Key strategies encompass the Quality and Safety Education for
Nurses (QSEN) approach, medication reconciliation protocols, computerized physician order
entry (CPOE) systems, barcode medication administration (BCMA) systems, clinical decision
support systems (CDSS), and value-based formulary management strategies.
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1. Nurse-Led Coordination to Optimize Patient Safety:

Nurses, in collaboration with other healthcare professionals, wield substantial influence over
medication administration accuracy. Transparent communication and collaboration among
nurses, physicians, and pharmacists diminish errors and enhance patient safety and
cost-effectiveness in healthcare settings.
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2. Collaboration with IT Personnel for Technological Advancements:

Effective collaboration between nurses and IT personnel ensures the efficient utilization of
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technological tools such as CPOE, BCMA, and CDSS, pivotal in preventing medication errors
and enhancing patient outcomes.
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3. Holistic Care Approach through Interdisciplinary Teams:

A holistic approach to patient care, facilitated by interdisciplinary teams and adherence to
regulatory standards, mitigates the risk of medication errors. Nurses collaborating closely with
other stakeholders prioritize patient safety and cost-effectiveness in healthcare delivery.

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Conclusion:
Medication administration errors pose substantial risks to patient safety and escalate healthcare
expenditures. By identifying contributing factors and implementing evidence-based strategies,
such as enhanced training, improved communication, technological advancements, and
interdisciplinary collaboration, healthcare institutions can effectively mitigate these risks and
ensure high-quality patient care. Efficient collaboration between nurses and other stakeholders
serves as a cornerstone in enhancing patient safety and achieving favorable healthcare
outcomes.

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References
Alrabadi, N., Shawagfeh, S., Haddad, R., et al. (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

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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

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Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., et al. (2020). Improving patient
safety through a pharmacist-led medication reconciliation program in nursing homes for the

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elderly in Spain. International Journal of Clinical Pharmacy, 42(2), 805–812.
https://doi.org/10.1007/s11096-020-00968-
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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
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Skalafouris, C., Reny, J.-L., Stirnemann, J., et al. (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
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Watanabe, Y., Claus, S., Nakagawa, T., et al. (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
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Weinmeyer, R. M., McHugh, M., Coates, E., et al. (2021). Employer-led strategies to improve
the value of health spending: A systematic review. Journal of Occupational & Environmental
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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

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