Health care is an important aspect in human life through out the world since it’s through this concept that ensures the continuity and development of human beings. It’s important to note that someone is referred to be in a good health status when the body is free from diseases and sickness that may comprise the perfect body organs operation. It is therefore a matter of concern to observe or rather prevent or avoid unhealthy actions that are directly or indirectly related to the illnesses.
although different preventive methods and measures have been applied in pursuit to eliminate illnesses and diseases or abnormalities, it has become the order of the day to find that diseases and other major and minor health disabilities are on the increase. It is through these experiences that we find nowadays there has been a tremendous increase in hospitals or medical centers and paramedics, which however is still far away in meeting the target of best healthcare. Due to the health status medication has therefore been subjected to heavy demand.
In united state of America health care systems has been affected by various factors which have caused negative impact in the life of human beings or the patients. Medication has been aimed to heal the patient and regain his proper health conditions. It is therefore not surprising to realize that medication errors have otherwise become the contributor to more injury or even death to the patients in the USA. It has also been observed that more dangerous consequences like permanent disabilities or irreparable condition have been as a result of medication errors that may arise from a couple of factors.
In attempt to deal with medication errors, research has been carried out in various medical centers, pharmacies, hospital etc which according to Kanse L. (2006), medical errors have been listed among the causes of death in United States therefore posing a serious condition more that it could have been thought. Before tackling the economical aspect of medical errors, various factors that are related to these errors can be considered. They can occur in different stages in the process of treatment.
For instance, once the patient meets the medical practitioners or doctor, he or she examines the patient in accordance with the medical situation at hand. Sometimes its necessary for the patient to undergo the laboratory tests. Medical errors might occur in the process of laboratory tests hence producing negative results. This wrong results when used by the medical practitioners or doctors leads to the wrong prescription to the patient which can have adverse effect to him or her. Sometimes premature laboratory results can also be used unknowingly hence carrying wrong medication to the patient.
The obligation of prescribing medicine lies with the trained paramedics however regardless of the experience and the training on their side wrong prescription still do occur especially when no test like laboratory tests or other medical checkup equipment has been involved. A lot of assumption and theoretical technicians should be extremely cautious while doing the tests especially that there has a tremendous increase of related diseases and unexpected variety of germs, virus and bacteria which has triggered more research in the medical field. It is during these laboratory tests that some unexpected abnormal results might occur.
Due to one reason or another manipulation of the laboratory results especially when strange test results are discovered might lead to wrong assumptions which may be applied in the determination of the condition of the patient. In other words lack of correct and efficient methods of dealing with laboratory results which produces unexpected or abnormal results might lead to medication errors. Based on the reliance on the experiments, trends and progress in medical research and treatments in the medical field, references and records have played a very significant role.
In the process of treatment and condition of the patient, there has always been consideration of similar previous cases. That means record keeping is important. Due to the bulkiness and a lot of records that are involved in medical field, improved filling systems has always been necessary. Advanced technologies in documentation in the medical centers are supposed to be adopted in attempt to reduce errors that arises in treating patients. According to Low and Belcher (2002), use of ancient filling systems and reluctance of adopting the improved and computer based filling technologies has contributed much in medication errors.
It can also be observed that a lot of manpower is required in old filling system which adds to the errors in filling which alternatively leads to the medications errors. Before the patient starts to use the medicine, the medical practitioner has to first examine the patient, and prescribe the medication to be used. It’s only after that the patient will be administered with the drugs prescribed and correct dosage. Drug dispensing has to follow the correct dosage as prescribed by the doctor or the medical practitioner.
In the process of dispensing medication, it has been noted that there has been a lot of errors that have been encountered in this process which has caused pain, suffering or even death to the patient. However, some cases of wrong dispensing of drugs have been realized before or after the patient has started the dosage and they have been corrected therefore causing minimum or no effects to the patient. Correct medicine or drug and the correct dosage should correspond to give better results to the patient.
This has always been the target for effective outcomes in the medicine field but how does the errors in dispensing medicine occur? This question has variety of answers. First of all, incompetence and lack of adequate knowledge on the staff responsible for administering or giving the drug to the patient consequently leads to giving of the wrong drugs to treat the patient. These drugs especially when taken by the patient for the wrong disease and also contrary to their dosage may be a major source of suffering or might even cause permanent disability or even death.
Contrary, to the suffering of the patient they might add the pain to the patient. Still on the point of inadequacy of knowledge, the pharmacist or the nurse might give the wrong dosage to the patient. Sometimes this happens due to wrong understanding on the prescribed medicine and dosage. Some cases result to be more complex in wrong dosage especially when methods like injections are used. The body might react abnormally and before the situation is corrected heavy damage might have been caused.
Some information is vital especially to some patients who suffer frequently due to their weak immune system in their bodies which in some cases if their health history is not clearly considered and the amount of drugs have been previously taken during the dispensing of the medications, errors can be done which might lead to overdose or even unacceptable mixing of drugs in the body. This indeed can be a terrible situation to the patient hence resulting to undesirable condition. In other cases devastating side effects occurs after a period of time from the day when the patient commenced on the use of the drugs.
These are among the dangerous conditions because the reaction of the drugs in the body might do internal damage without first being noticed especially if they contain the pain killing effect. Irrespective of the scientific and unique names that are used in the drugs, some have very confusing and similar names which might end up confusing while being given to the patient. This factor can contribute to the errors in dispensing medication. It can also be argued that inadequacy of staffing and the fatigue and exhaustion experienced by majority of the staff may result in errors in dispensing and medicines.
A lot of work and tiresome duties in the pharmacy or medical field has also been blamed since according to Copping, C. (2005), research has revealed that lack of concentration which is as a result of exhaustion causes the staff to unknowingly and inappropriately uses the wrong medication to the patient. This has been witnessed especially on the understaffed pharmacies and medical centers leading to overworking. This situation is mostly worsened by the fact that some drugs are not appropriately labeled and some of the important information about the drug missing.
Medication errors have been critically analyzed in collaboration with the pharmacies and medical centers and hospital which when quantified have been found to cause a huge illogical financial impact in the United States. Human life is always considered to be an expensive “commodity” especially by the fact that it can’t be replaced. Based on this fact the aspect of health has been an expensive exercise especially when the economical contribution factor is considered. A medication error physically affects the person which can cause him/her a lot of suffering and a lot of pain.
For these conditions of suffering and pain to be eliminated, financial aspect has to be applied. According to the research carried out by institute of medicine (IOM) figure like $37. 6 billion annually. This figure is not specific under which circumstances are considered. In terms of compensation due to the medication errors causing pain and suffering as a result of injuries caused, exact figures have not yet been defined since the resultant situations and conditions differ from one to another but the compensation rate is very high especially when it’s considered that the effects will affect the economical welfare of the affected patient.
In the case of death of the patient as a result of medication error, it can be quite an expensive situation to deal with especially if the court and the legal process is involved. No exact monetary figures that can be given since it will mostly depend on the condition the situation under which the suit has been filed. In most cases, same assumptions are made based on the ruined life of the patient and the years under the circumstances that results from the condition caused by the medical errors.
Following all these factors a lot of money has been spent in the United States which have caused a reasonable financial impact. It is not surprising to know that the huge figures are calculated in terms of billion dollars with the aim of sustainability and independency in the medical field trustworthy health care system is essential. There has been a negative financial impact to the health care system due to medication errors which has led to lesser financial support in medical field. There has been an urgent need therefore to improve and reduce the medication errors in the medical fields.
Different strategies have been implemented to reduce these errors. In order to begin prevention of medication errors from occurring it is useful to first examine the reasons why they occur. Griffith, R. ; griffiths, H. & Jordan, S. (2003) attempted to highlight the cause of errors in healthcare delivery, in their document ‘An Organization with a Memory’. They concluded that human error, rather than causing mistakes, was itself caused by the failure of the systems that are in place to safeguard our patients.
This would seem to place responsibility for reducing errors on the management teams within the NHS. However attractive an option it is to shift individual blame, each nurse has a professional responsibility and should certainly consider their role in risk assessment and error prevention. Technology can have negative consequences if the benefits arising from its use make us lazy as to forget the basics. Advanced pharmacological technology has produced increased errors in drug dispensing especially during ordering as well as dispensing.
This paper asserts that technological advancement must be embraced with care. Under-reporting is another area where improvements need to be made. This is considered a problem mainly because of the many learning opportunities that are lost due to failure to report. It is suggested here that reporting should be encouraged in order to allow learning from the mistakes made. Staff should not feel that they might be disciplined for reporting incidents. Bond, C. A, Raehl, C.
L, Franke, T (2002), carried out a longitudinal study of medication errors in a Scottish children’s hospital. It was found that error reporting increased as a result of assurances that action taken would not be aimed at punishing the person reporting or the one who erred. Fear of reprisal causes many nurses to fail to report incidences when error occurs. Another question that begs an answer is the level and sufficiency in the nurses training and knowledge. Several studies suggest that poor drug knowledge accounted for a big percentage of drug errors.
If a nurse recognizes that they have insufficient knowledge about drugs, then the nurse has to set individual learning targets to aid their learning, they are both accountable and responsible for their practice. Nurses also need to discuss this with a senior colleague and attend a pharmacology course to gain more confidence in drug administration and drug names. The nature of modern healthcare dictates that nursing care is often delivered in a busy and disruptive environment. It is not surprising then to find that patients are not always receiving the correct drug, at the right time and at the correct dosage.
Clearly, the potential for error in drug administration on the hospital wards makes this a problem of concern for nursing staff everywhere and there is certainly a strong argument for change in the rules and procedures applied in drug administration. Nurses often perceived distractions to be contributing to an increase in errors. Regardless of the availability of research, common sense would dictate that any task involving medication administration should be undertaken with the nurse’s full concentration.
The ideal environment in which to deliver nursing care should have the least distractions possible with low noise levels. Such factors are often outside the individual nurses’ control, however the literature does suggest a number of systems approaches to deal with the constant interruptions from other members of the multi-disciplinary team, visitors and patients at times when the nurse needs to concentrate most. Although much of the academic literature on drug errors comes from America, it is now accepted that these findings are applicable to other regions of the world.
The use of signage to draw attention to the need for concentration during drug rounds has been a subject of discussion. The idea was introduced into a hospital in the U. S where the signs were placed at strategic areas including medication trolleys. At the same time new protocol was introduced to the ward that required nurses to avoid conversation and prevent interruptions during drug administration. The signage proved to be very popular with a big number of nurses being very cooperative. The results were very encouraging. There is no doubt that technological innovations have saved and extended the lives of many patients.
But, increasingly, high-tech health care has had negative effects – often unexpected – on the health and quality of life of patients (Johnson W. 1992). An instructive example is the introduction of a simple piece of technology such as the latex glove. Our move away from commonsense procedures, such as hand-washing, has contributed to a high incidence of infection in hospitals. Inappropriate pharmacological intervention, such as the over-prescription of antibiotics, has also contributed to the increase of ‘super’ infections due to the creation of new, resistant strains of bacteria.
It has been suggested that there may be technological solutions and that pharmaceutical manufacturers could adapt their products in order to help nursing managers in their quest to lessen drug errors. Innovations such as ready to use pre-filled syringes and infusions, diluents products that can be permanently connected to drug vials during administration, ampoules and vials with flag labels that can be transferred to easily label syringes and infusion bags are some of the steps already taken by drug companies in order to help the nurse to avoid errors and could be introduced more widely.
The introduction of the Centralized Intravenous System (CIVAS) has moved a difficult and risk prone aspect of drug administration away from the nurse and into the hands of those best suited for the role, a simple and cost effective, but valuable solution (Williams CK & Maddox RR. 2005). The number of intravenous drugs supplied by the CIVAS service is currently limited and further study is required to investigate the implications of broadening the service to include all intravenous medications, thereby presumably further lowering the risk of error.
Although providing pre-mixed drugs does remove some of the risk, it is still the responsibility of the nurse to consult the specific guidance for administering the drug, as they need to be aware of its actions as well as any possible side effects relevant to the individual patient and their current condition. No amount of pre-prepared drugs can absolve the nurse of the responsibility of correctly following guidelines and protocols for safe drug administration. There are benefits to a CIVAS service in addition to financial ones.
The most important being increased patient safety. This is due to much less risk of microbial and particulate contamination, as reconstitution is done aseptically and reduction in medication error as the reconstitution is done by trained, dedicated staff in quiet working environment. Conclusion Drug errors are costly in terms of increased hospital stay, patient injuries, lives lost and are a source of personal anxiety to the professional nurse, with careers possibly ruined as a consequence.
Drug error has to be addressed in order to safeguard the patients’ well being, to increase public trust in the health institutions under the NHS and to reduce the financial loss that result from these errors. This cannot be done without involving the healthcare staff mainly the nurses because as studies suggest they spend about 40% of their time dispensing medication to the sick. This is a considerable amount of time in which the drug errors can occur.
To avoid developing complacent and relaxed attitudes towards drug administration, nurses should be prepared to challenge existing working practices through proactive action planning. Several areas of weakness have been highlighted as well as the various recommendation suggested. It is believed that if these are put in place, then it will be a big step towards reducing the incidences of drug errors.
Different aspects of the nursing profession as well as their working environment have been the centre of focus for this paper since this is the only way to truly identify the different loopholes that cause mistakes in drug administration. The main areas included distractions and disruption that are as a result of the nature of the work environment for nurses. The wards are usually busy with one nurse attending to more than several patients. Therefore all efforts need to be made to tackle the weaknesses that have been highlighted in this paper.
Patient safety is one of the biggest challenges that the NHS faces at present. As health professionals we have to ensure that all the care we provide in hospital and in the health service is as safe and reliable as possible. Clearly more study and emphasis needs to be placed on finding and implementing simple and cost effective methods to reduce drug errors. Reference Bond, C. A, Raehl, C. L, Franke, T (2002). Clinical pharmacist staffing in United States hospitals. Pharmacother. ; 22:1489-1499. Copping, C. (2005) Preventing and reporting drug administration errors.
Nursing Times, 101, 33, 32-33 Griffith, R. ; griffiths, H. & Jordan, S. (2003) Administration of medicines part 1: the law and nursing. Nursing Standard, 18, 2, 47-53 Johnson W. (1992). The economic consequences of medical injuries. JAMA; 267: 2487- 2492. Kanse L. (2006) Error recovery in a hospital pharmacy. Ergonomics; 49: 503-516. Low and Belcher (2002). Reporting medication errors through computerized medication administration. CIN. ; 20:178-183. Williams CK & Maddox RR. (2005) Implementation of an I. V. medication safety system. Am J Health Syst Pharm. ; 62:530-6.