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NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

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    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Student Name

    Capella University

    NURS FPX 4020 Improving Quality of Care and Patient Safety

    Prof. Name

    Date

    Improvement Plan Tool-Kit

    The Acadia General Hospital has been encountering medication administration erors compromising patient safety, for which safety improvement plan has been developed in previous assessment. This improvement plan toolkit addresses medication administration errors and enlightens the healthcare workforce of AGH with a better understanding of the safety improvement plan. This will potentially persuade the healthcare workforce to implement the safety improvement plan as it is based on evidence-based scholarly articles.

    The resource toolkit is prepared by thorough research on medication administration errors via multiple databases such as CINAHL, Google Scholar, PubMed, JSTOR, and PubMed Central. The resource tool kit focuses on four categories related to medication administration: Introduction to medication errors, Risk factors of medication administration errors, Nurses’ role in preventing medication administration errors, and Evidence-Based practices for minimizing medication administration errors.

    Introduction to Medication Errors

    Carver, N., Hipskind, J. E., & Gupta, V. (2019). Medical error. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430763/

    This resource covers medical errors from its introduction, issues of concern, and risk factors to clinical. significance. According to this resource, medication errors can be directed to different events varying in the magnitude of patient harm. The avoidable medication adverse events cause 44,000 to 98,000 mortalities in US hospitals. The resource further describes types of medical errors, comprising wrong dose, drug, patient, route of administration, diagnostic, and system errors. These events incur heavy costs to the community that range between 37.6 to 50 billion dollars, including additional healthcare costs, loss of productivity, and disability.

    The resource also emphasizes the multifaceted approaches to control errors, including error reporting culture, implementation of legislative measures to enhance patient safety, and use of strategies to prevent medication errors, such as using technology and improving communication among interdisciplinary teams. This resource is helpful for nurses to understand what medication errors are, their prevalence, and their types.

    This will lead to reduced risk to patient safety and improved quality of care with medication administration. Furthermore, nurses can use this resource in their healthcare settings, such as Acadia General Hospital, to understand factors leading to medication errors and strategies to avoid them. This will create an organizational culture prioritizing patient safety and reducing patient harm due to medication errors.

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2). https://doi.org/10.1136/bmjqs-2019-010206

     This study by Elliot and colleagues (2021) mainly focuses on the prevalence of medication errors and economic burden in England. This resource highlights that 237 medication errors occur in England annually, of which 66 million are of significant clinical value. Moreover, implications of these errors include the utilization of 181,626 bed-days and total costs incurred to NHS up to £98 462 582 per year. This resource is helpful for nurses as it enlightens them on the prevalence of medication errors outside the U.S. and the financial repercussions.

    Moreover, nurses can gain insights from this resource on how medication errors can cause a financial burden on the country and how these preventable adverse events can result in a better and more stable economy if the appropriate measures are adopted timely. Nurses can use this resource to understand medication errors from an economic perspective in their healthcare setting. Additionally, it can improve nurses’ work performance when they have adequate knowledge of the subsequent consequences of medication administration errors. 

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Rodziewicz, T., & Hipskind, J. (2020). Medical error prevention (pp. 1–37). http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf 

    This resource talks about the prevention of medical errors. This resource highlights multiple adverse events, including medication-associated errors, with their causes and preventive strategies. Moreover, it discusses healthcare technologies to prevent medication errors, such as electronic health records and computerized prescriber order entry. It guides nurses in preventing medication errors due to communication errors by integrating “read back” strategies on telephone orders and enhancing multidisciplinary team collaboration. Nurses can use this resource to discover the types of errors and preventive strategies to reduce the incidence of these errors in Acadia General Hospital (AGH) and better understand the safety improvement plan where technology is required.

    Risk Factors of Medication Administration Errors

     Walker, D., Moloney, C., SueSee, B., Sharples, R., Blackman, R., Long, D., & Hou, X.-Y. (2022). Factors influencing medication errors in the prehospital paramedic environment: A mixed method systematic review. Prehospital Emergency Care, 1–37. https://doi.org/10.1080/10903127.2022.2068089

    This study by Walker and colleagues (2022) highlights various factors contributing to medication administration errors. These include organizational factors such as a culture that does not encourage patient safety, understaffing, and inadequate resources and reporting systems. Medications with poorly labeled packaging and confusing names, such as look-alike-sound-alike medication, are medication-related factors that lead to medication errors. Additionally, external interruptions and inadequate lighting are environmental factors influencing medication errors.

    Other factors include procedure-related factors (poor medication verification processes) and cognitive factors (cognitive overload, poor memory, and confirmation biases). This resource provides a comprehensive list of factors that nurses can use to gain adequate knowledge on contributing factors towards medication errors and must take suitable measures to prevent them. This requires interdisciplinary collaboration and resources to eliminate these factors. Nurses of AGH can utilize this resource to learn about key factors that hinder patient safety and work accordingly to reduce medication errors owing to these mediators. 

    Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    This resource highlights medication administration errors and contributing factors among nurses that lead them to medication errors, reducing patient safety. The authors identified that lack of adequate training, inadequate work experience, and unavailability of proper guidelines for medication administration were major nurse-oriented factors that caused medication administration. Other factors are interruptions during medication administration and night duty shifts, which causes burnout among nurses.

    Nurses can use this resource to undermine these factors, their prevalence, and strategies to eliminate them in their nursing practices. This resource also highlights that continuous training on safe medication administration, crafting guidelines on medication administration, enabling a conducive environment for nurses to administer medication safely, and retaining trained nurses are the strategic steps to overcome the described factors. Nurses of AGH can use this resource to better implement the safety improvement plans by having clear insights into related factors of medication administration errors.

    Jessurun, J. G., Hunfeld, N. G. M., Roo, M., Onzenoort, H. A. W., Rosmalen, J., Dijk, M., & Bemt, P. M. L. A. (2022). Prevalence and determinants of medication administration errors in clinical wards: A two‐centre prospective observational study. Journal of Clinical Nursing, 32(1-2). https://doi.org/10.1111/jocn.16215

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    This resource discusses the prevalence and determinants of medication administration errors in hospitals. The identified determinants were related to the complexity of pharmaceutical dosage forms, complex patient populations, and working conditions. These determinants were the significant contributors to medication errors. About 25.2 % of parenteral medication errors. The resource further highlights that these factors must be targeted to prevent structural errors and improve patient safety by implementing suitable strategies. Nurses can use this resource to understand how different dosage forms with complex names and identities contribute to medication errors. Moreover, this resource directs nurses on targeting these factors to prevent medication errors and enhance patient safety.

     Nurses’ Role in Preventing Medication Administration Errors

    Hanson, A., & Haddad, L. M. (2022). Nursing rights of medication administration. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560654/

    This article highlights how nurses can influence medication administration and enhance patient safety. This article describes the five rights of medication administration, commonly called the “five R’s of medication administration.” These rights refer to right patient, right drug, correct route, right time, and right dose. Nurses must identify the patient for whom the medication is prepared by asking for his full name, medical wristbands, or medication administration charts.

    Moreover, the right drug is ascertained by double-checking the medication with adequate attention and collaborating with physicians in case of a misunderstanding of hand-written prescriptions. Lastly, the correct route, time, and dose are calculated by having a basic understanding of medication and coordinating with pharmacists in case of dose miscalculation or misunderstanding. This resource is helpful for nurses of AGH as they must have adequate training on implementing these five rights of medication administration and can use this resource to understand their practicality comprehensively. 

    Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2021). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62(62). https://doi.org/10.1016/j.pedn.2021.08.024

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    This systemic review and meta-analysis by Marufu and colleagues (2021) highlight the role of nurses in reducing medication errors in pediatric and neonates by multiple strategies. These interventions include computer-assisted drug dosing and administration, simulation training programs on double checking, implementing the five rights of medication, and recognizing barriers to reduce interruptions during calculation and preparation.

    Other improvement strategies included policy change, change of process, educational programs, and hospital-wide safety initiatives to promote patient safety and reduce patient harm. This resource can benefit nurses as it can help them better understand the intervention to stop medication administration errors, which are also part of a safety improvement plan designed to reduce medication errors in AGH. This resource is helpful for nurses to implement these strategies in their organization and enhance their knowledge of practical implementation to improve patient safety and quality of care.

    Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 1–15. https://doi.org/10.3390/ijerph17062028 

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    This resource presents a detailed review on nurses’ adherence to patient safety principles and how various factors influence nurses’ adherence to these principles. Some of these factors are individual to nurses’ attitudes, perceptions, information seeking and knowledge, which contribute towards adherence or inconsistent adherence behaviors to follow guidelines of safe medication administration. Other barriers to adherence to safety principles include a lack of patient engagement, interdisciplinary collaboration, higher rates of external interruptions, and a lack of appropriate infrastructure to perform medication preparation tasks. 

    This resource can guide nurses about the factors that encourage and hinder their adherence to medication safety principles. They can use this resource to evaluate how they can use the strategies to increase adherence to safety principles in AGH and how to address the concerns that hamper their nursing practices of safe medication management. 

    Evidence-Based Practices to Minimize Medication Administration Errors

    Mulac, A., Mathiesen, L., Taxis, K., & Granås, A. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223 

    This resource promotes the use of barcode medication administration to minimize medication errors in hospitals. The barcode medication administration is an innovative healthcare information technology that helps practically implement the five rights of medication administration where the right drug is matched with the patient’s barcode of prescribed medication on the wristband. The barcode on the medication is matched with the one on the patient’s wristband before administration. This resource further highlights how nurses use this technology in hospital practice and whether the technology is effectively utilized or poorly implemented.

    The results showed that 66% of nurses deviated from BCMA policy use during dispensing and 71 % during administration. Moreover, nurses could not scan 29% of medications and 20% of patients’ wristbands, leading to disrupted workflow and increased chances of medication errors. This resource emphasizes that nurses must adapt to work systems that enhance adherence to policy and optimize technology use to see promising results in patient safety post-implementation of BCMA. This resource is helpful for nurses to understand how BCMA can be effectively utilized and enhance patient safety by optimizing BCMA use.

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Moreover, nurses can use this resource to understand the existing loopholes even after implementing BCMA but without practical use. Nurses of AGH must learn to adapt to policies of BCMA use and factors that disrupt its functioning that might be related to technological factors (low battery, system freezing), environmental factors (patient drawer size, medication room location), or nurse-oriented factors (non-adherence to policies and inconsistent use of BCMA).

    Suleiman‐Martos, N., Gomez‐Urquiza, J. L., Aguayo‐Estremera, R., Cañadas‐De La Fuente, G. A., De La Fuente‐Solana, E. I., & Albendín‐García, L. (2020). The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta‐analysis. Journal of Advanced Nursing, 76(5), 1124–1140. https://doi.org/10.1111/jan.14318

    This resource stresses the implementation and effectiveness of mindfulness training among nurses. This resource shows that burnout in nurses causes increased chances of medical errors impacting patient safety and quality of care. For this purpose, mindfulness training is a practical approach where nurses are trained to consistently focus on the present task, i.e., medication administration. The mindfulness-based interventions include stress reduction (MBSR), cognitive therapy (MBCT), self-care, and resilience (MBSCR). These training sessions promote self-awareness and motivation toward behavioral change, leading to a focused medication administration.

    These training sessions reduced the emotional impact of burnout and improved the working performance of nurses. Nurses can find this valuable resource as they experience work burnout, and nurse leaders can conduct such mindfulness training sessions to reduce burnout among nurses and enhance work productivity, leading to reduced medication administration errors and improved patient safety. This resource can be used to implement the safety improvement plan for nurses of AGH better as it also focuses on training nurses on mindfulness.

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Labrague, L. J., Al Sabei, S., Al Rawajfah, O., AbuAlRub, R., & Burney, I. (2021). Interprofessional collaboration as a mediator in the relationship between work environment, patient safety outcomes, and job satisfaction among nurses. Journal of Nursing Management, 30(1). https://doi.org/10.1111/jonm.13491z

    This study, published in the Journal of Nursing Management, promotes interdisciplinary collaboration. to enhance patient safety outcomes and job satisfaction. The study describes that interdisciplinary collaboration bridges the relationships between positive work environments, enhanced patient safety outcomes, and improved nurses’ job satisfaction. The organizational culture that encourages interdisciplinary communication and coordination provides nurses with a conducive environment to share medication-related concerns, minimizing administration errors due to a lack of communication and misunderstanding among interdisciplinary teams.

    This ultimately leads to improved patient safety outcomes. Consequently, nurses experience increased job satisfaction. This resource is helpful for nurses as they must collaborate with interdisciplinary team members such as physicians, pharmacists, IT personnel, and healthcare administrators. Hence, nurses can use this resource to understand ways to collaborate with multidisciplinary teams to improve patient safety outcomes. This resource is also practical for nurses of AGH as the safety improvement plan requires interdisciplinary collaboration to efficiently utilize BCMA technology and policy development for better adherence to patient safety principles.

    Conclusion

    This resource toolkit comprises four categories of evidence-based scholarly studies that promote patient safety in the context of medication administration. This is crafted for nurses of AGH who can understand the safety improvement plan designed in assessment 3 in a better way through these research-based data on medication administration. The four categories are an introduction to medication errors, risk factors of medication administration errors, nurses’ role in managing medication errors, and evidence-based practices to minimize medication errors. Moreover, their usefulness and value for nurses have been highlighted thoroughly.

    References

    Carver, N., Hipskind, J. E., & Gupta, V. (2019). Medical error. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430763/ 

    Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2), bmjqs-2019-010206. https://doi.org/10.1136/bmjqs-2019-010206 

    Hanson, A., & Haddad, L. M. (2022). Nursing rights of medication administration. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560654/ 

    Jessurun, J. G., Hunfeld, N. G. M., Roo, M., Onzenoort, H. A. W., Rosmalen, J., Dijk, M., & Bemt, P. M. L. A. (2022). Prevalence and determinants of medication administration errors in clinical wards: A two‐centre prospective observational study. Journal of Clinical Nursing, 32(1-2). https://doi.org/10.1111/jocn.16215 

    Labrague, L. J., Al Sabei, S., Al Rawajfah, O., AbuAlRub, R., & Burney, I. (2021). Interprofessional collaboration as a mediator in the relationship between work environment, patient safety outcomes, and job satisfaction among nurses . Journal of Nursing Management, 30(1). https://doi.org/10.1111/jonm.13491 

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2021). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62(62). https://doi.org/10.1016/j.pedn.2021.08.024 

    Mulac, A., Mathiesen, L., Taxis, K., & Granås, A. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223 

    Rodziewicz, T., & Hipskind, J. (2020). Medical error prevention (pp. 1–37). http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf 

    Suleiman‐Martos, N., Gomez‐Urquiza, J. L., Aguayo‐Estremera, R., Cañadas‐De La Fuente, G. A., De La Fuente‐Solana, E. I., & Albendín‐García, L. (2020). The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta‐analysis. Journal of Advanced Nursing, 76(5), 1124–1140. https://doi.org/10.1111/jan.14318 

    Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 1–15. https://doi.org/10.3390/ijerph17062028 

    NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

    Walker, D., Moloney, C., SueSee, B., Sharples, R., Blackman, R., Long, D., & Hou, X.-Y. (2022). Factors influencing medication errors in the prehospital paramedic environment: A mixed method systematic review. Prehospital Emergency Care, 1–37. https://doi.org/10.1080/10903127.2022.2068089 

    Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0