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NURS FPX 8030 Assessment 1 Building the Case for Healthcare Improvement

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    NURS FPX 8030 Assessment 1 Building the Case for Healthcare Improvement

    Student Name

    Capella University

    NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner

    Prof. Name

    Date

    PRESENTATION OUTLINE

    Medication or Drug Error as a Patient Safety Issue at Healthy Elite Metropolitan Medical Center

    Objectives:

    • Identify internal practices necessitating change to address medication errors.
    • Determine organizational priorities in addressing medical errors.
    • Develop interventions and a Quality Improvement Project.

    PATIENT SAFETY ISSUE: Medication/Drug Errors

    Medication errors rank as the third leading cause of death in the United States (Ferrah et al., 2017). One in seven patients in healthcare organizations falls victim to medication errors. Key medical errors include technical errors, delayed diagnosis, medication errors, inadequate post-procedure monitoring, and failure to act on test results.

    PATIENT SAFETY ISSUE: Medication Error at Healthy Elite Metropolitan Medical Center

    Medication errors attributed to poor communication, administration of incorrect dosages, negligence by healthcare staff, and electronic medical record failures.

    INTERNAL EVIDENCE OF MEDICATION/DRUG ERROR

    Medication errors at Health Elite Metropolitan Medical Center contribute to increased lawsuits, patient deaths, and healthcare service costs. The organization incurred a loss of over $17.4 million in lawsuits within the last 12 months. Medication errors resulted in the layoff of over 20 healthcare workers, impacting healthcare service delivery.

    INTERNAL EVIDENCE OF MEDICATION/DRUG ERROR

    Timeframe

    • Within 12 months 40 –
    • Within 4 weeks 15 –
    • Within 8 weeks 13 –

    EXTERNAL EVIDENCE OF MEDICATION/DRUG ERROR

    Medication errors are a common patient safety concern globally (Mulac et al., 2021; Ferrah et al., 2017). Research indicates a 19% prevalence of medication errors in over 36 US healthcare organizations (Mulac et al., 2021). Causes include unauthorized medication administration (4%), omission errors (43%), and wrong dosage administration (17%).

    ORGANIZATIONAL PRIORITY FOR INTERVENTION

    Medication/drug errors significantly impact patient health, organizational operations, and community health. Consequences include severe physical, emotional, and psychological injuries, financial burdens, reduced community trust, and potential caregiver shortages. Creating awareness among patients can reduce errors, and community concern arises from the loss of loved ones and caregiver shortages.

    QUALITY IMPROVEMENT PROJECT AND PATIENT OUTCOME

    Quality improvement interventions:

    • Development of a verification system for medication prescriptions.
    • Use of barcodes.
    • Creating awareness about counterchecking lookalike drugs.
    • Implementing an effective medication error warning system.
    • Encouraging interdisciplinary collaboration.

    REFERENCES

    Ferrah, N., Lovell, J. J., & Ibrahim, J. E. (2017). Systematic review of the prevalence of medication errors resulting in hospitalization and death of nursing home residents. Journal of the American Geriatrics Society, 65(2), 433-442.

    Hines, S., Kynoch, K., & Khalil, H. (2018). Effectiveness of interventions to prevent medication errors: an umbrella systematic review protocol. JBI Evidence Synthesis, 16(2), 291-296.

    Mulac, A., Taxis, K., Hagesaether, E., & Granas, A. G. (2021). Severe and fatal medication errors in hospitals: findings from the Norwegian Incident Reporting System. European Journal of Hospital Pharmacy, 28(e1), e56-e61.

    Wheeler, A. J., Scahill, S., Hopcroft, D., & Stapleton, H. (2018). Reducing medication errors at transitions of care is everyone’s business. Australian prescriber, 41(3), 73.

    NURS FPX 8030 Assessment 1 Building the Case for Healthcare Improvement