Healthcare Policy And Quality Essay

The essay willing examine the management of medicaments indemnity on standards in music errors by nurses in the hospital environment, the road maps that nurses must follow when tolerant medical specialty in order to deflect medicament errors. A definition for answer of medicinal drug error will be give. raise issues to be discussed include wherefore medicine error happens, approaches aimed at minimising form of medicine error and the importance of groupwork , a brief reflection and a deduction based on the findings will be given. The aim of medicine appendage involves different wellness forethought passkeys as a result , medical specialty error fire take place relating to a series of travel in the dose delivery answer, and includes the serve of prescribing, dispensing, transcribing and administration (Chua et al., 2009 Zhan et al., 2006), in that locationby devising room for error to take place. Subsequent to prescribing errors, the administration of medicament errors is the most frequent type as they argon more than likely to buy the farm the longanimouss and the greater chance of causing patient role scathe (Chua et al.,2009).The legislation of medicines applies to prescribing, supply, computer memory and administration and it is heavy to wear lie withledge of and adhere to this legislation (Nursing & midwifery Council (NMC), 2008 Royal Pharmaceutical Society of Great Britain (RPSGB) (2009).The medicine management constitution on standards in notifying medication errors, near misses and ill medicate reactions was located on the local anaesthetic Trusts website and was easy to access. The topical anesthetic trust is an acute, non-profit, health service. From the policy alone provide involved in the prescribing , administration, dispensing and checking of medicine has the responsibility to ensure the policy is implemented and adhered to. In the local trust policy it states both member of staff can narrativ e a medication safety incident, near miss or adverse outcome. The local Trust Policy was re messed in January 2012. The trust will besides monitor all medication related incidents and an annual analyse will be carried out to assess the effectiveness of the policy. The analyse will be undertaken on a random selection of 30 cases of reported incidents.This Local Trust implemented the guidelines for the administration of medicines by the Nursing and Midwifery Council (NMC), 2008 which gives the nurture a prescription map must contain for safe and straighten out medicate administration and gives clear principles for prescribing medicines. If the prescription is clear and accurate, errors atomic number 18 little likely to occur. The guidelines in any case states In exercising your professional storyability in the best interests of your patients as a registrant, you must know the therapeutic use of the medicine to be dole outed, its normal dosage,side effects, precautions and c ontraindications,be certain of the identity of the patient to whom the medicine is to be administered , be aw be of the patients plan of worryTo appreciate medication mistakes and discuss policies for reducing and reporting medication errors, it is useable to understand the term medication error. The matter Coordinating Council for medicine Error Reporting and Prevention states a medication error is any preventable event that may cause or lead to out or keeping(p) medication use or patient harm while the medication is in the control of health professional, patient or consumer (cited in Chua et al., 2009 p. 215). divers(prenominal) standards and policies are formed for varied portion and situations as well as routine moments (Unver, 2012). One such standard is the Standard for Medicine charge which replaces the Guidelines for the Administration of Medicines 2004, even though many of its principles remain relevant trainly (Nursing and Midwifery Council (NMC), 2008. This standa rd points out the various ways of managing medicine for nurses as they are required to take responsibility for their actions and omissions for any errors they make when giving any medicine (Copping, 2005). Usually, medical mistakes do not harm patients (Department of wellness (DoH) (2004). Although, the National Patient Safety Agency (NPSA) (2009) gave a scripted account that in England, less than 1% of the key instance of harm or remainder in the National Health Institute (NHS) were getly conjugated to medication error 155 medical instances gave rise to severe harm and 42 deaths. Standards in the NHS are employ to make sure processes and procedures are carried out in a uniform and consistent manner to suffice professionals and patients ( Tzeng et al., 2013).Also , the similar process should be carried out in the resembling waywherever the site or location and under the same circumstance. This uniformity removes errors from personal judgement and panic decisions during situat ions which could ultimately lead to the death of people under various circumstances ( Fore et al., 2012). The administration of medication is likely to be based on errors in nursing as under normal circumstances, nurses are involved in the administration process and they spend 40% of their time giving it (W safe, 2013 Unver et al., 2012). Hence some studies have reported high error rates, indicating that nurses are putting patients in danger, when such errors would cause a low or minor risk to the patient (Wright, 2013). It is of great value to establish the cause of errors so that solutions can be put in place to reduce medication error rates. Although there are medication policies, adherence to these policies are low (Kim and Bates, 2012).Prior to medication administration, the following checks should be make right medication, in the right dose, to the right person, by the right route, at the right time (Kim and Bates, 2012) . Despite the guideline established in the administra tion of medicines using the five rights, nurses may demand in a way and give inaccurate assurance that the practice is safe ( Unver et al., 2012). Non-adherence to the five rights of medicine administration were observed by Kim and Bates (2012), the expressions salute that for defective dose (1.8%), wrong medicine (13%), wrong time (7.1%), wrong person (5.2%) and wrong route (1.8%).An observation of potential error in the administration of medicine was made during a recent clinical arranging in an elderly ward of a local trust. The ward has 30 beds and medicines were supplied in bulk to the ward, though more specific medicines were provided as superstar items on receiving a prescription by the pharmacy department. In addition, medication orders were written by doctors directly onto the patients medication chart without transcribing.The medication was given by nurses by referring to the medication chart. In view of human error, it was noted that the registered nurses on duty w orked over 12 hours a day and Tzeng et al., (2013) noted that taking everything into account nurses function is significantly greater when working a regular 8hour shift compared to over 12hours shift.Further circumstances that contributed to medical errors by nurses includetiredness which can affect parsimony (Copping , 2005), being distracted or interrupted (Wright,2013 Fore 2013), loss of density and a belief to the highest degree limited drug calculation and numeracy skills among nurses ( Ramjan 2011). In addition, Leape et al., (1995) reported former(a) types of medication errors short of knowledge of the drug, study intimately the patient, in breach of the rule, slip and memory lapses, transcription errors, faulty drug identity checking, not interacting with other services, not checking the dose, insufficient monitoring , drug stocking and delivery jobs Unver et al., (2012) also noted that medication error can also be as a result of systematic doers like fundamental wor kload for example, a study carried out by Karadeniz and Cakmakci , (2002) in jokester reported nurses fatigue was the primary cause of medication errors. Another factor is insufficient training . It has been well-known that impudently qualified nurses lack of skills in clinical locatetings affects the occurrence of medication errors. A patients circumstance, that is heterogeneous health conditions), doctor issue (multiple orders, illegible handwriting) and nurse aspect (personal neglect, newly qualified staff, not familiar with medication and patient) .The avoidance of medication errors is exceedingly imperative for patient safety (Unver, et al., 2012). In the early 2000s Pape et al., (2005) was the first to set about the use of aviations sterile cockpit code which has gained awareness in the health care to cut down on distraction during clinical tasks. The process included the use of vests and signs. The words Do Not ail positioned in the medication vicinity were used as p rompts to reduce distraction. Members of staff were also asked not to disrupt or distract the nurse doing the medication round of the ward. As a result , Papes (2003) study frame 63% fewer distraction when using a firm checklist set of rules. Similarly, a study by Federwisch (2008) reported a 50% lessen in the number of staff interruptions, an increase of 50% in the calibration of medication administration, 15% progress in the time vital to administer medications and 18% increase in on-time medication delivery when nurses wore yellow sashes during medication administration.On the whole, to lessen medication errors, the collaboration among doctors,pharmacists and nurses is necessary ( DoH, 2004). Doctors must know their shortcoming and recognize their interconnection with other health care professionals (Pedersen et al., 2007), in particular nurse prescribers who help to ease the work of junior doctors. arrest by another nurse is es moveial as double checking by other nurses in a dherence to the five rights of medicine administration can help reduce an error (DoH, 2004). Subsequently, pharmacists can lessen the chance of errors by being in attendance on the ward drug rounds and come off in their drug knowledge (DoH, 2004). Moreover, everyone in the health care aggroup can help reduce medical errors by keeping a reflective journal (Tzeng et al., 2013 ) as a practical egotism-help tool, though there is a not enough of empirical study to support its blue-chip effects (Fore, 2013). match to Fore (2013), health professionals can reflect by one or more of the subsequent methods welcoming feedback from colleagues about strengths and weaknesses checks on critical incidents to find out what went wrong , why it went wrong and how to avoid a recurrence of an error use of a diary for self evaluation and recognize knowledge gaps. It is generally accepted that system factors presents itself with medication errors in health care, nurses are the health professionals tha t frequently encounter and report medications error ( Roughead and Semple 2008). On the contrary, a study by Unver et al ,(2012) points out, more than half of nurses do not give an account of some medication errors as they are frightened of their colleagues reactions. As a result , it is important to foster a culture that is less fixed on pose guilt to promote communication and error reporting. The need to reduce medication error is a continuing process of timbre returns (Unver et al.,2012). According to Sanders (2005) , to establish risk is the first act to undertake, as any other strategy to reduce risk may be inappropriate. This can be made by means of using tools such as audit ( Montesi and Lechi, 2009).The World Health Organisations (WHO) (2009) fashion model for the classification of problem, process and outcomes of patient safety events is a practical base for a framework to learn the circumstances surrounding medication error. In spite of information of under-reporting o f medication errors, especially by physicians, (Franklin et al., 2007) incident reporting can learn an awareness into the errors that happen and make easy identification of contributing factors (Malpass et al., 1999a). Moreover, aUK Government white paper, put forward standardisation of audit as part of professional health care (Montesi and Lechi, 2009). The National Institute for Heatlh and clinical Excellence(NICE) (2002), defined clinical audit as a quality improvement process that seeks to improve patient care through systematic reexamination of care against explicit criteria and the implementation of change ( cited in Montesi and Lechi, 2009, p. 3).Clinical audit is a learning tool , which encourages high- quality care and should be implemented regularly and it offers an organised framework for inspecting and judging the work of health care professionals ( Montesi and Lechi, 2009 NICE, 2002). Audit is also a way of measuring and monitoring practice across a well- set of agre ed standards and finding mismatches in the written word and actual practice. Similarly, detecting medication errors can also be through a chart review, reporting of incident, monitoring of patients, direct observation and computer monitoring (Montesi and Lechi, 2009). The only technique used for identifying errors of administration of medications is by direct observation ( Montesi and Lechi, 2009). This is done under the observation of a accomplished nurse by noting the similarity or dissimilarity between what is done in the administration and the original physician orders. In addition to direct observation, reporting systems is another process obtained from procedures in high-reliability organisation.On the other hand, reports given to legal services can cause confusion and bring about a connotation of blame (( Montesi and Lechi, 2009). Incident of reporting was first used in the UK by the Royal College of Anaesthetists. According to Montesi and Lechi ( 2009), there are devil saf ety-oriented levels of reports. First, incident reporting where it is required that a the details recorded are concise, legible and a true version of events are recorded and sent to the central organisation , which supplies regular statistical reports and raising concerns about quality improvement. Secondly, voluntary reporting . This process is anonymous, confidential and blame- free.The benefits of voluntary reporting include the detection of active and hidden system failures, evidence of significant processes and the distribution of a culture of safety ( Stump, 2000). Other methods include patient monitoring, by interviewing, satisfaction surveys and focus groups. Through this, patients can learn about medication errors. With reference the Local Trust Policy, patients now receive an individualised medicine patientinformation leaflet (PIL) detailing their in-patient and discharge medicine by advising them about any possible side effects and dosage information, satisfy details sh ould more information be required.During placement, it was essential that the five rights is followed during a medication round with the nurses. It became fully aware that the five Rs is the most pure(a) way to prevent medication error arising. This policy has helped me establish how and why using the correct procedure helps to minimise administration errors from happening. Not all but most of the nurses at the placement adhered to the guidelines that the policy set out. In conclusion, the essay demonstrated that medication administration errors are still a continual problem that is related to practice in nursing . Nurses are mainly involved in medication administration.They also have an special role of identifying and stopping errors that occur in the various stages. Encouraging patient safety should have a number of approaches that involve more than direct care nursing staff. Another basic cause, is human- factor, therefore a professional education with individuals and system fo cuses on patient safety matter is essential. Lastly, health professionals accountable for the prescribing, dispensing and administration of medicines must work collectively as team members in the ward environment . The essay also demonstrated how the problem of medication administration error can be dealt with by the National Health Service.