Medication Errors & Nursing

Nurses are the health care professionals that collect and prepare medications for patients. They examine the doctor’s orders to see what medications patients are prescribed. Errors can occur in the distribution of these medications. As a result, the nursing ethic of do no harm may not occur. According to McIntyre, Thomlinson, & McDonald, “nurses are held in high regard” (2006, p.360). As such, nurses must keep this positive concept, as we are the health professionals that care for people when they are at their most vulnerable. There is a need for nurses to reflect back to nursing school and use the information taught to guide decisions regarding medications and their administration. This paper will examine medication administration errors as an issue in nursing. I will discuss three articles of which the media’s view, a scholarly article, and a website’s opinion of medication administration errors will be examined. Lastly, an evaluation of these articles based on the author’s credibility, documentation, and support for claims; an evaluation of the author’s disagreements or agreements; and an articulation of my personal position on these issues will be explored.

There is a rising trend in media reports of improper drug administration. For this reason, there is a demonstrated need for patient safety. As long as nurses are the health care professionals that administer medications to patients, they may face persecution from the public when medications are given in error. The Canadian Institute for Health Information, reports 1 in 10 people experience a medication error during hospital admissions (2007, p.18). This is a shocking trend if you factor in the rising number of people requiring hospital admissions. An article on CBC news has pointed out this rising problem. This article brought forth an incident in which a patient was given potassium chloride, which is the drug used in lethal injections, intravenously instead of the ordered sodium chloride, which lead to the death of this patient. This article proposes that to improve patient safety, the people on the front lines of patient care, such as the nurses and doctors need to look into ways to increase patient safety. The article suggests that patients are being admitted to hospitals with an inaccurate recording of their medications in their patient record. When their medication list is incomplete, patients do not receive their regular medications from home in the hospital, or other medications may be given that may conflict with existing medications they are taking resulting in adverse reactions and possibly death.

Additionally, the article suggests ways in which to reduce the problem of medication errors. Binks (2007) suggests that upon admission to patient-care units, the use of patient interviews is a solution in which information regarding the patient’s current medications can be gathered. As well, the author suggests that the definitive answer to correcting mediation errors is to implement the use of bar-coded medications that are scanned when leaving the pharmacy, and the use of patient wristbands with a bar code that is scanned prior to medication administration. This article confirms the importance of nurses following hospital protocol regarding the use of the seven rights of medication administration, importantly the identification of the right medication to which the right patient is being given.

Other than media reports, there are many articles and research currently being made on the problem of patient medication errors. The increase in such literature shows that there is a need to rectify this predicament. In an article from the Journal of Advanced Nursing, the nurse’s experience of medication administration errors was explored. This article lists reasons as to why medication errors are occurring. Some of the reasons are related to the increasing workload that nurses carry and the dosages and number of medications prescribed has increased which the author states “puts nurses at risk of making serious errors” (Schelbred & Nord, 2007). This article takes the nurses point of view of medication errors and has found that performing a medication error was traumatic, physically through the development of depressive symptoms and professionally to the nurse. Schelbred & Nord (2007) found that nurses need support from colleagues and managers after committing a medication administration error.

The article explores the results of interviews involving ten nurses that had committed medication errors and enquired into their experience and emotions, along with their colleagues and managers reactions to this event. The overall emotions that were experienced were feelings of guilt and shame in that they had betrayed the patient, their coworkers and their families. Additionally, some of the nurses developed a fear of making new mistakes, and a distrust of themselves in their profession. These medication errors resulted in some of the nurses developing depression, suicidal thoughts, and even symptoms related to posttraumatic stress syndrome. Throughout the interviews all the nurses took responsibility and reported their errors to managers. The result of reporting the medication errors, reactions from coworkers and managers, such as emotional support, relating personal mistakes, and silence were common responses.

In relation to media reports and scholarly papers, some websites address the issue of medication administration errors. An article on the International Council for Nurses (ICN) website asserts that patient safety is fundamental to quality nursing and health care (n.d.). This article suggests that the wrong drug name, dosage form, or abbreviation; mistakes on calculating dosage; and atypical or unusual and critical dosage are commonly associated with medication errors. Additional factors cited in this article can be related to lack of training, undue time pressure, and poor perception of risk. The ICN believes that understanding these factors are the first step in preventing medication errors. This organization declares that failure to administer a prescribed medication, improper dose, and administration of drugs that are not authorized by the physician are quoted as the most frequently reported errors.

The International Council of Nurses suggests that medication errors are not a result of a problem with bad professionals in health care, but of a bad system that requires change to become safer. This organization supports a system wide approach that emphasizes reporting, not blaming the care provider, and including actions that address human and system factors when medication errors occur. Problems with the health care system’s design, organization, and operation are believed to be at fault and