Essay on Double-Checking: A Key to Safer Medical Administration

Introduction

Medical administration errors mostly occur through defaults in; right patient, the medication, timing, dosage and the route used for administration. These errors may be as a result of slips and lapses. However, technological systems may be accountable for these errors sometimes. Human factors such as the population of nurses within the facility and mental conditions such as the equipment play a vital role too in the medical administration process eligibility.

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Effectiveness of Double-Checking to Reduce Medication Administration Errors: A Systematic Review

This review was done after the conduction of 13 studies involving both adult and pediatric inpatient populations. The studies were on the significant relation between double checking and the considerable decrease in medication administration errors. Amid the three convenient quality studies, only one disclosed a noteworthy connotation between double-checking and a decline in MAEs. However, among the 13 studies, some showed no relation between double-checking and reduced medical administration errors. In short, the findings, according to the reviews, were that single and double-checking are not directly linked to reduced medical administration errors. The level of devotion to autonomous double-checking was considered, and the evidence was still insufficient to make a firm conclusion. Therefore, this research states that existing evidence linking double-checking to reduced medical administration errors is inadequate (Koyama et al. 2019).

Causes of Medication Administration Errors in Hospitals: a Systematic Review of Quantitative and Qualitative Evidence

This review based on qualitative research demonstrates the various purposes to a medication administration error, which include both safe and unsafe doings. Several of these conditions, both the safe and dangerous, in addition to provoking situations may accumulate or combine sometimes to cause errors. However, the article states that there has been insufficient knowledge of the later. Slips and lapses were the utmost communal described unsafe acts leading to MAEs, then accompanied by knowledge-based faults and wary defilements. Knowledge-based mistakes include lack of sufficient knowledge by nurses or the use of outdated programs, while most of the intentional errors are ignorance-based (Keers, Williams, Cooke & Ashcroft 2013).

Error-provoking situations manipulating administration errors included scarce written message which consists of the medicaments, certification, and record. Other conditions provocative to failure, according to the article, are difficulties with medicines quantity and storage majorly the pharmacy bestowing errors and management of the stock in the ward. Workload issues which are known for severe implications such as fatigue are a significant influence on medical administration errors. An equipment issue within a department set up this includes access and proper functionality, factors based on patient's availability, in numbers, and the severances to their conditions. The mental health of the practitioners' matters concerning medical administration errors, major determinants being stress and fatigue, and frequency of interruptions during medication administration.

Ways Finding May Be Used in Nursing Practice

According to these articles, medical administration errors occur as a significant result of slips and lapses. The words, error, slip, and failure can be related as in; errors are actions intended but not performed. These errors can also be mistakes concerning insufficient planning and inadequate knowledge. Errors arising from imperfect execution of the already existing properly formulated plans are called slips and lapses occur due to the commitment of correct acts. These errors and slips being the significant findings towards medical administration errors can be used to improve nursing practices. In terms of errors arising from the use of equipment, most of them involve fusion pumps in the Intensive Care Unit sector.

Most of these errors involving the pump are related to digits fed incorrectly, incorrect settings, or other mistakes such as interrupting the infusion and forgetting to restart it. These errors can be prevented or reduced by ensuring that devices are programmed. This is because programmed equipment requires special attention to nurses. Therefore, the lapses and slips will be minimized due to the proper evaluation of equipment through; checklists and protocols specifically and the addition of standardized procedures. On the other hand, MAEs can reduce through educational improvement among health professionals, nurses. The educational standards should ensure proper theoretical comprehension, sound practices, and the scientific comprehension of technological equipment. Clinical competence and the incorporation of evidence-based practices should be encouraged in the nursing practices for better medical administration results.

Nurses can create defensive obstructions with the target of interrupting errors and upholding system security. Most of the mistakes were also discovered to be as a result of mishandling the infusion pumps at the Intensive care unit. Therefore, nurses can use this discovery and countercheck their equipment, shoes, and monitors, among others, properly before getting to work with them. Nurses should also avoid disruptions while working with these innovation machines. The nursing medication administration practices can also be improved through ensuring proper psychological conditions of nurses in terms of stress and fatigue by reducing the workload per nurse in health facilities.

Ethical Considerations Associated with The Conduct of The Studies

The significant factors towards ethical considerations in research include; informed consent, beneficence which bases on not causing harm, respect to anonymity and confidentiality, and respect for privacy. Therefore, concerning the reference articles, the ethical codes were followed as in honesty. The sources of information offered to affirm to the stated facts. Both pieces of research also described the objectives and worked in line with it. For instance, the second article's aim was to systematically evaluate and appraise experimental confirmation relating to the causes of medication administration errors (MAEs) in hospital settings, which has been evidenced throughout the article. Nobody was harmed through the data collecting methods in both studies as the studies used already existing data to collect information. Confidentiality was observed as in revelation of the identity of the individuals who took part in creating the data.

Conclusion

In conclusion, medical administration errors occur as a result of medications conducted to the wrong patient, the type of drugs administered, the type of dosage, and the route used for administration. According to the qualitative articles summarized, these errors occur as a result of slips and lapses. Slides are what happens as a result of the misconduct of planned activities. Double-checking has often been linked with reduced MAEs. However, there is insufficient evidence linking double-checking this statement. However, other causes of slips and lapses are factors such as technological administered dosage, condition of the nursing personnel and different timing. The nursing personnel may misconduct medical administration as a result of stress or fatigue due to excess workload. Inadequate information by the nursing personnel may also be a limiting factor. Therefore, from these findings, the nursing practice can be improved through the improvement of educational standards for these health personnel, as it will consequentially result in reduced MAEs.

References

Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. Drug safety, 36(11), 1045-1067. doi:10.1007/s40264-013-0090-2

Koyama AK, Maddox CS, Li L, et alEffectiveness of double checking to reduce medication administration errors: a systematic reviewBMJ Quality & Safety Published Online First: 07 August 2019. doi: 10.1136/bmjqs-2019-009552

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