Clinical Application Project Titlestudent Namehospital And Unitresurre ✓ Solved

Clinical Application Project Title Student Name Hospital and Unit Resurrection University, NUR 4642: Role Transition Your information here Your information here Your information here Your information here Using simple, well designed graphics can help to effectively communicate results Your information here ( Your information here Your information here Place titles here Title Preventing Medication Error in Nursing 8 Preventing Medication Error in Nursing Tredia Pereira College of Nursing, Resurrection University NUR 4642- Professional Role Transition Professor Brandon Hauer March 14, 2021 Preventing Medication Error in Nursing A medication error is defined as any preventable event by the healthcare professional that may cause or lead to inappropriate medication use harm the patient according to the National Coordinating Council for Medication Error Reporting and Prevention (Center for Drug Evaluation and Research, 2019).

Unfortunately, medication errors happen frequently, and their type and frequency vary in hospitals and nursing homes, and it can lead to serious injuries or even deaths. It can occur from the prescribing the medication stage to the administering stage, and although most of it does not end up in a patient’s death, it is a common problem in the healthcare world. The adverse events and errors committed by health care professionals pose a threat to patient safety and may have minor or severe consequences depending on the type of medication error committed. Because of how important it is, patient safety is now a health policy (Asensi-Vicente et al., 2018). On the telemetry floor, a medication error prevention is pertinent because some of the patients that get admitted to the floor come with a wide range of diseases that could require multiple medications being prescribed.

Their medication list has sometimes six to ten medications and nurses on the floor have up to five patients per shift. It is very easy to make a mistake by selecting the wrong patient and withdrawing the wrong medication and that almost happened to one of the nurses I was shadowing. One of the nurses on the unit supported the topic and expressed how relevant the topic is to the unit because it is very easy to make a mistake if you are overwhelmed by your patients’ needs especially since they all have different needs, and some are more difficult than others. Preventing medication errors on the floor not only will help keep the patients safe, but it will also prevent the nurses from getting in trouble because medication error is a serious issue in the healthcare world.

Taking extra precautions on the unit can also increase a sense of security among the patients and help decrease their fear of not receiving the appropriate care. Adding preventive measures can also decrease patients’ anxiety and uncertainty due to them feeling more secure and protected by specific and intentional safety measures put into place to better the care they receive. Literature Review of the problem Medication errors remain the eighth leading cause of amenable and preventable death in the United States of America (USA), causing about 225,000 deaths each year. According to various studies on drug-related hospital admissions, five percent to six percent of all hospitalizations are due to medication-related problems.

Reasons or events that can lead to medication errors include patients commonly receiving new drugs or having alternate drugs due to drug formularies limitations which could limit to certain medications during the hospitalization. In addition, the lack of communication, understanding, and collaboration among healthcare providers is a significant factor in preventing medication errors in hospitals (Almalki et al., 2021).. In this meta-analysis, the authors found a significant variation in the reported rates of medication errors in different hospitals in Saudi Arabia. The integrated medication error rate in Saudi Arabia hospitals was estimated to be 44.4% which is very high and shows how often it does happen.

Furthermore, it was found that the most frequently reported category of medication errors according to medication-use process stages is in the medication-prescribing stage which is very concerning and puts patients in danger. Waaseth et al. composed a study on medication errors and patients’ study in a Norwegian hospital and discovered that medication errors are associated with prolonged hospitalizations at higher health costs and represent increased burdens for patients and public healthcare services. (Waaseth et al, 2019). Medication error is punitive and because of that, a lot of healthcare workers do not report it when it happens in fear of losing their job which results in a lot of medication error not being reported.

The authors discovered that nurses, more frequently than doctors, reported medication errors and discussed reported errors at staff meetings while doctors preferred to solve the problem directly by writing a new medication order rather than writing a report(Waaseth et al, 2019). They discussed that the aim of medication error reporting is to learn from our mistakes and to continuously improve treatment and ultimately treatment outcome. Reporting medication errors improves the safety of future patients and helps prevent serious injuries that could happen from it. Literature review of the solution According to Alomari et al. (2018), all nurses need to be familiar with various strategies to prevent or reduce the potential risk for malpractice.

The first strategy is to ensure that they are using the five drug administration rights and that institutional policies regarding drug transcription are adhered to. It is important to make sure that the right medication is prescribed to the right patient in the right dose, in the right way, and calculated correctly. The second strategy is to document everything correctly while making sure that the documentation is easy to read and includes a proper record of the drug administered. Proper documentation about the drug plays a huge role in preventing medication errors. A very important step before medication administration that a lot of healthcare professional skip is reading the prescription label and checking the drug expiration date because sometimes it is possible that a drug expired already and nobody noticed it.

Rodziewicz & Hipskind (2018) stated that malpractices are very common and that healthcare providers should prioritize avoiding them at any cost. Nurses spend a lot of time with their patients and have a great responsibility to prevent malpractice. When administrating medications, nurses need to use some important identifiers such as the patient name, the right medication, right dose, and right route to ensure that so that the patient is receiving the correct medication. According to Gorgich et al. (2016), to prevent this frequent error, medical professionals should first identify the cause. The survey included information about strategies that are effective in preventing frequent outbreaks.

According to nurses and nursing students in the study, several factors influence the frequency of malpractice. Based on the data collected, the 5 most causes of frequent medication error were fatigue, increased patient ratio, unreadable doctor’s orders, short staffing, and increased distractions. Implementation Medical malpractice has become one of the most dangerous aspects of treatment in hospitals and primary care environments. Patients are at risk of seemingly simple and preventable medication errors. Studies have shown that most malpractices are due to understaffed or overworked nurses, improper prescribing of medications, or improper medications.

Failure to communicate between interdisciplinary teams compromises patient safety. As these instances begin to grow exponentially, healthcare professionals need to work together with solutions that can be used anywhere. The more information and research is done, the more we can work towards the overall goal of patient safety with medication. Patients safety is critical in planning care and medication errors can ultimately be reduced by educating the inter-disciplinary team. The project will address the issue by organizing more in-service on the unit regarding medication administration, another one for doctors regarding medication prescription and assessing if there is a decrease in the medication error rate after the first three months of implementing the in-service.

Also, increasing interaction between healthcare providers and nurses, and better-educating patients on their current medication before they return home is important. There are no guaranteed solutions that can immediately fix the problem of medication error, because it will take a progressive collective work from the healthcare team to reduce its rate. Patients can be kept safer if healthcare professionals on the unit work as a team and the best way to create a productive and positive environment is trough constant education . The more empowered and collaborative the nursing team is, the safer the patients will be. The in-service will take place every three months, and members of the healthcare team will provide their feedback and also give suggestions on how to better tackle the issue.

It is important for healthcare professionals to maintain close communication between nurses, doctors, and other members of the interdisciplinary team because the stronger the communication, the safer and healthier the patient. Malpractice is the most harmful, costly and have a direct impact on patient safety. To address this persistent problem, there is the need to improve overall communication, provide more accurate treatment instructions and monitoring, and educating patients as well on their treatment plan. References Almalki, Z. S., Alqahtani, N., Salway, N.

T., Alharbi, M. M., Alqahtani, A., Alotaibi, N., … Alshammari, T. (2021). Evaluation of medication error rates in Saudi Arabia. Medicine , 100 (9). Alomari, A., Wilson, V., Solman, A., Bajorek, B., & Tinsley, P. (2018).

Pediatric nurses’ perceptions of medication safety and medication error: a mixed-methods study. Comprehensive Child and adolescent nursing , 41 (2), 94-110. Asensi-Vicente, J., Jiménez-Ruiz, I., & Vizcaya-Moreno, M. F. (2018). Medication errors involving nursing students.

Nurse Educator , 43 (5). Center for Drug Evaluation and Research. Working to reduce medication errors . Gorgich, E. A.

C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global journal of health science , 8 (8), 220. Kavanagh, C. (2017). Medication governance: preventing errors and promoting patient safety.

British Journal of Nursing, 26(3), Rodziewicz, T. L., & Hipskind, J. E. (2018). Medical error prevention. Waaseth, M., Ademi, A., Fredheim, M., Antonsen, M.

A., Brox, N., & Lehnbom, E. C. (2019). Medication Errors and Safety Culture in a Norwegian Hospital. Studies in health technology and informatics , 265 , 107–112. CAP e-Poster Creation & Presentation Guidelines Poster presentations share research and clinical projects.

Your electronic (e-) poster will present key elements of your Clinical Application Project (CAP). · The CAP e-poster is to be designed on a PowerPoint template, but not printed. You will simply submit the PowerPoint file to the Brightspace submission folder. · If you are unfamiliar with creating a scientific poster, instructions are outlined at the bottom of this document. It’s easier than you think. Because you are limited by space in the poster format, you must be clear and concise in your writing. · Refer to the CAP rubric for all necessary requirements. General guidelines for e-poster: · The e-poster should look neat, professional, and visually appealing · Use a simple font (like Arial), no smaller than size 32; larger for section headings and even larger for title/presenter name · Regarding text: · Labels or headings should be clear and easy to understand. · Select contrasting colors; darker letters are effective when used on a light background & vice versa. · Text should be brief and to the point; use short sentences or phrases to summarize key points; bullet points work well. · If you are planning to use charts or graphs on your poster: · Visual data help to express ideas; graphics should be understandable. · Keep it simple; don’t overwhelm the audience with too many numbers. · Make sure there is a clear caption so the reader understands the significance. · Assure consistency in use of format. · Check and double check spelling.

Reminders: · Include any form, brochure, or handout you develop as part of the project. · A reference page in APA format must be submitted with your e-poster. The reference page should include at least the journal articles that were discussed in the literature reviews of the clinical topic and solution. Poster Instructions 1. Open the poster template in the course shell (or find your own) and save it to your computer. 2.

Experiment with different colors, fonts, designs. 3. Keep in mind the “general guidelines†listed above. 4. Add your content, graphics, charts, etc.

5. Save your work frequently as you create. CAP Video Presentation Due to the pandemic, we will not be able to gather for in-person poster presentations like we have in the past. Instead, students will create a video presentation of their Clinical Application Project and upload to Brightspace by the date listed in the syllabus/course calendar. This brief (no more than 4 minutes) presentation is an overview of your CAP.

It will include the following: · name and clinical location of your project · why this is an important topic for your clinical area · what your literature search revealed about the topic and the solution · how you would specifically implement your project · what future benefits this project could have on nursing Be sure and present professionally, as if you were in front of a live audience. This means: well-groomed, including hair pulled back, minimal makeup/jewelry; maintains eye contact with camera; stands still/camera does not sway; speaks clearly and audibly; knowledgeable and confident about project This video presentation is worth 10 points. See CAP Video Presentation grading rubric (in Brightspace) so you understand how points are allocated.

Gestational Diabetes Mellitus: Interventions for Hispanic/Latina Pregnant Women Luis A. Gutierrez PSMEMC OB Unit Resurrection University, NUR 4642: Role Transition Problem/topic Gestational Diabetes Mellitus (GDM) impacts 2%-10% of all pregnancies in the United States every year (Center for Disease Control and Prevention, 2017). Per care team, PSMEMC has experienced an influx of Hispanic/Latina pregnant women diagnosed with GDM. Language barrier is the biggest obstacle with patient education. Staff members reported that Spanish speaking resources for GDM and nutritional education are scarce.

Community background The racial disparities seen in GDM directly impacts St. Mary’s and Elizabeth Medical Center due to the physical location of the hospital. St. Mary’s and Elizabeth Medical Center is located near the Humboldt Park neighborhood. Literature Review Problem/topic Cultural/linguistic barriers.

Carolan-Olah et al. (2017) identify that language is one of the barriers understanding the impact that GDM could have on the mother’s health as well as the newborns. In addition, cultural food selection greatly increases the risk for developing GDM for Spanish speaking mothers. Lack of activity and poor dietary selections. Chasan-Taber (2012) identifies that there is a higher likelihood for gestational diabetes and macrosomia to develop in Latinas who are obese. Solution Linguistic adaptation.

Schellinger et al. (2017) demonstrate that Hispanic/Latina pregnant women participating in a group care model offered in Spanish showed indicators of effective education and implementation regarding GDM and pregnancy. Cultural background, socioeconomic status and nutrition. Rhoads-Baeza and Reiz (2012) determine that the relevancy of the dietary recommendations provided to women, incorporating cultural factors, contributed and facilitated the success of interventions addressing Hispanic/Latina pregnant women. Solution An educational group program will be implemented at the St. Mary’s and St.

Elizabeth’s OB unit. The educational group program will provide: Access professionals in Spanish. Education and information on reducing their risk for GDM. Space and support for women to learn healthy diet options that are culturally and linguistically relevant. Implementation Recruitment Women at risks for GDM will be referred to group by PSMEMC OB Clinic Intervention Group will receive psychoeducation on GDM Participants will be taught to test and measure glucose levels independently Utilizing food journals to track meals and generate discussion around their current dietary practices Nutrition education providing suggestions to each participant based off of food that is culturally relevant to them.

Assessment Staff member will be able to track and share patient information with their medical physician for continuity of care. To monitor patient’s health status throughout their pregnancy, surveys and glucose levels will be utilize. Future Implementations Acknowledgements I would like to thank my Preceptor Ami Patel, BSN-RN and secondary preceptor Jennifer Kruc, BSN-RN who endorse this project and felt that it would be beneficial to the unit. I would also like to thank the OB residents who provided feedback on my intervention. Gestational Diabetes Mellitus (GDM): Interventions for Hispanic/Latina Pregnant Women (Clinical Unit Here) Resurrection University, NUR 4642: Role Transition While Hispanic/Latina women are the population that is being seen at PSMEMC, they are not the most at risk for GDM.

Nationally, Asian/Pacific Islander women are increasing at faster rates (See Table 1). Utilizing this model of incorporating cultural components to dietary interventions could also assist in dropping rates of GDM in that population. Table 1 Printing: This poster is 48†wide by 36†high. It’s designed to be printed on a large-format printer. Customizing the Content: The placeholders in this poster are formatted for you.

Type in the placeholders to add text, or click an icon to add a table, chart, SmartArt graphic, picture or multimedia file. To add or remove bullet points from text, just click the Bullets button on the Home tab. If you need more placeholders for titles, content or body text, just make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else. Want to use your own pictures instead of ours?

No problem! Just right-click a picture and choose Change Picture. Maintain the proportion of pictures as you resize by dragging a corner.

Paper for above instructions

Tredia Pereira

College of Nursing, Resurrection University
NUR 4642: Professional Role Transition
Professor Brandon Hauer
March 14, 2021

Introduction

Medication errors are preventable incidents that can lead to inappropriate medication use or harm to patients (Medication Errors: The Role of the Nursing Professional, 2019). In the United States, medication errors represent the eighth leading cause of preventable deaths, accounting for approximately 225,000 fatalities annually. A significant proportion of these errors occurs at various stages of the medication-use process, including prescribing, transcribing, dispensing, and administering medications (Almalki et al., 2021; Waaseth et al., 2019).
On the telemetry floor where I am stationed, medication errors present a critical challenge owing to the complexity and polypharmacy common among patients, some of whom may have as many as ten prescribed medications (Rodziewicz & Hipskind, 2018). It is essential for nursing professionals to actively engage in practices that minimize the risk of medication errors to ensure patient safety, uphold professional integrity, and enhance the overall quality of care provided.

Problem Statement

Medication errors occur frequently in healthcare settings, often leading to severe adverse consequences for patients (Center for Drug Evaluation and Research, 2019). Studies suggest that communication breakdown and insufficient collaboration among healthcare professionals significantly contribute to these errors (Almalki et al., 2021).
On the telemetry unit, nurses are responsible for administering medications to potentially five patients at a time, which creates an environment ripe for errors due to increased workload and distraction (Gorgich et al., 2016). By identifying the root causes of medication errors and addressing them through structured interventions, we can enhance patient safety and foster a culture of transparency and learning within the healthcare system.

Literature Review: Causes of Medication Errors

1. Fatigue and Overwork: Nurses frequently cite fatigue and high patient ratios as key factors leading to medication errors (Gorgich et al., 2016). Hospitals with higher nurse-patient ratios tend to have higher rates of errors.
2. Communication Gaps: The lack of effective communication among healthcare professionals often contributes to medication discrepancies—particularly during shift handovers and interdisciplinary team meetings (Almalki et al., 2021; Waaseth et al., 2019).
3. Prescribing Stage Errors: Research indicates that most medication errors occur at the prescribing stage, primarily due to illegible handwriting from providers and inadequate patient information (Waaseth et al., 2019).
4. Limited Reporting Culture: As noted by Waaseth et al. (2019), a punitive culture surrounding medication errors leads to underreporting among healthcare personnel. Nurses are more likely to report errors than physicians, often due to the fear of job loss or disciplinary action.

Literature Review: Solutions to Medication Errors

1. Adhering to the Five Rights: Education on the "Five Rights" of medication administration—right patient, right medication, right dose, right route, and right time—is fundamental for all nursing staff. Studies have shown that adherence to these principles significantly reduces the risk of error (Alomari et al., 2018).
2. Effective Documentation: Accurate documentation of medication administration is critical for ensuring patient safety. Nurses should ensure their documentation is legible and informative, detailing the exact medications administered, their doses, and the time.
3. Use of Technology: Leveraging electronic health records (EHR) can streamline and enhance the prescribing and medication administration processes. EHR systems improve communication among healthcare team members and minimize the risk of errors associated with handwritten prescriptions (Rodziewicz & Hipskind, 2018).
4. Culture of Reporting and Continuous Improvement: Encouraging an environment where medication errors can be reported without fear of retribution promotes transparency and learning. Regular education and training sessions can support staff in understanding how to report errors and analyze them for continuous improvement (Waaseth et al., 2019).

Implementing Solutions on the Unit

Our project proposes a structured training program for nurses on the telemetry unit focused on medication administration guidelines, emphasizing the importance of collaboration and effective communication among interdisciplinary team members (Center for Drug Evaluation and Research, 2019). We will also schedule monthly in-service training sessions that cover the following:
1. Case Studies: Analyzing actual medication error incidents to understand their causes and how to prevent similar occurrences in the future.
2. Simulation Exercises: Implementing hands-on activities that replicate medication administration scenarios to help nurses practice problem-solving in a controlled environment.
3. Reviewing Documentation Practices: Nurses will receive training on how to document medication administration accurately, emphasizing the importance of clarity and completeness.
To evaluate the effectiveness of our interventions, we will conduct a survey among nurses before and after the training programs to assess their confidence levels in medication administration and error reporting. Regular discussions at staff meetings will allow for shared learning and strategies to further reduce errors.

Conclusion

Preventing medication errors is vital for safeguarding patient health and ensuring high-quality nursing care. By implementing structured training programs, enhancing communication, and promoting a transparent reporting culture, we can foster a safer healthcare environment on the telemetry unit. Future efforts should be focused on continuous evaluation and refinement of these initiatives to achieve sustained improvement in medication safety across healthcare settings.

References

1. Almalki, Z. S., Alqahtani, N., Salway, N. T., Alharbi, M. M., Alqahtani, A., Alotaibi, N., & Alshammari, T. (2021). Evaluation of medication error rates in Saudi Arabia. Medicine, 100(9).
2. Alomari, A., Wilson, V., Solman, A., Bajorek, B., & Tinsley, P. (2018). Pediatric nurses’ perceptions of medication safety and medication error: a mixed-methods study. Comprehensive Child and Adolescent Nursing, 41(2), 94-110.
3. Center for Drug Evaluation and Research. (2019). Working to reduce medication errors.
4. Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevent them from nurses and nursing students' viewpoints. Global Journal of Health Science, 8(8), 220.
5. Kavanagh, C. (2017). Medication governance: preventing errors and promoting patient safety. British Journal of Nursing, 26(3).
6. Rodziewicz, T. L., & Hipskind, J. E. (2018). Medical error prevention.
7. Waaseth, M., Ademi, A., Fredheim, M., Antonsen, M. A., Brox, N., & Lehnbom, E. C. (2019). Medication errors and safety culture in a Norwegian hospital. Studies in Health Technology and Informatics, 265, 107–112.
These references highlight the critical importance of ongoing education and awareness in mitigating medication errors and enhancing the safety of patient care within nursing practices.