Medication administration is a high-risk nursing task. Drug error can happen at any phase such as prescribing, dispensing, transcribing, and administering. A few factors that can contribute to this error can be high-risk medications, exhaustion and fatigue of healthcare workers, and look alike -sound alike medication.
High risk medications can cause serious injury or even death when incorrectly used. These medications include heparin, insulin, and IV potassium chloride (Mancha, et.al, 2019). This journal analyzed the circumstances that could lead to high- risk medication errors by monitoring calls to the hospital pharmacy to clarify doses, routes of administration and so forth. Medication error with high risk medication often occurs due to a lack of knowledge of medication. Most of the healthcare settings, require two professional registered nurses to verify the order and medication before the drug administration.
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Look like /Sound alike (LASA) medications are another factor contributing to medication error. Shao et.al (2018) reiterate in their journal the need for constant attention needed by healthcare professionals, medical industry and regulatory authorities to avoid look alike medication packages in the interest of medication safety. Medication error prevention requires clinical vigilance. For example, In a 2016 study, the US Food and Drug Administration (FDA)approved a name change for the Brintellix, an antidepressant to Trintellix after citing 55 reports of confusion with the blood thinner name Brilinta and 2 documented incidences of serious adverse events.
Another element that could attribute to a medication error is the exhaustion and the fatigue of health care workers from overworking. COVID 19 pandemic contributed substantial modifications to nurses’ day to day work which includes redeployment to priority areas that were unfamiliar to many of the nurses, mandatory full-time work schedules, and overtime hours. Burnouts can negatively impact patient care. A high level of “burnout” is an indicator of a reduction in perceived patient safety among critical care nurses (Alma’ Mari, et.al, 2020).
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The main goal of nurses is to provide excellent and quality care to all patients. Medication errors pose significant risks to patients as they can be sometimes fatal. To maintain a safe environment and to avoid medication errors it is important for all health care professionals starting from ordering physicians to transcribing pharmacists to the nurse administering medication to follow the safe medication practices. The prevalence of medication error in an emergency room is moderately high. These errors include wrong medication or overdose/underdose. The emergency room is busy in nature and always has a heavy workload with requires attention of multiple specialties, various disease conditions requiring high-alert medications, and patients of all ages from newborns to the elderly. These conditions make an emergency room more prone to making medication errors (Shitu, et.al., 2020).
I worked as an emergency room nurse a few years back and during that time I have prepared and administered high alert medication most of my shifts. As a nurse, it is crucial to pay attention to what medication is being ordered for the patient, what medications need to be pulled out from the medication pyxis, and how to administer the medication. Strictly maintaining and following the five rights of mediation administration can widely prevent medication error to a greater extent. Adhering to the five rights of medication administration does not mean you won’t have any medication errors but it can decrease the chances of having one occur (Manouchehr, 2020).
Interventions have been developed and implemented to reduce drug errors in all healthcare settings. There are many ways to improve medication safety. When considering options to reduce medication errors, it is necessary to look at the nurses’ competency, storage of high alert medications, and electronic medical records like computerized physician order entry (CPOE).
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