Benchmark – Medical Errors Discussion
Benchmark – Medical Errors Discussion
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system. PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures. Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.Benchmark – Medical Errors Discussion
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Benchmark – Capstone Project Change Proposal
Background
Medical errors are among the patient safety problems associated with adverse effects such as morbidity and mortality, prolonged length of hospital stay, and increased healthcare costs. Medical errors are preventable and avoidable and nurses play a key role in the prevention of medication errors (Gorgich et al., 2016). Medication errors can occur due to inadequate knowledge, professional practice, as well as factors related to the patients, systems, and policies. Pediatrics are more predisposed to medical errors such as medication errors because of the need to calculate the dosage according to the weight of the patient, body surface area, age, and their condition; this increases the possibility of medication errors, especially dosing errors (Izadpanah et al., 2015). Nurses are the healthcare providers who have the most contact with patients and they are actively involved in the administration of medications. However, evidence indicates that nurses may lack competence regarding the safe administration of medication due to inadequate pharmacology knowledge, side effects, and other elements of medication safety (Ltheeth & Abbas, 2017). Decreased medical errors and improved patient safety presents an important focus for healthcare organizations in regard to risk management and quality improvement.
Clinical Problem Statement
The prevalence of medical errors is high among hospitalized pediatric patients. Evidence shows that errors such as medication errors in the pediatric population are three times higher when compared to the adult populations (Izadpanah et al., 2015). The pediatrics with multiple drug prescriptions are predisposed to avoidable adverse drug events. Dosing errors like wrong dosage or occurrence of medication administration, as well as overdosing/underdosing are among the common medication errors (Musharyanti et al., 2019). Medication errors in the pediatric population can cause severe adverse reactions and events. Therefore, nurses need to be aware of special dosing considerations for children and careful monitoring after administering the medication.Benchmark – Medical Errors Discussion
Purpose of the Change Proposal
The purpose of the proposed change is to decrease the rate of medical errors within the pediatric unit and improving the patient outcomes by training and educating nurses to ensure they are competent in handling medical errors and preventing them.
PICOT Question
In the pediatric department (P), can training of the nursing staff on how to hand and prevent medical errors (I), when compared to no training (C), result to a reduced rate of medical errors and improve patient safety (O), within 3 months (T)?
Literature Search Strategy
Various databases such as PubMed, CINAHL, Web of Science, and Cochrane Library will be used to search for and locate suitable studies. Only studies published in the English language and after 2015 will be included during the search. The search terms during the search will include “medical errors”; “medication errors”; “pediatric population”; and “nurse education & medical errors”. The search will be validated and confirmed through hand searches and by reading through all the retrieved articles to confirm they are relevant to the proposed study. The articles will be selected by reading through the titles, abstracts, and finally by screening the entire article for relevance. The screening to confirm the eligibility of articles will be performed by the author.
Evaluation of the Literature
Medical errors present a major public health problem and it is a major cause of death within the US. Nurses play an important role during care provision and thus ensuring patient safety is an important nursing duty (Gracia et al., 2019).
According to (Musharyanti et al (2019), pediatric medical errors are higher when compared to adults due to childhood development, dependency on parents and healthcare providers, demographics, as well as varying epidemiology of health conditions. For example, (Izadpanah et al (2015) explain that prescription, dispensing and medication administration errors represent a major element of preventable medical errors in the pediatric population. Moreover, electronic health records (EHRs) are mostly designed to serve adults and have limited efficacy in lowering pediatric-specific medical errors. Reasons associated with medical errors in the pediatric population are multifactorial. Gorgich et al (2016) outline these factors to include physical aspects such as weight-based medication dosing; and developmental issues such as mental and physical age.Benchmark – Medical Errors Discussion
Pediatric medical errors in the emergency department are attributed to several factors such as improper patient identification; lack of experience and knowledge among the staff in handling pediatric patients, calculation of the medication doses for the pediatric population; and challenges in carrying out technical procedures (Gracia et al., 2019). Other sources of medical errors include poor hand-off process. The utilization of a standardized hand-off process has been demonstrated to reduce errors. Other sources of medical errors include medication errors, diagnostic mistakes, as well as environmental deficits like equipment failure (Musharyanti et al., 2019).
Factors associated with medication errors include abbreviations in prescriptions, illegible prescriptions, poor communication skills, language barriers, fatigue for the nursing staff, and multiple medication combinations (Izadpanah et al., 2015). Other errors consist of improper selection of medication, wrong route of administration, failure to monitor for side effects or screen for medication interactions and allergies, as well as ineffective communication among the healthcare team members.
Nursing Theory Utilized
The selected theory to manage the change is Havelock’s theory. Havelock’s theory manages change through planning and effective monitoring of the change. The first step will involve building trust and relationships within the organization and among the staff members. The second step involves forming a committee that will steer the proposed change and then diagnosing the need for the change and locating the necessary resources for the project (Kodama & Fukahori, 2017). During this step, the required information will be located, and particularly evidence-based information. A suitable strategy is then chosen and the selected quality improvement initiative is adopted. In this project, the proposed strategy is to educate nursing staff on how to handle medical errors. The final step will involve empowering the nursing staff to embrace the change and utilize the acquired knowledge and skills (Kodama & Fukahori, 2017). Finally, the findings regarding the change are then communicated to the relevant stakeholders.Benchmark – Medical Errors Discussion
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Implementation Plan with Outcome Measures
Engaging all stakeholders by soliciting their input and building trust is the first step towards implementing the change. The metrics and outcomes of the proposed change are then defined and this is followed by holding a meeting for all stakeholders. The next step should involve garnering support from the organizational management because the organizational leadership plays a big role in supporting ta change and providing the required resources (Bahadori et al, 2017). Once the organizational management provides the necessary support such as the required resources to drive the change, the change champions and agents will steer the change and persuade the stakeholders to support the proposed change. The change champions will educate the nursing staff about the importance of being competent in handling and prevention of medical errors. The outcome measures in the proposed change include a decreased rate of medical errors in the pediatric unit, improved patient satisfaction, and improved patient outcomes.
Evaluating the Proposed Nursing Intervention
The proposed intervention will be evaluated by comparing the rate of medical errors in the pediatric department before and after the implementation of the proposed change. This will involve collecting baseline data about the rate of medical errors in the unit, and then collecting the rate post-intervention implementation and finally comparing the rate. A reduced rate of medical errors post-project implementation will be an indication of the efficacy and success of the implemented nursing intervention.
Potential Barriers to Plan Implementation
The main barrier to implementing the proposed change is resistance to change by the organizational staff. The nursing staff may not be willing to take part in the training due to heavy workload and tight schedules and thus they may resist the change. To overcome the barrier, change champions and agents will persuade the staff about the importance of embracing the change. Moreover, meetings will be held to inform the staff members about the proposed change and ensure that all relevant stakeholders are involved in all steps. This way, the staff will feel that they are part of the change and own the change (Bahadori et al, 2017). The other possible barrier is the lack of support from the management. This barrier will be overcome by seeking a meeting with the management to explain to them about the benefits associated with the proposed change. Lack of time is another possible barrier due to the heavy workload among the nursing staff. This barrier can be overcome by convincing the organizational leadership to recruit more nursing staff to reduce heavy workload (Fischer et al., 2016).
References
Bahadori M, Mehdi R, Ramin R & Mahaki B. (2016). The barriers to the application of the research findings from the nurses’ perspective: A case study in a teaching hospital. J Educ Health Promot, 5(14). Benchmark – Medical Errors Discussion
Fischer F, Lange K, Klose K, Greiner W & Kraemer A. (2016). Barriers and Strategies in Guideline Implementation—A Scoping Review. Healthcare (Basel), 4(3), 36.
Gracia, J. E., Serrano, R. B., & Garrido, J. F. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC health services research, 19(1), 1-9.
Gorgich, E. A., 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), 54448. https://doi.org/10.5539/gjhs.v8n8p220.
Izadpanah, F., Haddad Kashani, H., & Sharif, M. R. (2015). Preventing Medicine mistakes in pediatric and neonatal patients. Journal of medicine and life, 8(3), 6–12.
Kodama Y & Fukahori H. (2017). Nurse managers’ attributes to promote change in their wards: a qualitative study. Nurs Open, 4(4), 209–217.
Ltheeth, H., & Abbas, S. (2017). Effectiveness of an Educational Program on nurses’ Knowledge Concerning Medication Error at Teaching Hospital in AL-Nasiriyah City. International Journal of Science and Research, 6(8), 2.
Musharyanti, L., Claramita, M., Haryanti, F., & Dwiprahasto, I. (2019). Why do nursing students make medication errors? A qualitative study in Indonesia. Journal of Taibah University Medical Sciences, 14(3), 282–288. https://doi.org/10.1016/j.jtumed.2019.04.002 Benchmark – Medical Errors Discussion
YMweek_6_Capstone_Change_Project_Resources
