5 strategies for reducing medication errors
Wednesday, October 02, 2019
As a healthcare professional, you constantly monitor your hospital to make sure patient safety is the ultimate priority. But improving your approach on a constant basis is also vital.
What strategies should you be implementing to ensure your patients receive their medication properly, without hazard and in a timely manner? Use these science-driven pieces of advice to accomplish these essential goals.
Understand the patterns of medication errors, first and foremost.
Do a deep dive into reviewing data on all medication areas at your facility, going back five years.
Hopefully your institution has a clean record so your work will not be cut out for you. But if your hospital has experienced recurrent problems, you must identify patterns in order to rectify them.
Monitor IV fluids given to heart failure patients.
A study from Yale University, led by author Behnood Bikdeli, found that a large number of heart failure patients receive IV fluids during the initial portion of their hospital stays, which is counterproductive to traditional diuretic treatment and can worsen their symptoms. Make sure your nursing staff is up to speed on the risks of fluids and that they're actively working with your cardiac team to avoid this problem.
Follow improved admission protocol.
The American Heart Association published a scientific statement that can help reduce medicine errors for seriously ill cardiovascular and stroke inpatients. These include:
- weighing patients upon admission;
- monitoring kidney function from admission using the Cockroft-Gault formula;
- adjusting meds stringently depending on the needs of older patients;
- including nurses and pharmacists as key members of cardiovascular care teams;
- always using computerized order entries (which should go without saying);
- using standardized orders for anti-coagulation; and
- making sure your staff understands the right way to identify and use high alert medications by establishing a clear culture of safety.
A few extra steps can make a huge difference.
Stress the vital importance of not delaying meds administration.
A study from the University of Finland, including the work of Marja Harkanen, found that omission errors, especially with staff administering anticoagulants and antibiotics, were significant reasons why meds errors can lead to patient death.
Half of the patients in this study who died from these kinds of meds errors were elderly. It's crucial that your staff members double-check their schedules so no patient misses their medicine, especially those who may not be able to advocate for themselves.
Encourage patients to report missed dosages, too.
Advocacy cannot be stressed enough. Your patients should know they have the right to speak up if they don't receive their meds on time, and know they're encouraged to talk to a nurse manager if the problem persists.
Conduct regular physician chart reviews.
Work with your doctors, especially your interns, to make sure they are properly noting meds changes to avoid dosing errors. Make vigilance a staff priority at all times. The result? Improved outcomes and great patient satisfaction.
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