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NURS FPX 4020 Assessment 3: Improving Quality of Care and Patient Safety

NURS FPX 4020 Assessment 3: Improving Quality of Care and Patient Safety

Improvement Plan In-Service

In-service education (ISE) for nurses is to enhance engagement and competency for improved task execution, assisting the organization in achieving its objectives (Jackson et al., 2018). Practical application is one of the key characteristics of in-service education. Nurses play an essential part in raising health standards. They must be informed of new developments in both the field’s theory and practice. In reality, in-service education helps to develop best practices for carrying out various activities and responsibilities while also keeping staff members’ professional knowledge and occupational skills up-to-date (Germossa et al., 2018). Nurses who are actively involved in in-service education can effectively learn and progress in their line of work (Kavita et al., 2020).

Purpose and Goals of In-Service Sessions on Safe Medication Administration

ISE programs for nurses in a healthcare organization help in eliminating the difference between evidence-based practice and traditional medical practices (Happell et al., 2020). An increase in nursing productivity and competency, providing safe and effective patient care by nurses, assuring satisfying work performance by nurses, and orienting the staff to care objectives, job obligations, and organizational policies are among the goals of in-service education on medication administration (Farzi et al., 2018). Inservice training sessions on safe medication administration for nurses include the following purposes (Asiamah et al., 2019). 

  1. Understanding the health and safety issues that affect the administration of particular medications to patients.
  2. Procedures that are precise and secure reduce risks and errors in health and safety.
  3. Reporting to the nurse trainer about observational findings and medication errors.

One of the purposes of ISE plans is to improve the nurses’ knowledge and attitudes toward dealing with a particular patient condition (Germossa et al., 2018). Nursing leaders are now struggling with helping nurses with appropriate medication administration. A crucial first step in increasing patient safety and high-quality outcomes is for healthcare companies to mandate in-service training for nurses. The in-service education and training of nurses may be hampered by a lack of motivation, emotional stress, the insufficiency of staff, a lack of time and programs, and long working hours (Mousazadeh et al., 2020). Therefore, sufficient in-service training must be provided to ensure the safety of both healthcare professionals and patients.

Need to Improve the Medication Administration

It’s necessary to keep in mind that mistakes during medication administration may cause patient morbidity or even death. Additionally, these mistakes can harm a healthcare facility’s reputation and increase organizational and governmental expenses (Saljoughian, 2020). Annually, overall medical errors result in up to 98,000 fatalities. More people die from it than from AIDS, cancer, or car crashes combined. Each year, medication mistakes result in more fatalities than workplace accidents (Rodwin et al., 2020). The expense of these mistakes makes it much more vital to solving this pervasive underestimated issue.

NURS FPX 4020 Assessment 3: Improving Quality of Care and Patient Safety

Limited knowledge, distractions, complicated procedures, and incorrect system design are a few examples of structural reasons for medication administration problems (Taxonomy of Medication Errors, 2022). Medication administration mistakes continue to be a problem despite attempts to reduce them by using new technology and simplifying procedures. Researchers calculated average mistake percentages of 8%–25% throughout drug administration based on a survey of direct observation studies on medication errors in healthcare facilities (Alghamdi et al., 2019).

The Process to Improve Safety Outcomes Related to Medication Administration

A crucial component of providing safe medical care is ensuring that medications are administered appropriately and securely. Every healthcare professional receives training on the significance of adhering to the “Six Rights” of Medication Administration: Right patient, medication, dose, route, time, and documentation (Kartika & Melani, 2018). 

Safety Improvement Plan

There are several methods and techniques for enhancing the safety outcomes of medication administration. The following five can have an effect.

  • Evaluate the workplace

Medication administration errors and other safety hazards are influenced by specific employment settings. These include employee shortages or turnover, many disruptions and diversions, inadequately planned pharmaceutical safety practices, and disregard for rules and regulations (Alshehry et al., 2019).

  • Integrate technology for medication safety

Technologies that can lessen or avoid medication administration errors include electronic prescribing input, medication safety warnings, medication barcoding, smart IV infusion pumps, and single-use medication containers (He et al., 2019).

  • Educate the patients and healthcare providers

Give patients and their caregivers enough information on how to take their medications at home and when to call them if unsure about how to take the medications.

  • Implementation of the strategies for LASA drugs

Numerous medications look alike or sound alike (LASA). These drugs can be mixed up if their names, packing, or administering device designs are identical. A list of the troublesome drugs has been compiled by The Joint Commission (Joint Commission, n.d.). 

  • Take high-alert medications with special vigilance

Medication with a significant threat level is more likely to be mishandled and result in damage or death. There is a list of drugs that require high alert according to the Institute for Safe Medication Practices (ISMP) (ISMP, 2018).

Audience Role in Making the Improvement Plan a Success in Medication Administration

The audience is in charge of actively participating in and carrying out strategic planning. Involvement from the crowd can result in efficient learning and personal growth (Guinea et al., 2019). To assist their knowledge acquisition, nurses must be conscious of the learning goal. Engagement of the audience entails multidimensional cooperation, counseling, and active involvement in helping people live better lives. Successful quality management and drug administration efforts may be promoted by an engaged public and audience. By recognizing the current gaps in medicine delivery, the audience may comprehend and participate effectively. Through the use of digital and visual technologies, the audience may develop plans and spread the information to guarantee the community receives high-quality results. Participants might more effectively assess the health objectives.

NURS FPX 4020 Assessment 3: Improving Quality of Care and Patient Safety

The interdisciplinary environment might encourage audience involvement (Manias, 2018). To maintain a secure medication administration and also the well-being of patients, public and audience participation is essential. The audience’s and the government’s healthy growth is realized via the growth, assessment, and consequences of continual improvement. Additionally, audience accessibility to updated medical equipment can be improved through visual aids and digital apps. The audience can employ media-rich tools for successful communication since utilizing technology is a cost-efficient measure.

Resources to Encourage Skill Development in Safety Improvement for Medication Administration

The creation of multidisciplinary teams is one of the solutions offered to address medication administration errors in the healthcare industry. Additional resources include digitizing data, installing barcodes, and improving communication (Kartika & Melani, 2018). These approaches are suggested to strengthen the concern’s effectiveness by ensuring proper multidisciplinary teams. These teams would guarantee that the workplace is kept in good condition and that each person’s workflow is efficient at all levels. The implementation of barcodes and a well-organized collection of instruction manuals might contribute to the problem’s simplification in this regard. Individual skill development requirements are met by employing a medication module structure, which is also easily adaptable to different situations (Yu et al., 2021). This method enables nurses to build skills for coping constructively with medication errors. In addition, examining a drug’s accuracy in light of its prescription charts is helpful. Additionally, it was found that there were significant communication breakdowns between the parties involved in the drug allocation and supply process, which resulted in the patient receiving the incorrect medication and the dosage being incorrectly adjusted (Alghamdi et al., 2019). In addition to poor communication, this procedure was unproductive and worked against the interests of the patients due to the added workload placed on the nurses and their difficult shift schedules.

Furthermore, a crucial part of managing medicine administration is developing an electronic filing system (Pohlmann et al., 2020). This automated filing system features well-designed phases, such as well-organized patient background information. Proposal and construction of materials to support updating information on patient health; analysis of updates regarding patient protocol; use of test procedures and evaluation to support obtaining specific information about patient recovery. The activity involves:

  • Divide the audience into two groups
  • Assign the pros and cons of the electronic filing system to each group separately
  • Ask each group to argue with the other group to support their point. 
  • A more convincing group will be declared the winner

Soliciting Feedback

  • Maintain behavior that encourages the audience to give feedback
  • Can get help from a facilitator as well
  • Tools for getting feedback to involve 
  • Surveys
  • Feedback boxes
  • Activities

Conclusion

In all research domains, it is crucial to recognize the errors that have already occurred since often the underlying causes are not immediately apparent. Numerous elements might have good or negative effects that can even result in the patient’s death. Examining these errors in light of the objectives of the study enables the development of recommendations for healthcare organizations and future recurrence prevention. However, without the actual implementation of in-service training programs and problem-based learning, the detection of medication administration errors is insufficient. A vital activity is staff collaboration to influence organizational performance and patient safety. Making a strategy for follow-up measures requires a thorough review of the error and any related factors.

References

Alghamdi, A. A., Keers, R. N., Sutherland, A., & Ashcroft, D. M. (2019). Prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care settings: A systematic review. Drug Safety, 42(12). https://doi.org/10.1007/s40264-019-00856-9 

Alshehry, A. S., Alquwez, N., Almazan, J., Namis, I. M., & Cruz, J. P. (2019). Influence of workplace incivility on the quality of nursing care. Journal of Clinical Nursing, 28(23-24), 4582–4594. https://doi.org/10.1111/jocn.15051 

Asiamah, N., Mensah, H. K., & Ocra, B. (2019). An assessment of education, in-service training and tenure prolongation as methods for enhancing nursing performance. International Journal of Health Care Quality Assurance, 32(6), 910–926. https://doi.org/10.1108/ijhcqa-07-2018-0190 

Farzi, S., Shahriari, M., & Farzi, S. (2018). Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study. Journal of Education and Health Promotion, 7(7), 115. https://doi.org/10.4103/jehp.jehp_169_17

Germossa, G. N., Sjetne, I. S., & Hellesø, R. (2018). The impact of an in-service educational program on nurses’ knowledge and attitudes regarding pain management in an Ethiopian University Hospital. Frontiers in Public Health, 6. https://doi.org/10.3389/fpubh.2018.00229

Guinea, S., Andersen, P., Reid-Searl, K., Levett-Jones, T., Dwyer, T., Heaton, L., Flenady, T., Applegarth, J., & Bickell, P. (2019). Simulation-based learning for patient safety: The development of the tag team patient safety simulation methodology for nursing education. Collegian, 26(3), 392–398. https://doi.org/10.1016/j.colegn.2018.09.008

Happell, B., Waks, S., Horgan, A., Greaney, S., Manning, F., Goodwin, J., Bocking, J., Scholz, B., Hals, E., Granerud, A., Doody, R., Platania‐Phung, C., Griffin, M., Russell, S., MacGabhann, L., Pulli, J., Vatula, A., Browne, G., Vaart, K. J., & Allon, J. (2020). It is much more real when it comes from them: The role of experts by experience in the integration of mental health nursing theory and practice. Perspectives in Psychiatric Care, 56(4). https://doi.org/10.1111/ppc.12496

He, J., Baxter, S. L., Xu, J., Xu, J., Zhou, X., & Zhang, K. (2019). The practical implementation of artificial intelligence technologies in medicine. Nature Medicine, 25(1), 30–36. https://doi.org/10.1038/s41591-018-0307-0

ISMP. (2018, August 23). High-alert medications in acute care settings. Institute for Safe Medication Practices. https://www.ismp.org/recommendations/high-alert-medications-acute-list

Jackson, L., Jowsey, T., & Honey, M. L. L. (2018). In-service education: Evolving internationally to meet nurses’ lifelong learning needs. The Journal of Continuing Education in Nursing, 50(7), 313–318. https://doi.org/10.3928/00220124-20190612-06

Kartika, I. R., & Melani, V. (2018). Application of “six rights” on medication administration by nurse and patient satisfaction. Indonesian Nursing Journal of Education and Clinic (INJEC), 2(2), 178. https://doi.org/10.24990/injec.v2i2.144

Kavita, K., Thakur, J., Vijayvergiya, R., & Ghai, S. (2020). Nurses’ role in cardiovascular risk assessment and communication: Indian nurses perspective. International Journal of Noncommunicable Diseases, 5(1), 4. https://doi.org/10.4103/jncd.jncd_29_19

Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: An integrative review. Expert Opinion on Drug Safety, 17(3), 259–275. https://doi.org/10.1080/14740338.2018.1424830

Mousazadeh, N., Yektatalab, S., Momennasab, M., & Parvizy, S. (2020). Intensive care unit nurses’ perception of the barriers to effective in-service education: A qualitative study. Journal of Nursing and Midwifery Sciences, 7(4), 241. https://doi.org/10.4103/jnms.jnms_27_20

Rodwin, B. A., Bilan, V. P., Merchant, N. B., Steffens, C. G., Grimshaw, A. A., Bastian, L. A., & Gunderson, C. G. (2020). Rate of preventable mortality in hospitalized patients: A systematic review and meta-analysis. Journal of General Internal Medicine, 35(7), 2099–2106. https://doi.org/10.1007/s11606-019-05592-5

Saljoughian, M. (2020, June 18). Avoiding Medication Errors. Department of Pharmacy Alta Bates Summit Medical Center Berkeley, California. https://www.uspharmacist.com/article/avoiding-medication-errors

Taxonomy of Medication Errors. NCC MERP. (2022). Retrieved 19 October 2022, from https://www.nccmerp.org/taxonomy-medication-errors.

The Joint Commission (n.d.). Patient safety. A trusted partner in patient care https://www.jointcommission.org/resources/patient-safety/ 

Yu, G., Chen, Z., Wu, J., & Tan, Y. (2021). Medical decision support system for cancer treatment in precision medicine in developing countries. Expert Systems with Applications, 186, 115725. https://doi.org/10.1016/j.eswa.2021.115725

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