How to Prevent Medication Errors in a Hospital
Preventing Medication Errors is one of the most important concerns of a healthcare organization or hospital. This is because a small error or mishap in giving patients their medication could lead to a worsening of their medical condition, more health problems and even worse, death. Medication errors can occur in hospitals, clinics, doctors offices, nursing homes, pharmacies, during routine procedures etc. There is no shortage of instances and situations that a patients medication or dosage can get mixed up. In addition, medication errors do not refer to just mixing up drugs but it can also mean mixing up dosages or mixing up the food for a patient that needs a specific diet. This is why Preventing Medication Errors is a big concern for medical facilities. Below we discuss ways that medication errors can be avoided in a healthcare facility.
Always Follow the Medication
Regulation and Procedures
There are institutional policies and regulations that have been established to help prevent medication errors and these policies should always be adhered to. Nurses, doctors, and other care providers must ensure that the correct medication is given to the right patient and at the right dosage and at the right time. Following the right guidelines will help care providers achieve that. Healthcare organizations and hospitals should have set mechanisms in place for proper medication reconciliation when transferring patients to a different medical institution. Medication reconciliation ensures that after the patient is transferred, they are still given the right medication at the right time and the proper dosage is followed. The medication chart and transfer orders should be reviewed to show the correct dosage, correct medication, and any other information. All this information about a patients medication must be compared to the medication administration record (MAR) and verified.
Always Verify the Medication and Dosage
Doctors, nurses, and anyone in charge of a patients medication must double check and even triple check procedures at all times. When there is a shift change, the incoming shift must review everything done by the outgoing shift so that nothing is missed and mistakes are avoided. They must review all patient orders to ensure that it is noted correctly and that new orders are highlighted. Dates and times should always be written down clearly and if there is a color coordinating system it should be easy to understand and well known by all who use it. Also, when a physician is prescribing medication and a nurse is writing it down, the nurse should read back the order to the prescribing physician to make sure everything he said has been transcribed properly. This is also another way of double checking and triple checking to ensure accuracy and avoid errors.
Use a Name Alert
A name alert is used to point out when patients have similar sounding names or name spellings and when they are patients with the same first and last names. The name alert helps prevent any potential mixups and medication errors. For example, a patient names Kristin Smith could easily be mixed up with a patient names Kirsten Smith and this could lead to devastating consequences. Hence, a name alert helps prevents medication errors caused by problems and mixups like this.
Place a Zero in Front of
the Decimal Points
Little nuances like this could lead to huge errors. Placing a zero in front of a decimal point ensures that there cannot be a mixup with the number. Nurses work long hours and a nurse bugged down with fatigue and tiredness can easily mistake a .2mg or a 2mg dosage and this could lead to them delivering the wrong dosage. Not only, tired nurses but a nurse in a hurry or a nurse who does not pay close attention to the chart could make the same mistake. Not just people reading the dosage but the nurse or doctor writing the dosage might not properly write the dosage or make the point legible enough leading to an error occurring which would otherwise lead to adverse effects and consequences for the patient.
Use Proper Medication Documentation
All medication must be documented appropriately and labeled to ensure that the information is always available, accurate and transferred. Medication should be documented right when they are given and not left for later. Failure to document properly could result in another dosage being administered to the patient as the first one was not properly documented. This, of course, leads to overdosage for the patient. Documentation also means correctly labeling medication in terms of names and expiration dates. When a medication has an incorrect label it could lead to a patient being given the wrong drugs or being given expired medication.
Store Medication Properly
All medication should be properly stored to ensure their potency. Some drugs come with specific storage instructions such as drugs that need to be refrigerated or those that need to be kept in room temperature. The storage rules must be documented properly and must be strictly adhered to.
Drug Guide Training
A healthcare organization should have a drug guide and the drug guide should be followed by all the nurses who must be trained properly on how to follow the guide. The guide should include the rules and guidelines of the administration's medication policy and the specific rules of each type of drug. During training, nurses and clinicians should be tasked with familiarizing themselves with guidelines such as the Beers’ list, black box warning labels, and look-alike/sound-alike medication lists etc. They should also familiarize with the basic rules and drug policies to the extent that it becomes second nature to them. In addition to that, the drug guide should be available at all times and within quick and easy reach of nurses and clinicians so it can be referred back to when needed.