assignment 2

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Capella University *

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Medicine

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Apr 3, 2024

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Applying Library Research Skills 1 Applying Library Research Skills Deepali Patel Capella University Developing a Health Care Perspective Rita Wunderlich May 2021

2 Applying Library Research Skills Medication errors remain a major cause of patient morbidity and mortality. Over this two-year, Coronavirus has engulfed the whole world in its tangle. More challenges are faced by health care workers today than ever before. There is a significant increase in patients’ admissions to the intensive care unit and other casualties. With COVID-19, opportunities have increased for serious medication errors. Health care providers are being hurried, overwhelmed and emotionally drained taking care of the critically ill patients. Medication errors are being reported less due to significant and understandable lack of time. Working side by side with nurses everyday has opened my eyes to challenges they face with patient in radiation oncology department. Working everyday with the patient you see how our healthcare system is fragmented which contributes significantly to medical errors. Patients tend to see multiple health care providers, and everyone might not have the same access to information as other. There are many medication errors, but the two main ones are prescribing error and wrong dose errors. Prescribing error is when the selection of the medicine is wrong based on patient’s allergies. The form, quantity, route all adds to prescribing error. Wrong dose error is when the correct dose was prescribed but not administered. There are many possible reasons why a medication error occurred, healthcare workers are distracted, the workload, lack of knowledge, incomplete patient information and systemic problems. Knowing the patient is very important. Using all the information at your disposal should ensure patients safety. Rely on your instinct and ask questions. Most important part is keeping the communication line open. Documenting any drug administered is very important. COVID-19 is showing to be a long uphill battle. The horizon seems very far right now. The stress and anxiety caused by the burden of this pandemic is unimaginable on health care workers.

3 Medication error does not just occur as a result of incompetence but there are many factors such as faulty systems and working conditions that contributes to it. Institution should promote error reporting under leaders who are reliable and credible. The reporting system should be confidential, clear and easy to use, as well as helpful. The crisis now has created difficult pathways to health care workers. As a health care worker, treating cancer patients has been stressful with COVID. With COVID, visitors are not allowed at my cancer care. Patient who has language barrier, who are old frail and weak are at a disadvantage since they have no one accompanying them inside the hospital. It is a lot to process once you step in the hospital. Identifying and Assessing Credibility of Information Sources I was able to search into resources from Capella University. From their Library’s database, I went to summon which is a single search box to find articles and other resources. From there I was able to search keywords such as “ medication errors, “and “patient safety.” I was able to find on ProQuest Central database the articles I was looking for. I investigated peer- reviewed journals from recent years through advanced search. To confirm that all contained good information, I only investigated authors who had great knowledge in health care. In each article, I wanted to have a solution to the problems they were experiencing. All the publications are current. Annotated Bibliography Aseeri, M., Banasser, G., Baduhduh, O., Baksh, S., & Ghalibi, N. (2020). Evaluation of medication error incident reports at a tertiary care hospital. Pharmacy, 8 (2), 69. http://dx.doi.org.library.capella.edu/10.3390/pharmacy8020069

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4 This article used retrospective study to evaluate all reported medical errors over the year of 2015. Reports were taken from the hospital Safety Reporting Systems (SRS). Data gathered were analyzed using the SPSS, version 20. In the study, total of 624 medication error reports were presented. High-alert medications were on top of the list in the report. The top pitfall that occurred in this study was dispensing/administrating wrong medication. In the study it was also reported that most medication error occurs during day shift. Lack of communication, missing patient information, absence of double-checking administration of medication were all contributing factors to medication error. The article sprouts few solutions, the main one being reaching out when a near miss even occurs. Unsafe occurrences are a very real possibility when there are different groups of health care workers taking care. The authors at end with targeting the multiple reasons such as time pressure, fatigue, understaffing, inexperience the purpose of choosing the article was to show how every corner of different hospital, any department can have medication error that could error in patient safety . Car, L. T., Nikolaos, P., Urch, C., Azeem, M., Rifat, A., Josip, C., & Vincent, C. (2017). Prioritizing medication safety in care of people with cancer: Clinicians’ views on main problems and solutions. Journal of Global Health , 7(1) http://dx.doi.org.library.capella.edu/10.7189/jogh.07.011001 Like the article above, this one focuses on medication error issue using prioritize. Prioritize methodology concentrates on priorities in health care services delivering using clinicians as experts and determines priorities. Forty cancer care clinicians identify the main concern and solution to the medical errors happening in Oncology department. When it comes to Cancer treatment, there is a high chance of errors due to its

5 multifaceted and dynamic nature. The article hits close to the heart as I work in the Radiation Oncology Department. The main problems leading to medication errors in this article was found to be poor understanding of medication due to language or education difficulties. Having better communication specially around prescribing stage is least way to make a medication error. As a radiation therapist, there are so many factors that can contribute to medical error. There are patients who needs to have concurrent chemo drugs with radiation. With so much information given to patient, it is very overwhelming. Providing a channel to communicate whenever patient has a concern is a great step to reduce errors. Lorainne, T. C., Papachristou, N., Gallagher, J., Samra, R., Wazny, K., El-Khatib, M., . . . Franklin, B. D. (2016). Identification of priorities for improvement of medication safety in primary care: A PRIORITIZE study. BMC Family Practice , 17 http://dx.doi.org.library.capella.edu/10.1186/s12875-016-0552-6 The purpose of this article is to discuss and come up with a solution to reduce medication error. The study used prioritize methodology by modifying the Child Health and Nutrition Research Initiative(CNHRI) which concluded main concern by investigating from two sides: problems and solutions. The authors start this study by inviting 500 North West London primary care clinicians and asking them open ending questions. The results brought three top ranked problems leading to medication errors. First was incomplete reconciliation of medication during shift change or hand over. Second is poor education of medication knowledge on how to take medication and lastly poor discharge summaries. The study brings solutions to these three problems by creating standardized discharge summary templates, reduction of unnecessary prescribing, and avoidance of polypharmacy. Poor

6 communication among health care workers and patients as well as poor documentation are also one of the main risks to medication error. The study is applicable to the topic of medication error as it brings forward the problems and the solution towards it. Spruce, L.,D.N.P.R.N.C.N.S.-C.P.C.N.O.R.A.C.N.S.A.C.N.P.F.A.A.N. (2020). Back to basics: Medication safety: The official voice of perioperative nursing. AORN Journal, 111 (1), 103-112. http://dx.doi.org.library.capella.edu/10.1002/aorn.12891 The article above provides information on medical administration in the perioperative patient care setting. In perioperative environment, there are no standard safety checks such as pharmacy approval or multiple checks at the time of administration. The article gives a glance at a case on February 4 th , 2019, where a nurse was charged with careless homicide. She was arrested for medication error that happened in 2017 which resulted in a patient death. She however, allegedly performed an override from cabinet medication a took out different medication. The medication had the same first two letter as the prescribed medication. The patient had a heart attack and could not breathe. In this study, researcher completed a seven-month prospective observational study. In which 3,671 medication administration, 193 of which involved a medical error. The most common medication error occurred was incorrect dose. The solution at the end of the article suggested to work closely with pharmacy to have single use vials and prefill syringes when possible. Avoiding verbal medication orders should also be lessened. Monitoring patient to document any physiological or psychological should always be required.

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7 Knowledge from the Research Shift changes are busy times in hospitals. They can create openings for dangers and miscommunications about patient care. Hospitals should work on making shift changes safer by taking action to minimize the chance of errors at crucial time. Even though it is completely impossible to remove all medication error as human error can occur, there are steps needed to be taken in order to reduce it. Reporting near miss error is valuable as it reveals the hidden danger on what could have happened. Several interventions care needed to improve the outcome. Patient involvement needs to be more, patient education, automatization of the prescription process using computerized solutions, and promoting mutual responsibility are all the ways to be better. Talking to the nurses in my department, I learned more information on how easily a harm could be done with a medication error. Cancer patients can be on lot of pain medication and anxiety medications. Mixing chemotherapy drugs or seizure medication could be fatal to their health. Having someone double check medication specially when it is a high-risk medication should be implemented.

8 References Aseeri, M., Banasser, G., Baduhduh, O., Baksh, S., & Ghalibi, N. (2020). Evaluation of medication error incident reports at a tertiary care hospital. Pharmacy, 8 (2), 69. http://dx.doi.org.library.capella.edu/10.3390/pharmacy8020069 Car, L. T., Nikolaos, P., Urch, C., Azeem, M., Rifat, A., Josip, C., & Vincent, C. (2017). Prioritizing medication safety in care of people with cancer: Clinicians’ views on main problems and solutions. Journal of Global Health, 7(1) http://dx.doi.org.library.capella.edu/10.7189/jogh.07.011001 Lorainne, T. C., Papachristou, N., Gallagher, J., Samra, R., Wazny, K., El-Khatib, M., . . . Franklin, B. D. (2016). Identification of priorities for improvement of medication safety in primary care: A PRIORITIZE study. BMC Family Practice, 17 http://dx.doi.org.library.capella.edu/10.1186/s12875-016-0552-6 Spruce, L.,D.N.P.R.N.C.N.S.-C.P.C.N.O.R.A.C.N.S.A.C.N.P.F.A.A.N. (2020). Back to basics: Medication safety: The official voice of perioperative nursing. AORN Journal, 111(1), 103-112. http://dx.doi.org.library.capella.edu/10.1002/aorn.12891

assignment 2

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