BUS 519 Project Risk Management Risk Management Plan
BUS 519 Project Risk Management Risk Management Plan
Introduction
The primary objective of the risk management approach is to mitigate medication errors, a complex and critical issue within the healthcare domain that poses significant threats to patient safety. Medication mistakes can result in severe repercussions for patients. A significant number of medication mistakes of a severe kind lead to avoidable adverse drug events (ADEs), with roughly 20% of these occurrences posing a danger to the patient’s life. The yearly mortality rate attributed to drug mistakes is estimated to be 7,000, as stated in the paper titled “To Err is Human” by the Institute of Medicine. Despite the diligent efforts of nurses, it has been shown that a significant proportion, namely over 40%, of adverse drug events (ADEs) that are severe in nature and pose a danger to life may be avoided with appropriate measures.
Significance of The Problem
Medication mistakes may lead to significant financial burdens. Adverse drug events (ADEs) contribute an annual sum of about $7.5 billion only to hospital expenses on a national scale. Moreover, it is worth noting that this particular statistic does not take into account other significant expenses associated with prescription mistakes, such as the premiums for malpractice insurance and the negative impact on workforce efficiency. Preventable adverse drug events (ADEs) may occur due to errors that arise in several phases, including ordering, administration, transcribing, and dispensing. According to Austin et al. (2022), more than 30% of these mistakes occur during the administration phase.
Barcode medication administration (BCMA) technology
Barcode medication administration (BCMA) technology is a recognized health information technology that has been attributed to the prevention of pharmaceutical mistakes and the enhancement of patient safety, provided that it is used with precision. The use of BCMA technology facilitates the verification process by the scanning of barcodes on both medicine and patient identification wristbands. This automation assists nurses in ensuring adherence to the fundamental principles of medication administration, often referred to as the ‘five rights’: patient identity, medication accuracy, dosage precision, appropriate administration route, and timely delivery.
Rationale
Hospitals have actively promoted the introduction of Barcode drug delivery (BCMA) as a preventive measure against the adverse outcomes associated with drug delivery mistakes. The efficacy of BCMA in mitigating pharmaceutical delivery mistakes and minimizing the adverse effects resulting from substantial medication errors has been well-documented. Prior research has also shown a rise in rates of patient identification verification after the implementation of the Barcode Medication Administration (BCMA) (Hogerwaard et al., 2023). Although BCMA has been in existence for more than twenty years, hospitals have encountered difficulties in integrating and executing it within their current infrastructure. Multiple studies have shown that the implementation process plays a crucial role in determining the overall effectiveness of BCMA.
Support
The introduction of BCMA (Barcode drug delivery) has shown significant efficacy in mitigating drug delivery mistakes. The deployment of BCMA-eMAR at an academic medical institution was examined in the research, which revealed a relative decrease of 41.1% in nontiming mistakes during medication administration. Consequently, there was a relative reduction of 50.8% in probable adverse drug events (ADEs) caused by these errors (Austin et al., 2022). The adoption of BCMA (Barcode drug delivery) in the Emergency Department (ED) has shown a significant decrease of 80.7% in drug delivery mistakes. The BCMA system has also been shown to provide financial advantages. The deployment of BCMA is associated with an approximate cost of $2,000 per prevented hazardous medication mistake, which is comparatively lower than the anticipated cost range of $3,100 to $7,400 for a detrimental error.
Implementation
The healthcare organization will establish a standardized framework for the implementation of BCMA in the hospital, with the assistance of a national panel of BCMA specialists. The healthcare organization’s standard will prioritize the adoption of four components of the BCMA. The implementation process will aim at promoting the level of BCMA adoption across various units within the hospital, specifically focusing on medical and/or surgical units, critical care units, and labor and delivery units. The hospital’s adherence to doing patient and drug scans at the bedside before medication administration will also be promoted. The decision support capabilities provided by the hospital’s Barcode Medication Administration (BCMA) system, as well as the organizational structures will be used by the hospital to monitor and mitigate workarounds.
Planning and Implementation
The management of the facility will designate a BCMA Coordinator who will be in charge of overseeing and executing all procedures to increase the security, effectiveness, and effectiveness of the drug administration management process (Zheng et al., 2020). The individual in the role of Coordinator will have responsibility for overseeing procedures, ensuring equipment upkeep, and providing advice about business operations. A diverse team consisting of individuals from various disciplines, such as personnel working in front-line nursing, nursing administration, pharmacies, health information technology, laboratory staff, respiratory treatment, biomedicine, quality improvement, risk management, staff development, laboratories, and blood banks, will be selected to collaborate with the BCMA Coordinator. Representative members will be chosen on an ad hoc basis from the office of the chief of staff, the medical staff, and the engineering departments.
The bar-code medication administration team will be responsible for the selection of technology, the initial policies and processes for staff training, and the deployment plan for implementation and maintenance throughout the hospital. Policies will be written to address continuing staff education, new employee orientation, and annually updated competencies. The continued operational practice will create solutions for problems, such as: missed medication doses; equipment malfunction, maintenance, and repair; life cycle replacement; and bar-code quality on wristbands and medication packaging. Performance measures will be evaluated for as-needed (PRN) medication effectiveness, medication variances, and intravenous fluid (IV) documentation (Zheng et al., 2020).
Challenges
The implementation of BCMA technology poses a significant challenge in terms of redefining caregiver responsibilities and workflows. This necessitates extensive training and demonstrations to effectively communicate these changes to staff. Cultural barriers can impede the implementation of BCMA. Some nurses are hesitant to use BCMA due to the added steps it introduces to their busy care schedules (Hogerwaard et al., 2023). The implementation and operation costs of BCMA are prohibitively high.
Need to Overcome Challenges
Hospitals may require support from purchasers to optimize the efficiency of their BCMA systems, considering the existing challenges. Although BCMA systems may necessitate substantial financial investments, they effectively mitigate the occurrence of medication errors, thereby preventing potentially higher costs. BCMA systems can effectively mitigate the risk of adverse drug events, which can have severe consequences, including employee fatalities (Brown, 2023).
Evaluation
Direct observation is considered the gold standard for evaluating compliance with policies and procedures in BCMA. However, it is a time-consuming and expensive method. According to Brown (2023) the hospital will develop a 32-item checklist to evaluate compliance during medication administration by nurses. Observers will use this checklist during both AM and PM shifts. The checklist will encompass armband characteristics, medication bar code, the five rights of administering medication, nurse alerts, and patient allergies.
Opportunities
Health organizations and hospitals are adopting BCMA (Barcode Medication Administration) to enhance patient safety. In response, nursing leadership is tasked with conducting research and establishing optimal practices for the implementation of this technology. Hospitals have demonstrated significant dedication and financial investment in the implementation of effective BCMA systems, indicating a strong emphasis on quality and patient safety within healthcare systems (Saulan et al., 2023). Although focusing on nurse workflow alone may not eliminate medical errors, implementing technology system operations and adhering to patient safety practices can effectively decrease medical errors and enhance the quality of care. By persistently pursuing solutions and dedicating efforts to enhance healthcare quality, it is possible to address medication errors and optimize the utilization of technology.
References
- Austin, J. M., Bane, A., Gooder, V., Saltsman, C., Wilson, M., Stewart, K. B., Derk, J., Danforth, M., & Michalek, C. (2022). Development of the Leapfrog Group’s Bar Code Medication Administration Standard to Address Hospital Inpatient Medication Safety. Journal of Patient Safety, Publish Ahead of Print(6). https://doi.org/10.1097/pts.0000000000001052
- Brown, K. A. (2023). Reducing Medication Errors in Inpatient Hospital Settings by Implementing the Barcode Medication Administration Technology: An Integrative Review. Scholars Crossing. https://digitalcommons.liberty.edu/doctoral/4483/
- Hogerwaard, M., Stolk, M., Dijk, L. van, Faasse, M., Kalden, N., Hoeks, S. E., Bal, R., & Horst, M. ter. (2023). Implementation of barcode medication administration (BMCA) technology on infusion pumps in the operating rooms. BMJ Open Quality, 12(2), e002023. https://doi.org/10.1136/bmjoq-2022-002023
- Pruitt, Z. M., Kazi, S., Weir, C., Taft, T., Busog, D.-N., Ratwani, R., & Hettinger, A. Z. (2023). A Systematic Review of Quantitative Methods for Evaluating Electronic Medication Administration Record and Bar-Coded Medication Administration Usability. Applied Clinical Informatics, 14(01), 185–198. https://doi.org/10.1055/s-0043-176143
- Saulan, T. L. M., Belknap, M., & Taubkin, B. (2023). Augmenting the 5 Rights: Improving Compliance with Barcode Medication Administration. Journal of PeriAnesthesia Nursing, 38(4), e13. https://doi.org/10.1016/j.jopan.2023.06.073
- Zheng, W. Y., Lichtner, V., Van Dort, B. A., & Baysari, M. T. (2020). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research in Social and Administrative Pharmacy, 17(5), 832–841. https://doi.org/10.1016/j.sapharm.2020.08.001
Risk Management Plan
Note: The assignments in this course are a series of papers that are based on the same case, which is located in the XanEdu tab in the left-hand menu of your course. The assignments depend on one another. In this assignment, you will create a risk management plan. You have a budget of $100,000 and a timeline of six months for the plan. Please refer to the Risk Management Plan Template (Figure A-1 in Practical Project Risk Management) to create the plan.
Write an 8–10 page paper in which you:
Prepare the scope and objectives of the Risk Management Process section of the Risk Management Plan, based on the facts presented in the case study.
Determine the project size, based on the facts presented in the case study, and provide justification based on the Example Project Sizing Tool (Figure 3-4 in Practical Project Risk Management).
Select the risk tools and techniques, and complete the Risk Tools and Techniques section of the Risk Management Plan for both the qualitative and quantitative aspects of the project. Provide a rationale for the selections.
Develop the Risk Reviews and Reporting section of the Risk Management Plan, based on the project size previously determined.
Define the Probability and Impacts section of the Risk Management Plan, and justify the values assigned.
Define the Risk Thresholds section of the Risk Management Plan, and justify the values assigned.
Use at least three quality resources in this assignment. Note: Wikipedia and similar websites do not qualify as quality resources.
This course requires the use of Strayer Writing Standards. For assistance and information, please refer to the Strayer Writing Standards link in the left-hand menu of your course. Check with your professor for any additional instructions.
The specific course learning outcome associated with this assignment is:
Create a risk management plan that includes justification to support your rationale.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
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Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.