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NSG 4029 W3 Project

NSG 4029 W3 Project

Patient Care Problem

Operational efficiency is an objective that healthcare organizations strive to achieve in their service provision. Operational efficiency enhances the performance and competitiveness of health organizations due to resource optimization in service provision. Strategies such as the use of health information technologies, evidence-based practices, and effective human resource management contribute to operational efficiency in healthcare. Safety events such as medication errors in practice however affect the financial performance and efficiency in health organizations. It also affects the financial stability, marketability, and viability of the organization’s operations in its markets. Therefore, the purpose of this paper is to explore the effects of medication errors in practice on the budget of an organization and the role of the nurse in the problem.

Patient Care Problem

The selected patient care problem is medication errors. According to Chen et al., (2017), medication errors refer to mistakes that occur during the process of medication use. The errors can occur in processes such as transcription, prescription, dispensing, monitoring, or administration. Medication errors may contribute to unintended harm to patients. As shown by Walsh et al., (2017), medication errors result in adverse drug events that are associated with considerable effects on patient health, healthcare institutions and the economy of a state. Medication errors have notable health effects. They include the emergence of a new health problem such as skin disfigurement, rashes, itching, or organ damage and death in severe cases.

Medication errors also have economic impacts that may affect the financial status of a health institution, patients, and the state as a whole. According to Chen et al., (2017), adverse drug events contributes to prolonged hospital stays ranging between 2.2 and 4.6 days as well as costs of care between a range of US$2595 and US$4685. Other studies report that medication errors contribute to an increase in hospital stay by 1.91 days and cost of US$2262. The risk of mortalities due to adverse drug events rises by 1.88 times among hospitalized patients (Chen et al., 2017). Economics data shows that approximately $20 billion is spent on medication errors on an annual basis in the USA. In addition, about 100000 people die from medication errors on an annual basis (Rodziewicz et al., 2021). Healthcare organizations also suffer from the effects of medication errors. Accordingly, medication errors increase the utilization of the scarce resources in addressing the care needs of the patients. It also results in increased workload as well as tainted image of the institution (Formica et al., 2018). Medication errors also predispose institutions to lawsuits. For example, a family in Chicago was awarded $7 million for a medical error lawsuit in 2013 (chhlaw.com, 2014). Lawsuits affect the reputation as well as the financial performance of healthcare institutions.

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Role of the Nurse

Nurse leaders have a critical role in mitigating medication errors in patient care. Nurse leaders act as agents of change that drive transformational practices to minimize the risk and rate of medication errors in their institutions. Nurse leaders play a proactive role in implementing procedures that will ensure safety in medication processes. They advocate the adoption of innovative practices such as the use of bar code systems of medication administration to prevent and minimize the risk of medication errors (Jember et al., 2018). Nurse leaders also ensure the utilization of evidence-based practices in medication processes. For example, they ensure nurses adhere to the five rights of medication administration that include right drug, patient, dose, time and route. Institutional factors such as high workload facing the nurses and shortage of nurses have been implicated in medication errors. In this case, nurse leaders have the role of ensuring that the work conditions in their institutions minimize the predisposition of nurses to committing medication errors (Rutledge et al., 2018). For example, nurse leaders advocate the provision of conditions that meet the needs of the nurses as well as the creation of patient safety culture in their organizations.

Nurse leaders also encourage the culture of reporting of adverse and near miss events in their organizations to address the issue of medication errors. They encourage transparent reporting of medication errors and near miss events by ensuring non-discrimination of the involved staffs. Through it, they create a culture where staffs uphold transparency, accountability, and responsibility in patient care for safety and quality in nursing. Nurse leaders also encourage interdisciplinary collaboration between healthcare providers to ensure that best practice interventions are incorporated into patient care (Kavanagh, 2017). Therefore, nurse leaders have critical roles to play in addressing the issue of medication errors in their institutions.

Regulatory Agencies and Policies

A number of regulatory agencies are involved in overseeing patient safety issues that include medication errors. One of the agencies is the Food and Drug Administration (FDA). The FDA requires hospitals to report voluntarily medication errors to their Adverse Event Reporting System. The agency requires institutions and healthcare providers to report information such as circumstances, types, effects, and safety risks associated with a medication error or near miss events. The FDA uses the information to develop regulatory actions that institutions can adopt to prevent errors in care (FDA, 2021). The other agency that is involved in issues related to medication errors is the Agency for Healthcare Research and Quality (AHRQ). AHRQ sponsors researches on patient safety and implementation of quality initiatives that promote safety in healthcare in different healthcare institutions. The institution also collects data from hospital on safety and quality indicators in healthcare (AHRQ, n.d.). The data is used for developing policies that guide the quality and safety improvement initiatives in healthcare.

Healthcare providers and institutions are expected to embrace a number of policies to prevent and minimize the risk of medication errors in patient care. One of such policies is the five rights policy. The five rights policy requires that healthcare providers ensure right patient, drug, time, dose, and route prior to medication administration. The policy minimizes the risk and rate of medication errors in healthcare institutions (Zarea et al., 2018). The other policy relates to medication reconciliation procedures. The law requires healthcare institutions to develop policies for medication reconciliation and review in cases of referring patients from a unit to another. The reconciliation policy should ensure accuracy and safety in medication processes. The AHRQ further requires that healthcare institutions should develop policies that promote open communication among healthcare providers and accuracy in documentation of safety events to inform future change initiatives to address the problem (Billstein-Leber et al., 2018). Therefore, healthcare institutions and providers should adhere to the above policies for safety in patient care.

Organizational Budgets Affected by the Issue

Medication errors in patient care affect a number of organizational budgets. The affected budgets include master, operating, cash, financial, and static budgets. Master budget refers to the budget that the different functional areas create in the organization. The management of an institution uses master budget to plan for the activities needed to achieve the set organizational goals. Medication errors affect this budget by reducing the cash forecast, financial statement, and financial plans, as costs are diverted to address the care needs of patients affected by adverse drug events. Operating budget refers to the budget that shows the projected expenses and revenues of a firm within a given period. Medication errors cause unpredicted spending in the institution, which affects the projected revenues and spending. Cash budget provides estimate for money received or spent in a firm. Medication errors create an imbalance in cash budget, as the resources used in patient care might not align with the inputs utilized in the process. Financial budget provides insights into the capital needed in a firm within a given period. Medication errors affect this budget by inflating the required capital due to expenditures such as costs incurred in unforeseen lawsuits. Lastly, static budget refers to the expenses and revenues that will remain unchanged throughout a financial year (Waddill-Goad, 2017). Medication errors may affect this budget by forcing an organization to use its revenues to meet the complex care needs of patients if the rate of errors is high.

Conclusion

Overall, medication errors have significant implications to healthcare. It affects the health of patients as well as their economic status. It also affects economic performance of the state and healthcare institutions. Nurse leaders have critical roles to play in ensuring the prevention and minimization of medication errors. Medication errors affect budgets of healthcare institutions. Therefore, policies that aim at strengthening safety in patient care should be implemented in nursing.

 

 

References

AHRQ. (n.d.). Medical Errors | Agency for Healthcare Research and Quality. Retrieved October 11, 2021, from https://www.ahrq.gov/topics/medical-errors.html

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP Guidelines on Preventing Medication Errors in Hospitals. American Journal of Health-System Pharmacy, 75(19), 1493–1517. https://doi.org/10.2146/ajhp170811

Chen, C.-C., Hsiao, F.-Y., Shen, L.-J., & Wu, C.-C. (2017). The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit. Medicine, 96(34), e7883. https://doi.org/10.1097/MD.0000000000007883

chhlaw.com. (2014, January 1). Chicago-area family awarded $7M in medication error lawsuit. Cirignani Heller & Harman, LLP. https://www.chhlaw.com/chicago-area-family-awarded-7m-medication-error-lawsuit/

FDA. (2021, September 2). Medication Errors Related to CDER-Regulated Drug Products. FDA; FDA. https://www.fda.gov/drugs/drug-safety-and-availability/medication-errors-related-cder-regulated-drug-products

Formica, D., Sultana, J., Cutroneo, P., Lucchesi, S., Angelica, R., Crisafulli, S., Ingrasciotta, Y., Salvo, F., Spina, E., & Trifirò, G. (2018). The economic burden of preventable adverse drug reactions: A systematic review of observational studies. Expert Opinion on Drug Safety, 17(7), 681–695. https://doi.org/10.1080/14740338.2018.1491547

Jember, A., Hailu, M., Messele, A., Demeke, T., & Hassen, M. (2018). Proportion of medication error reporting and associated factors among nurses: A cross sectional study. BMC Nursing, 17(1), 9. https://doi.org/10.1186/s12912-018-0280-4

Kavanagh, C. (2017). Medication governance: Preventing errors and promoting patient safety. British Journal of Nursing, 26(3), 159–165. https://doi.org/10.12968/bjon.2017.26.3.159

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2021). Medical Error Reduction and Prevention. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK499956/

Rutledge, D. N., Retrosi, T., & Ostrowski, G. (2018). Barriers to medication error reporting among hospital nurses. Journal of Clinical Nursing, 27(9–10), 1941–1949. https://doi.org/10.1111/jocn.14335

Waddill-Goad, S. (2017). Business Basics for Nurses. Sigma Theta Tau.

Walsh, E. K., Hansen, C. R., Sahm, L. J., Kearney, P. M., Doherty, E., & Bradley, C. P. (2017). Economic impact of medication error: A systematic review. Pharmacoepidemiology and Drug Safety, 26(5), 481–497. https://doi.org/10.1002/pds.4188

Zarea, K., Mohammadi, A., Beiranvand, S., Hassani, F., & Baraz, S. (2018). Iranian nurses’ medication errors: A survey of the types, the causes, and the related factors. International Journal of Africa Nursing Sciences, 8, 112–116. https://doi.org/10.1016/j.ijans.2018.05.001