A medication error is a process that may lead to inappropriate use of medication or harm, while the medicine is controlled by the patient or health care professional. Medication error is a major cause of morbidity and mortality in a health care setting. In the United States of America, medication mistakes result into between 44,000 to 98,000 avoidable deaths and over 1 million injuries annually. These errors not only lead to the loss of lives but also possess a huge financial burden that is approximated to be in the range of $17 billion to $29 billion dollars per year. Despite the increasing recognition of the significance of this phenomenon, there is inadequate knowledge on the interventions that can be adopted to effectively prevent the incidence and impact of medical errors. There is optimism that evidence-based approaches such as simple behavioural interventions, technology-based information, system based and human-based methods would play a significant role in preventing incidences and consequences of medication mistakes. This paper examines evidence-based methods of preventing medication errors and introduces an empirically supported opinion on the methodologies employed.
The first step in medication errors prevention methodology is aberration detection. The most common evidence-based methods of error detection include direct observation, chart review, computerised monitoring, incidence reporting, patient monitoring, claiming data, and administrative database. The usage of this methodology that revolves around healthcare professionals, patients and medical equipment, promotes disclosing medication errors that form the basis of warning and encouraging physicians to embrace a culture of safe healthcare practice. Therefore, it is believed that the avoidance of medication mistakes will be a counterproductive procedure if the evidence-based methodology is not employed for detecting medication errors. Studies indicate that 42% of medication errors are preventable if an appropriate methodology is applied at the detection stage.
Since evidence-based methodology entails the adoption of best scientific evidence combined with clinical experience, patience preference and values in the prevention of medication errors, the methodology can appear to be extremely accurate and reliable. In such a manner, all the three elements, namely the usage of scientific approach, clinical experience and patient values and preferences, serve a significant role in the detection and avoidance of the medication error. An analogy of a three-leg stool can be employed to illustrate the significance of combining three components in a methodology utilized to detect and prevent medication mistakes. In a comprehensive logic, it is credible that in order to be effective in preventing medication error, any methodology must incorporate three elements of evidence-based practice.
Safety Measures and Medication Use Method
Safety aspects compile the outstanding importance to all health care professionals. Nursing as a profession appreciates a long history of patient safety as a primary precept. The basic requirement in a hospital is that the health care professionals should cause no harm to a patient. The research indicates that the human brain is created and wired to commit errors.Therefore, if nurses and other health care professionals would appraise this assumption, then it should be evident that systematic approach should be employed in preventing medication errors. This approach would avoid the “blame game”, whereby the last medical personnel in the health care chain bear the responsibility. Normally, this a health care provider who administers medication without directing focus on other health care givers who might have participated in the medication error. Health care providers should perform two critical roles in preventing medical mistakes: investigation with a purpose of ensuring that any healthcare giver has not committed an aberration in the field of medication order chain, and guaranteeing that they themselves do not commit any error.
There are several stages of the use chain where medication errors can be committed. These phases include ordering, prescribing, and administering. The prescription of an erroneous drug accounts for 48% of medication errors. In general, nurses intercept 58% of all medication mistakes. Unfortunately, administration failures that compile 28% of all medication errors are not intercepted. The emphasis should be placed at this stage to ensure that this error is prevented. It should be mentioned that health care providers can impede medication errors by double control of drugs, especially of high-alert medicines that pose a high risk of causing medication mistakes when improperly administered.
Person-Based and System-Based Approach
The person-based method considers medication errors as occurring due to human frailty of healthcare providers such as poor motivation, carelessness, forgetfulness, or negligence. Prevention of medication mistakes, from this perspective, includes warning, instituting disciplinary action, blame and shame, or threats of lawsuits. Healthcare providers should ensure the double control of high –alert drugs because they have a potential of causing serious health implication to a patient when inappropriately utilized. Furthermore, healthcare professionals should switch their concentration before reviewing their prescription calculations. Healthcare givers are more likely to detect and therefore prevent medication errors when they practice taking a break between checks. It is believed that the root cause of many medication mistakes arises as a result of aberrations committed by health care providers when they deal with patients to some extent. However, if medical professionals can exercise caution in duties, it can significantly facilitate the reduction of incidences of death and other harmful effects resulting from human errors. The research indicates that 42% medication mistakes are due to medical personnel negligence, which is easily preventable.
System based approach anticipates that errors will occur. Mistakes are perceived as the end consequence rather than the cause. The system method assumes that there is a potential error and a recurring error in every system. Thus, solutions are based on the strong belief that conditions can be altered rather than health care providers would be substituted. Barriers and safeguards are implemented to mitigate medication errors. In system based approach, focus is on the manner the system collapses to prevent the mistake rather than the way humans fail. Machines utilized in the diagnosis process should be properly maintained and regularly serviced because the improper diagnosis will lead to the erroneous prescription, and thus the chances of committing medication errors increase. Apparently there is a need to train nurses who use machines in providing medical care to ensure that system approach of medication error becomes more effective.
Other methods of preventing medication errors include, strictly adhering to five rights of medication administration, proper storage of drugs for efficacy, documenting everything, using a name alert to prevent the possibility of medication confusion, and the applying drug guides, particularly for new nurses. The empirical evidence indicates that if a nurse rigorously manages to adhere to the five rights of medications, 55% of errors are preventable. Therefore, there is a tendency to believe that nurses possess a crucial role in the prevention of medication errors. To ensure that they perform their duties effectively, the need to guarantee their socio-psychological requirements appears. Patients should also participate in preventing medication errors. These can be achieved by patients complying with the prescription of the nurses. At the same time, patients should not hesitate to report any adverse health implication after taking drugs to healthcare providers so that they review the prescribed medicine in good time and thus prevent the possibility of committing medication error.
Pertinently, there are numerous methods adopted to prevent medication errors. The prevention of medical mistakes entails having epidemiological knowledge, improvement of performance, and detection of errors. Healthcare providers should always double control high alert drugs before they administer them to a patient. The relatively uncomplicated method of intervention such as adhering to the 5 rights of medication administration and double-checking procedures may enormously contribute to the avoidance of medical errors. Evidence-based methods or error prevention needs to be categorised, replicated and tested in order to minimise the mistakes in medical practice. In comprehensive logic, the prevention of medication errors is a multidimensional assignment, whereby both the healthcare professional and the patient must be actively involved.
