Description
Describe the health care problem or issue you selected for use in Assessment 2 and provide details about it.
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.
Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
You may find the applicable Undergraduate Library Research Guide helpful in your search.
Review the Think Critically About Source Quality to help you complete the following:
Assess the credibility of the information sources.
Assess the relevance of the information sources.
Analyze the health care problem or issue.
Describe the setting or context for the problem or issue.
Describe why the problem or issue is important to you.
Identify groups of people affected by the problem or issue.
Provide examples that support your analysis of the problem or issue.
Discuss potential solutions for the health care problem or issue.
Describe what would be required to implement a solution.
Describe potential consequences of ignoring the problem or issue.
Provide the pros and cons for one of the solutions you are proposing.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
Describe what would be necessary to implement the proposed solution.
Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
Provide examples from the literature to support the points you are making
The following resources provide information about evidence-based practice:
Macias, C. G., Loveless, J. N., Jackson, A. N., & Srinivasan, S. (2017). Delivering value through evidence-based practice. Clinical Pediatric Emergency Medicine, 18(2), 89–97.
Thomas, S. J. (2016). Does evidence-based health care have room for the self? Journal of Evaluation in Clinical Practice, 22(4), 502–508.
Agency for Healthcare Research and Quality. (n.d.). EPC evidence-based reports. http://www.ahrq.gov/research/findings/evidence-bas…
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Analyzing a Current Health Care Problem or Issue
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Analyzing a Current Health Care Problem or Issue
Makeiah Karmea Bynum
Capella University
NHS-FPX4000: Developing a Healthcare Perspective
Instructor: Dr. Joan Vermillion
April 10, 2023
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Applying Ethical Principles
It is impossible to overestimate the significance of pharmaceutical errors in healthcare,
which I have already mentioned. In this investigation, concerns about patient safety that
unintentionally occur when getting medications will be explored upon. Healthcare providers
should take all reasonable precautions to ensure patient safety. Patient safety should be promoted
in all facets of healthcare. If nurses were able to implement a culture where drug errors were a top
priority, it would be a significant step in preventing those errors from frequently occurring.
Everyone involved in the healthcare system should discuss how to make it better. Improved
infrastructure would also be a big help in resolving this issue. Pharmaceutical errors do not only
happen in hospitals. Medication mistakes may accompany the patient back to their home or
nursing home (Fatima, Douglas & Richard, 2020).
Elements of the Problem/Issue
Studies show that patients receiving care from hospital medical professionals are
susceptible to drug mistakes and potential harm. Patient safety issues are typically caused by
medication errors, which are preventable adverse outcomes (Albara, Suzanne, Joanne, & Val,
2020). Medication errors can be caused by three main sources: not understanding the directions,
fulfilling the order too swiftly, and communicating with other healthcare professionals.
When a nurse disregards her incapacity to grasp the instructions and nonetheless provides
the authorized dose, the wrong medication or the erroneous dosage may be given. A patient may
experience terrible side effects if they receive an excessive amount of one drug. For instance,
sliding-scale insulin has parameters that determine how much to provide dependent on the
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patient’s blood sugar level. If you don’t understand the parameters, you might administer too much
insulin and cause hypoglycemia in the patient (Albara, Suzanne, Joanne, & Val, 2020).
Rushing through an order to finish it can cause you to miss a mistake that the doctor might
have made. Without taking the time to read the order carefully and determine whether what was
ordered for the patient makes sense, the patient could suffer severe harm. A person who is
prescribed Lasix because their lower extremities retain fluid is an example of this. In addition to
causing them to lose vital electrolytes, which can cause a host of other problems, failing to review
the most current lab findings could force all the fluid to come off them. Therefore, the key to
avoiding a medicine blunder is to carefully read the order.
The outcomes of poor doctor-nurse communication can be disastrous. Negative outcomes
for a patient could result from failing to inform a doctor that a particular order might cause more
damage than good to a patient. A doctor prescribing MiraLAX to a patient is an illustration of
this. Because it is ordered, new nurses will provide it, even when the patient is experiencing
bowel movements. Dehydration could result from this, which can cause a diverse range of
problems. The nurse could hold the order or inform the doctor that they are using the restroom
and stop the order to prevent fluid imbalances.
Analysis
Since becoming a registered nurse, I made it a critical part of my practice to make sure I
completely understand the medication that I am administering to my patients prior to them being
given. I am the last resort in the line of defense before they can receive the medication that has
been prescribed by a medical professional. Making a mistake when administering medication or
failing to spot a mistake made within the medication order can result in serious harm to the
patient. When I am unsure about any orders or prescriptions given, I make sure to question and
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receive other people’s opinions, preferably seasoned nurses, or the provider themselves, to make
sure that I avoid making a mistake. Anyone can make a mistake. If a mistake were made, it is best
to inform the manager about the error because it can help improve strategies to prevent the error
from happening again, therefore, reducing medication error frequency.
The Context for Patient Medication Errors
Another contributing factor to patient medication errors is the constant evolution of
healthcare. It is changing constantly with daily research being done to progress medicine. As an
employee in medicine, we must make sure we are up to date on these advances in healthcare. It is
highly exhausting to learn the newest and best information that is other it. It is also a challenge to
always provide top-notch healthcare to our patients when there are staffing shortages, unsafe
assignments, and unavailable equipment that is needed to perform our duties. Any arrangement of
these factors can result in unsatisfactory healthcare and increase the likelihood of medication
errors.
Populations Affected by Patient Safety Issues
Medication errors do not have a stereotype. Any demographic group can become a victim
of a medication error. As healthcare providers, we try to notice any mistake that is made including
medication errors, but because we are human, that is not always possible. We can strive to make
as few mistakes as possible, but even then, some adverse effects can be unknown. Every shift, I
notice where an error could have been made had I not been more vigilant and paying attention to
my orders. The best way to become excellent at identifying errors and preventing harm is
knowing the medication you are attempting to give and asking questions at any point where there
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is uncertainty. Due to this, I eliminate any mistakes that might occur which prevents my patients
from suffering an avoidable injury.
Considering Options
To reduce medication errors, healthcare professionals could implement some of these
strategies. Education on carefully reviewing orders and querying the physician if an order doesn’t
seem correct is a step in preventing errors from happening. As a new grad nurse, I was always
unsure when to question a physician about an order. Now after two years, I have found that
sometimes orders get put in on the wrong patient and it was a good step that I questioned the
orders that didn’t seem to relate to my patient’s primary complaint. Another is assigning fewer
patients so that the nurse can focus on a smaller ratio. Anyone working in healthcare currently
knows that depends on staffing. Reviewing the orders that have been placed in detail is the easiest
and most obvious course of action. Taking your time and avoiding rushing through the task is a
key step in minimizing prescription error rates. The opportunity of sitting down and carefully
reading directions would lessen the likelihood of medication errors. Prescription errors would be
less likely if it was possible to sit down and attentively study orders.
Questioning a doctor when they issue an order that appears to be erroneous is one of the
hardest things to undertake. The ability to discuss it with the doctor is a key method where drug
errors could be prevented. Although incredibly intelligent, doctors are nonetheless human and fall
short just like everyone else. Because of this, it’s crucial for nurses to contact them if an
instruction seems strange. The patient could avoid injury thanks to this very little interaction. The
interaction between healthcare professionals is one element that I believe is neglected. I believe it
is crucial to note the time you administered painkillers in your report. A medication error can be
avoided by having open communication.
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Solution
It is impossible to find only one solution for the treatment of medical errors because there
is a variety of contributing factors that lead to the error occurring, which means there needs to be
a solution for every possible factor out there. Improving communication between physicians and
nurses, querying orders when clarification is needed, lowering patient ratios, and having adequate
time to carefully review orders in full detail could improve the prevention of medication errors.
As healthcare professionals, all we can do is continue in our efforts to reduce the occurrence of
drug errors.
Implementation
Every healthcare worker signed an oath before beginning their employment. One of the
most important aspects of that oath is nonmaleficence, or the duty to do no harm. The best care is
given to each patient as part of our effort to show this. Medication mistakes can be considerably
reduced by putting these changes into practice. A number of these adjustments must be made and
implemented by the person. Management is unable to use them precisely. The greatest way to
lessen prescription errors, in my opinion, is to employ these strategies.
Conclusion
Eliminating drug mistakes won’t ever be successful 100%. It is impossible to totally
eradicate drug errors because mistakes will always be made by people. On the other hand, the
implementation of some strategies discussed along with increasing healthcare professional
awareness could significantly help minimize the frequency of medication errors which in turn
would provide the patients with the best care possible. It is crucial that nurses comprehend that
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implementing these measures is not intended to make their jobs harder, but rather to safeguard
both the patient and their professional license.
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References
Alomari, A., Sheppard‐Law, S., Lewis, J., & Wilson, V. (2020, July 6). Effectiveness of Clinical
Nurses’ interventions in reducing medication errors in a paediatric ward. Journal of
Clinical Nursing, 29(17–18), 3403–3413. https://doi.org/10.1111/jocn.15374
Alqenae, F. A., Steinke, D., & Keers, R. N. (2020, March 3). Prevalence and Nature of
Medication Errors and Medication-Related Harm Following Discharge from Hospital to
Community Settings: A Systematic Review. Drug Safety, 43(6), 517–537.
https://doi.org/10.1007/s40264-020-00918-3
Athanasakis, E. (2019, June 6). A meta‐synthesis of how registered nurses make sense of their
lived experiences of medication errors. Journal of Clinical Nursing, 28(17–18), 3077–
3095. https://doi.org/10.1111/jocn.14917
Secginli, S., Nahcivan, N. O., Bahar, Z., Fernandez, R., & Lapkin, S. (2021, October 8). Nursing
Students’ Intention to Report Medication Errors. Nurse Educator, Publish Ahead of Print.
https://doi.org/10.1097/nne.0000000000001105
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