Medication Error
Student’s Name
Institutional Affiliation
Medication Error
In the US, medical errors cause the death of about 98,000 people each year (Pham et al., 2012). Such errors result in increased mortality and morbidity, high healthcare costs, and loss of public confidence. To find effective strategies to identify and minimize medical errors, two qualitative and two quantitative research studies have been analyzed and discussed in this paper.
Quantitative Studies
After an increased occurrence of preventable medical errors, Blendon et al. (2002) conducted a study to find solutions. The prevention of medical errors were a concern to healthcare givers. Eight hundred thirty-one practicing physicians responded to mailed questionnaires, and 1207 public members were interviewed after random-digit-dialing in 2002, in a stratified randomization process. The study used the responses (independent variables) to find the causes of medical errors (dependent variable). The responses were compared using Fisher’s exact test. The research questions were whether or not the respondents had experienced medical errors, how often it occurred, and the possible ways to control it. No unusual events or changes in the number of participants were reported. The study did not build on previous research; however, its findings were later affirmed by Ulanimo et al. (2007), and Coombes et al. (2008). Forty-two percent of the public and 35 percent of physicians reported that they had directly or indirectly experienced error in care; for 24 percent of the people and 18 percent of physicians, the errors resulted in adverse health consequences, including death (Blendon et al., 2002). Half of the physicians reported the significant causes or errors in healthcare are overstaffing the health professionals. Medical errors can be minimized by providing better training for caregivers, and suspension of license for health professionals found guilty of committing medical errors.
Fogarty and McKeon (2006) conducted a study in an attempt to find and correct the factors that encourage the medical errors. Medical errors were a leading cause of unintended patient harm. The research will minimize the problem under study. The study involved nurses working in rural areas, in 2005. Fogarty and McKeon (2006) utilized a sample of 176 nurses working in 11 rural hospitals in Australia, in a simple randomization process. The study used structural equation modeling to assess the effects of violations and organizational climate (independent variables) on medication administration behaviors (dependent variable). The variables were concrete and measurable using the Queensland Public Agency Staff Survey (QPASS), Violation Behavior Scale, and Error Index. No research question or hypothesis was stated. No hypothesis or research question was stated. The violations scale was used to find how often the nurses made medical errors; QPASS to measure nurses’ satisfaction with the work environment, and error-index to investigate non-compliance to the ‘five rights.’ No unusual events occurred; the number of participants remained constant. Contrary to previous research by Fogarty, stress levels were revealed to share a weak connection with mistakes. The study did not build on the research by Blendon et al. (2002). Fogarty and McKeon’s (2006) research will help improve observation of the ‘five rights.’ The study revealed that organizational climate, quality of working life, and morale had a negative correlation with medication errors; the findings applied to the sample. Despite knowing the ‘five rights’ – right patient, drug, dose, route, and time – some nurses mistakenly committed medication errors (Fogarty & McKeon, 2006).
Qualitative Studies
A study by Coombes, Stowasser, Coombes, and Mitchell (2008) was done to identify and analyze factors that lead to intern prescribing errors. Adverse events resulting from medication errors were found to cause patient harm. The research will inform the development of medication-safety interventions. The study was conducted in a referral tertiary teaching hospital, Brisbane, Queensland, between February and June 2004; 14 interns involved in 21 medical errors participated in a simple randomization process. The factors in prescription (independent variable) that cause medical errors (dependent variable) were investigated. The variables were measurable using structured questionnaire responses and semi-structured face-to-face interviews. Based on the human-error theory, transcripts were analyzed to find the underlying themes. No hypothesis or research question was stated. No limitations or change in the number of respondents was reported. This study adds insightful knowledge on the causes of medical errors to other studies discussed in this paper; it is essential for clinical practice because it will improve prescription skills to minimize mistakes. Workload and staffing levels, physical and mental wellbeing, lack of skills, inadequate supervision, poor communication with patients, case complexity, and taking prescribing as a task that had low risk and required little thought were cited as the leading causes of errors; the results were applicable to the interns.
Ulanimo, O’Leary-Kelly, and Connolly (2007) conducted a study to find nurses’ perception of medical errors, causes, and the empowerments and barriers to reporting. Before the study, no published studies on the topic with Information Technology systems in place were found; Ulanimo et al. (2007) decided to conduct the research. The study will improve patient safety by helping to understand the causes of medical errors. Ulanimo et al. (2007) used a descriptive design in a survey involving medical-surgical nurses at a Veterans Affairs Medical Centre in 2005; a non-random sample of 61 nurses was used. The perceived cause of medical errors (dependent variable) was the failure to identify patients appropriately before administering medication (independent variable). The variables were concrete and measurable using a modified Gladstone instrument and questionnaires for data collection. The research questions were: What are nurses’ perception of medical errors? What are the barriers to reporting? The Statistical Package for Social Science (SPSS) was used to analyze data. Two questionnaire responses were not used because the participants left them blank. The number of participants did not change, and unusual event occurred. Both the studies by Fogarty et al. (2006) and Ulanimo et al. (2007) found that failure to identify the right patient before administering medication causes errors; therefore, the later affirmed the findings of the former. The study is relevant in clinical practice; it will help to reduce medical errors. The results were applicable to sample; the nurses should talk to patients before giving medication. The leading causes of medication errors were found to be the failure to check patient’s name before administering medication, and overloading the workers; medical errors were not reported due the fear of disciplinary action.
Summary
The four research articles discussed above agree that the workload placed on healthcare givers can promote medication errors. However, personal factors associated with violation of the patient’s five rights resulted in higher medical errors. For instance, in their studies, Ulanimo et al. (2007) found failure to confirm the patient name before administering medication to be one of the major causes of errors, and Fogarty and McKeon (2006) revealed that non-compliance to five rights elevates the problem.
Ulanimo et al. (2007) revealed that medication errors are rarely reported due to the fear of punishment; therefore, the management cannot help to prevent the problem. Identifying the factors that increase errors can help in creating interventions to mitigate the issue; for instance, Blendon et al. (2002) used their research to identify training and punishment for violations as productive methods to control errors. Although nurses are aware of the ‘patients’ five rights’ they mistakenly commit medical errors; however, they can reduce the problem by observing the rights in their practice.
Conclusion
Two qualitative and two quantitative studies were used in this study to find strategies to identify the causes and minimize medical errors. Factors that lead to increased errors are organizational climate, overworking care providers, and failure to observe their wellbeing and non-compliance to the ‘five rights.’ Medical errors can be minimized through training, and suspension of license for health professionals found guilty of the offense.
References
Blendon, R. J., DesRoches, C. M., Brodie, M., Benson, J. M., Rosen., A. B., Schneider, E., …&Steffenson, A. E. (2002). Views of practicing physicians and the public on medical errors. England Journal of Medicine, 347(24), 1933-1940. https://doi.org/10.1056/NEJMsa022151
Coombes, I. D., Stowasser, D. A., Coombes, J. A., & Mitchell, C. (2008). Why do interns make prescribing errors? A qualitative study. Medical Journal of Australia, 188(2), 89-94. https://doi.org/10.5694/j.1326-5377.2008.tb01529.x
Fogarty, G. J., & McKeon, C. M. (2006). Patient safety during medication administration: the influence of organizational and individual variables on unsafe working practices and medication errors. Ergonomics, 49(5-6), 444-456. Retrieved from https://eprints.usq.edu.au/5539/2/Fogarty_McKeon_2005_PV.pdf
Pham, J. C., Aswan, M. S., Rosen, M., Lee, H., Huddle, M., Weeks, K., & Pronovost, P. J. (2012). Reducing medical errors and adverse events. Annual review of medicine, 63, 447-463. https://doi.org/10.1146/annurev-med-061410-121352
Ulanimo, V. M., O’Leary-Kelly, C., & Connolly, P. M. (2007). Nurses’ perceptions of the causes of medication errors and barriers to reporting. Journal of nursing care quality, 22(1), 28-33. https://doi.org/10.31979/etd.nr6d-3nhy
