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NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Student Name

Capella University

NURS4020 Improving Quality of Care and Patient Safety

Prof. Name

Date

Improvement Plan Tool-Kit 

This assessment presents an improvement plan toolkit for the healthcare workforce of Tampa General Hospital to reduce medication administration error rates and enhance patient safety. This toolkit gathers authentic and credible information from databases such as Google Scholar, CINAHL, PubMed, and Capella Online Library. This improvement plan toolkit aims to enable healthcare professionals of TGH to implement practical measures to deliver high-quality care treatments with most minor incidences of medication errors, particularly relevant to medication administration errors.

Through adequate knowledge substantiated with evidence, the nurses and relevant healthcare professionals can implement a safety improvement plan effectively as their concepts are clear with a thorough understanding of the proposed plan. This resource toolkit comprises four major sections, including an overview of medication administration errors and nursing practices, preventing medication administration errors, training nurses on safe medication administration, and technological tools relevant to medication administration. 

Overview of Medication Administration Errors and Nursing Practices

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0 

This resource discusses medication administration errors in hospitals in Ethiopia. Moreover, it highlights the risks and contributing factors that persist among healthcare organizations and lead to medication administration errors by nurses. The identified factors leading to the onset of these errors are lack of adequate training among nurses, unavailable guidelines on medication administration, external interruptions, insufficient work experience, and night duty shifts.

This resource is helpful for nurses as they can predict the factors that lead to medication administration errors and gain further insights from this study’s past experiences and data. Moreover, they can use this resource to further educate their colleagues on the factors nurses must be careful about while administering the medications. Lastly, nurses can use the strategies provided by this resource, such as adherence to guidelines during medication administration and training nurses on the safe administration of medications.

Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, Volume 13(13), 1621–1632. https://doi.org/10.2147/ijgm.s289452 

This article by Tsegaye and colleagues provides an overview of medication administration errors, including prevalence and types of medication administration errors such as errors of wrong dose, wrong time, parenteral route errors, wrong evaluation, and underdose errors. Furthermore, it highlights the work, managerial, and professional-related factors that lead to medication administration errors.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

The factors included a lack of adequate communication, sufficiently trained nurses, interruptions, and unavailability of protocols for medication administration. Nurses can take help from this resource as it guides them on all possible factors that nurses must consider to avoid errors during medication administration. They can use this resource to overcome these factors in their healthcare settings and learn from the information discussed in this article. This will help them prevent medication administration errors due to these risk factors.

Hanson, A., & Haddad, L. M. (2022). Nursing rights of medication administration. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560654/ 

This resource discusses medication administration from a nursing practice perspective. It provides detailed information on nurses’ role in medication administration, issues of concern, clinical significance, and interdisciplinary interventions for safe medication administration. This resource highlights the nursing rights of medication administration, which nurses must learn and implement to improve patient safety and reduce medication administration errors.

Nurses can use these rights of medication administration by using technologies like barcode medication administration (BCMA) or electronic medical records (EMR) to verify medications. Therefore, this resource can play a vital role in delivering medication administration as they must adhere to the five rights of medication administration.

Preventing Medication Errors

Rodziewicz, T., & Hipskind, J. (2019). Medical error prevention. http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf

This resource describes medication errors, types of errors, and multiple preventive measures for medication errors. This resource also highlights medication administration errors and ways to prevent them. For instance, training nurses or pharmacists to double-check medications, integrating barcode administration technologies, and medical reconciliation. Nurses can use this resource to learn about medication errors and practical strategies to overcome them.

Moreover, they can integrate these preventive measures into their healthcare setups. Nurse leaders can propose these strategies to hospital administration to implement them and reduce medication administration errors. This resource will reduce patient safety risks by giving clear preventive measures for improving the quality of care with medication administration.

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309 

This resource highlights the interventions to reduce and prevent medication errors in medical and surgical units. This systemic review describes interventions for various errors, including prescribing, administering, and dispensing errors. Nurses can utilize this source to gain insight into medication administration errors and ways to prevent them. For instance, this resource emphasizes that computerized prescription entry (CPOE) and automated medication distribution systems reduce medication-giving errors. This resource can help nurses obtain knowledge and understanding of the combination of interventions implemented to reduce medication errors, such as the use of AMDS systems along with medication matching by trained nurses. 

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 1–15. https://doi.org/10.3390/ijerph17062028 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

This study discusses the nurses’ adherence to patient safety principles and emphasizes their role in providing safe and effective care treatments. This review article also highlights how nurses’ inadequate adherence to patient safety principles leads to medication administration errors. Moreover, it talks about the nurses’ adherence to principles of nursing care based on the task and work environment. For instance, nurses show better adherence to cooperative tasks such as double checking drugs during administration and availability of equipment such as BCMA for better compliance with medication administration.

Nurses can utilize this resource to improve adherence to safety principles to prevent medication administration errors. Moreover, this resource can guide nurses on areas where their keen attention is required to prevent medication administration errors. For instance, nurses must avoid bedside communication while delivering medication to prevent errors due to poor attention. This resource is also helpful for nurses in convincing them to comply with organizational policies on medication administration strictly.

Training Nurses on Safe Medication 

Sarfati, L., Ranchon, F., Vantard, N., Schwiertz, V., Larbre, V., Parat, S., Faudel, A., & Rioufol, C. (2019). Human-simulation-based learning to prevent medication error: A systematic review. Journal of Evaluation in Clinical Practice, 25(1), 11–20. https://doi.org/10.1111/jep.12883 

This resource is based on training nurses to prevent medication errors by the use of simulation-based approaches. Human simulation-based learning includes standardized patient, medical examination, communication skills, and hierarchy-related errors. This method enables training nurses without involving patients directly. Nurses can use this resource to train and educate nurses on safe medication administration and prevent medication errors through the human simulation method. This will foster a conducive environment for nurses to improve interdisciplinary communication, maintain confidence, and promote shared decision-making, all essential factors in safe medication administration.

Rouleau, G., Gagnon, M.-P., Côté, J., Payne-Gagnon, J., Hudson, E., Dubois, C.-A., & Bouix-Picasso, J. (2019). Effects of e-learning in a continuing education context on nursing care: Systematic review of systematic qualitative, quantitative, and mixed-studies reviews. Journal of Medical Internet Research, 21(10), e15118. https://doi.org/10.2196/15118 

This article is based on the effectiveness of E-learning in providing continuous education to nurses. E-learning promises continuous education and enhances nurses’ knowledge and skills. The article evaluates the efficacy of E-learning based on nurse behavior toward E-learning, their learning and behaviors, and patient outcome and cost results.

Based on the nurses’ attitude toward E-learning, it shows that it is a valuable tool to train and educate nurses for continuous education and enhancing nursing practices in terms of quality and safety. This resource is helpful for nurses as they can implement E-learning for preventing medication administration through continuous education via video recordings and live sessions. Nurse leaders can propose the idea of E-learning among nurses to healthcare administrators to reduce medication errors through this resource. 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4481-7 

The study mentioned above highlights the importance of training sessions for nurses by researching the existing drug knowledge gaps among nurses. The study further analyzes the medication errors that take place in the ICU of General Hospital of Spain and their relation with the level of nurses’ knowledge of drugs involved in medication errors. The study revealed that nurses’ average score was 47% on drug knowledge.

This shows that drug knowledge gaps among nurses lead to medication administration errors. This article stresses the need for drug education and training so nurses prevent such medication errors due to inadequate knowledge. Nurses can use this resource to identify the critical areas for enhancing their knowledge of drugs, such as widely used medications like antibiotics, to prevent medication errors due to insufficient knowledge. This resource will enable nurses’ continuous education and training, which is part of the safety improvement plan for TGH.

Technological Tools Related to Medication Administration

Williams, R., Aldakhil, R., Blandford, A., & Jani, Y. (2021). Interdisciplinary systematic review: Does alignment between system and design shape adoption and use of barcode medication administration technology? BMJ Open, 11(7), e044419. https://doi.org/10.1136/bmjopen-2020-044419

This article highlights the factors associated with adopting and using barcode medication administration to prevent medication errors. The mediating factors identified were pre/post-implementation, user needs clarity, appropriate technology, infrastructure and staffing, and analysis of existing workarounds.

By involving a collaborative approach between end users and system designers, BCMA can be effectively used for delivering medications to patients, reducing medication administration errors. This resource is helpful for nurses to enhance interdisciplinary collaboration while using BCMA within hospitals for its practical use. Moreover, this resource can be utilized to evaluate the factors that hinder BCMA’s true safety potential.

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-0043-1761435 

This resource evaluates electronic medication administration records and uses BCMA technology to reduce medication administration errors. This review article extracted data from 41 out of 1,992 articles; the reports described that implementing these two technologies enhanced effectiveness up to 52.3%, 62.2 % patient satisfaction, and 27.3 % efficiency. This resource is helpful for nurses in identifying how effective and efficient the use of EMR and BCMA can be in reducing medication administration errors.

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Moreover, nurses can reveal this data to other nurses who exhibit change resistance behaviors when implementing these technologies. Nurses can use this resource to convince patients who resist new healthcare technologies. Ultimately, medication administration errors in TGH can be reduced by using these technologies.

Wang, Y.-C., Tsan, C.-Y., & Chen, M.-C. (2021). Implementation of an automated dispensing cabinet system and its impact on drug administration: Longitudinal study. JMIR Formative Research, 5(9), e24542. https://doi:10.2196/24542

The study conducted by Wang and colleagues discusses implementing the automated dispensing cabinet system and its potential to reduce nurses’ drug administration errors. The evaluation of its efficacy was determined by estimating the time measurements of drug preparation with and without ADS use. The results showed medication administration errors were reduced after implementing this technology for one year.

This resource is helpful for nurses in learning the effective use of ADS and reducing their time in dispensing medicines without ADS. This enhances work efficiency and reduces medication errors due to wrong dispensing. Nurses can use this resource to convince their healthcare authorities to integrate and implement this technology to reduce medication administration errors. 

Conclusion

This paper highlights the safety improvement plan toolkit for nurses by gathering multiple evidence-based resources. These resources are from reliable databases like Google Scholar, PubMed, CINAHL, and Capella Online Library. Moreover, these resources are relevant to medication administration errors and emphasize their usefulness and value to nurses. These resources discussed medication administration errors and nursing practices, prevention of medication errors, training nurses on medication safety, and technological tools useful in medication management.

Nurses can gain valuable insights from these resources to reduce medication administration errors and implement them in TGH to overcome the alarming issue of medication administration errors.  

References

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4481-7 

Hanson, A., & Haddad, L. M. (2022). Nursing rights of medication administration. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560654/ 

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309 

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-0043-1761435 

Rodziewicz, T., & Hipskind, J. (2020). Medical error prevention. http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf 

Rouleau, G., Gagnon, M.-P., Côté, J., Payne-Gagnon, J., Hudson, E., Dubois, C.-A., & Bouix-Picasso, J. (2019). Effects of e-learning in a continuing education context on nursing care: Systematic review of systematic qualitative, quantitative, and mixed-studies reviews. Journal of Medical Internet Research, 21(10), e15118. https://doi.org/10.2196/15118 

NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Sarfati, L., Ranchon, F., Vantard, N., Schwiertz, V., Larbre, V., Parat, S., Faudel, A., & Rioufol, C. (2019). Human-simulation-based learning to prevent medication error: A systematic review. Journal of Evaluation in Clinical Practice, 25(1), 11–20. https://doi.org/10.1111/jep.12883 

Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, Volume 13(13), 1621–1632. https://doi.org/10.2147/ijgm.s289452 

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 1–15. https://doi.org/10.3390/ijerph17062028 

Wang, Y.-C., Tsan, C.-Y., & Chen, M.-C. (2021). Implementation of an automated dispensing cabinet system and its impact on drug administration: Longitudinal study. JMIR Formative Research, 5(9), e24542. https://doi.org/10.2196/24542 

Williams, R., Aldakhil, R., Blandford, A., & Jani, Y. (2021). Interdisciplinary systematic review: Does alignment between system and design shape adoption and use of barcode medication administration technology? BMJ Open, 11(7), e044419. https://doi.org/10.1136/bmjopen-2020-044419 

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0