NURS FPX 4020 Assessment 1 Attempt 3 Enhancing Quality and Safety

Medication errors are defined as errors that might occur due to the wrong administration of a drug or dose or prescribing the wrong medication. Medication administration is one of the most common types of medication error. It means to administer the wrong medication either orally or intravenously. Hence, the healthcare community emphasizes providing quality care without medical errors. According to the statistics provided by Patient Network System in 2018, the rate of medication administration error ranges from 8-25% (Schroers et al., 2021). Hence, the healthcare community needs to address the issue related to medication administration errors. The wrong drug administration, dose, duration, and frequency are included in prescribing and dispensing errors. 

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Scenario Chosen for Medication Administration

In 2014, a medication administration error occurred at Vibra Hospital of Sacramento, California. This administration error took the life of the patient. The California Department of Public Health (CDPH) took legal action against the facility and penalized them for about $75,000. The issue was that Levophed (a drug used when a patient is in hypotension) was administered by the nurse 3000-8000 times more than the prescribed dosage intravenously (IV). The medication error was due to certain factors like lack of experience of the nurse, lack of safeguards for any high-alert medication, and the senior nurse did not sign off on dispensing the medication. She did not check the doctor’s prescription that stated Levophed was to be administered only when the blood pressure was below 65. In the report by the CDPH regarding the facility, it was mentioned that the facility has failed to highlight the importance of Standard Operating Procedure (SOP)’s and did not implement the policies properly (Hamzaoui & Shi, 2020). 

Elements of Quality Improvement Initiative

Improving the quality of the healthcare facility is linked to improving the care of the patients. Quality improvement means standardizing structures for reducing variation, achieving results that were once hypothetical, and improving outcomes for patients and organizations. Healthcare facilities can improve the quality of care by setting goals, analyzing data provided and not repeating the same mistakes, and communicating with the interprofessional team (Afaya et al., 2021). The Electronic Health Record (EHR) can record a patient’s medical history digitally; it includes progress notes, problems, medications, and critical administrative and clinical data. For improving medication administration errors, barcodes can be used. It will ensure that the right drug is administered every time. A quality improvement plan has four major components.

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• Problem- It is essential to have in-depth knowledge about the problem before finding a solution for it.
• Goal- Setting a goal is challenging for a lot of healthcare facilities. They have to form a plan for promoting cost-effective health quality. 
• Aim- The aim is to implement the plan by setting milestones fully.
• Measure- Baselines should be set to evaluate the success of implementing the plan.

For the success of the quality improvement plan, it is essential to have leadership qualities, knowledge and devotion to make a change. The research shows that medication administration errors (MAEs) have an error rate of 60%, usually due to the administration of the drug at the wrong time, wrong rate or wrong dose (Härkänen et al., 2019). In another study, it has been reported that one in every three adverse drug events occurs due to nurses administering the wrong medication. Medical errors can be reduced by (1) Computerized Physician Order Entry (CPOE) which reduces medical errors by 3.15%. It further reduced medical errors by up to 20% by minimizing the use of wrong acronyms. (2) 2.10% of medical errors are reduced by using Electronic Medication Administration Record (EMAR). It reduces medical errors by 80% when using barcode readers (Härkänen et al., 2019).