Medication administration to patients has become the subject of constant criticism over the past years due to continuous errors that have harmed patients and left some with near-death experiences. The medication administration phase has been found to contain several errors that harm the patients. Administration of medicine refers to a wide range of activities that include giving the right medication to the right person at the stipulated time issued by a qualified professional via the correct method and route. One of the most common errors during the medication administration process is the issue of dispensation errors occurring at the time of drug issuance by a nurse practitioner. This can happen in several ways, such as the wrong amount of medicine or the wrong medicine. However, the error can be reduced by using a computerized physician order entry and the issuance of guidelines for safe medication administration.
Causes of Dispensation Errors
One of the common dispensation errors is the wrong prescription, where a patient is given the wrong medicine that does not align with their current medical condition. The medication problem may be because of doctors’ sloppy handwriting; hence, the nurses cannot correctly read the type of medicine to be issued. Although nurses can always confirm the medication they have noted down with the prescribing doctor, it is sometimes difficult because of the high volume of patients the nurses often handle. Prescription errors can also be due to the wrong amount of doses big issued to a patient (“Medication errors in nursing,” 2019).
Adverse drug reactions accrue due to wrong medication or wrong dosage (Tariq et al., 2021). The results are usually fatal as patients can exhibit severe side effects, leading to other medical conditions that never pre-existed.
Several nurses had also reported that the dispensation errors they committed occurred when they were interrupted during a treatment process. This is a situation where a nurse’s concentration is not fully on the patient, and any little distraction can lead to a grave mistake. The nurses also reported that most distractions occur during night shifts (Wondmieneh et al., 2020). The distractions during night shifts could be due to fatigue which has been known to cause poor judgment. Despite professionalism requiring nurses to be vigilant and practice beneficence towards their patients, they are humans prone to error. A slight nap during drug dispensation could lead to an unexpected mistake that is avoidable. The nurses, therefore, are to play a huge part in dealing with errors of dispensation as most if not all administration errors lead back to them.
The wrong dispensation can also be because of chronic overworking of nurses and systematic errors related to the labeling of medicine. Overworking is due to the environment where a nurse is situated, this makes them strain to provide services. The nurses, therefore, make errors based on exhaustion and lack of resources (Wondmieneh et al., 2020). Usage of traditional methods of dispensation is what is referred to as systematic errors.
The drugs might have similar labels and names that are close to resembling that of different medicine. For example, a tired nurse would be unable to differentiate between Aciphex and Aricept. The situation is the same for drugs like Cathflo Activase and Activase, ado-trastuzumab emtansine, and trastuzumab. However, the said errors can be limited by using the computerized physician order entry, where all instructions and patient files are stored electronically.
Dealing with Dispensation Errors
Dealing with dispensation errors is a collective responsibility that involves key stakeholders in the health sector. The stakeholders that can help alienate the problems related to drug administration and especially dispensation include doctors, hospital administration, patients, pharmacists, and nurses. Hospital administrators need to put in place guidelines for safe medication administration to both inpatient and outpatient. One of the strategies to be put in place is look-alike and sound-alike (LASA) drugs. LASA drug list lists drugs whose names look alike or sound the same, confusing nurses administering the medicine (Institute For Safe Medication Practices, 2019).
The Institute for Safe Medication Practice already has a list of the LASA drugs on their websites for free, and the only remaining thing is for the issuance of a printout to pharmacists. The LASA drugs system will also alert physicians whenever they are prescribing drugs on the list.
Nurses should be held accountable whenever any drug administration error occurs—being responsible means that nurses have to adhere strictly to rules outlined for drug administration. First, nurses have to stop relying on memory and use the issued checklist in addition to a memory aid when administering drugs (Doyle, & McCutcheon, 2018). Any order for issuing medicine that is not clear is subject to clarification from the resident physician or the doctor who has given the medication.
Clarification will thus prevent cases or wrong dispensation in terms of administering drugs to the wrong patient or administering bad drugs and the wrong dosage. In addition to that, traditional systems should be abandoned or incorporated with modern technology to help solve the dispensation problem. This would give all the stakeholders an easy time as electronic systems have fewer errors. Furthermore, electronic systems store useful information that physicians can use for future decision making when patients visit again for treatment.
The electronic system that can eliminate dispensation errors is a computerized hospital management system with an automated physician order entry. The system becomes active the moment a patient steps into the consultation room when visiting a hospital. The attending physician in the consultation room takes note of the symptoms shown by the patient and inputs them into the system. The physician then sends notifications on the preferred tests to the laboratory technician via the computer. After the tests, the results of the test are returned to the physician for decision making. A list of medicine to be issued to the patient s sent to the pharmacist, and the dispensation occurs. For inpatients, nurses are given tablets containing every patient’s information and the drugs to be administered (Adeli et al., 2020). This system reduces errors and helps physicians in making sound judgments.
To conclude, nurses are humans, and they are not immune to errors that involve dispensation and administration of drugs to patients. The most common mistakes regarding the dispensation of drugs that often occur are medicine given to the wrong patient, a patient either overdosed or underdosed, and the medicine provided at the wrong time. Sometimes the issue with the dispensation and the responsibility should not be solely shouldered by nurses but by the stakeholders in the healthcare sector.
First, hospital administrations should provide a safe environment for nurses to work. The environment should not subject the nurses to be chronically overworked but should be conducive and free of distractions that can steer them to errors. The hospital should use a computerized physician order entry system to make the error eradication process more efficient. This system stores all the information about a patient electronically to minimize errors often observed with drug dispensation.
References
Adeli, K., Alter, D. N., Babady, E., & Bachmann, L. M. (2020). Laboratory information management. In W. Clarke & M. Marzinke (Eds.), Contemporary practice in clinical chemistry (4th ed., pp. 301-321). Academic Press.
Doyle, G. R., & McCutcheon, J. A. (2018). Non-Parenteral medication administration. In R. Clarke (Ed.), Clinical procedures for safer patient care (pp. 425-511). Pressbooks.
Institute for Safe Medication Practices. (2019). List of confused drug names. Web.
Medication errors in nursing: Common types, causes, and prevention. (2019). Medcom, Inc. Web.
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2021). Medication dispensing errors and prevention. StatPearls Publishing.
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(1). Web.