NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

Walden University NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

The introduction for the Walden University NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

After the introduction, move into the main part of the NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

Initiatives for quality improvement are methodical, data-driven strategies aimed at enhancing both the safety and quality of healthcare delivery. Initiatives to increase quality are concentrated on providing timely, safe, equitable, efficient, and patient-centered care. Analyzing medical data as well as the methods and procedures utilized in the delivery of care might serve as the basis for such initiatives. This results in the identification of areas that require improvement as well as the processes and systems that can be fixed to raise the standard of patient care.

A Brief Explanation of the QI Initiative Selected

The decrease in hospital readmission rates is the QI project that I have chosen for this discussion. Hospital readmissions occur when a patient returns to the hospital within 30 days of being released from the hospital (Gupta et al., 2019). High rates of readmission to hospitals present a serious problem for medical facilities and staff. High rates of hospital readmission also put a burden on healthcare resources and jeopardize patient outcomes. High readmission rates pose a danger to patient safety since they can result in unfavorable outcomes like increased stress levels and high death rates (Wadhera et al., 2019). Because it aims to address the several drawbacks connected to high readmission rates, a quality improvement project to lower hospital readmission rates is therefore a wonderful idea. By delivering high-quality care and improving patient outcomes, lowering hospital readmission rates guarantees lower healthcare costs (Wadhera et al., 2019).Initiatives aimed at enhancing quality are motivated by the necessity to assure the safe provision of medical care. According to Gupta et al. (2019), the six main objectives of patient care are to guarantee that medical treatment is equitable, timely, safe, effective, and patient-centered. As part of a quality improvement program, lower hospital readmission rates are linked to higher patient satisfaction and better medical results.

How Adverse Events are Handled in the Healthcare Organization or Nursing Practice Including an Explanation of How This May Impact Both Public and Internal Perspectives on Healthcare Quality. 

Unforeseen incidents frequently occur in the healthcare industry, and the way these incidents are managed can greatly influence the public’s and internal perceptions of the quality of service. According to Young et al. (2019), an adverse event is any unplanned or unforeseen incident that causes harm to a patient or causes them to become temporarily or permanently disabled. A healthcare provider must notify the patient and their family about an unfavorable event that has occurred. According to Hernández et al. (2023), the healthcare practitioner also needs to pay attention to the patient’s and their family’s worries and complaints regarding the adverse event. Following discussions with the patient and their family, a system of documentation has been established. The medical facility mandates that all adverse events be reported, noted, and documented. The counseling department provides emotional support to patients and their families, assuring them that all feasible measures will be made to mitigate the negative impact of the unfavorable incident. Transparency is ensured by the healthcare facility through communication with patients and their families, which increases patients’ trust in the hospital. Acknowledging and accepting culpability by acknowledging a negative incident According to Rodziewicz and Hipskind (2020), maintaining communication guarantees that patients and their values are acknowledged and honored. Healthcare practitioners are aware of the need to be open and honest. Negative occurrences should be reported, noted, and documented to identify areas that need improvement (Hernández et al., 2023). This is important because it guarantees that by fixing system flaws or other error sources that caused the unfavorable outcomes, they can be prevented in the future. Healthcare personnel understand that they won’t be criticized or shamed, according to the internal perspective on this. Nonetheless, it is expected of all healthcare workers to accept ownership and responsibility for their actions. The public gains greater faith in the healthcare organization when such incidents are disclosed and addressed because they know that ongoing quality improvement programs will be implemented to prevent such incidents in the future (Rodziewicz & Hipskind, 2020).

Error Rate From the Selected Article and How This May Relate to the Healthcare Organization or Nursing Practice.

 I chose a news statement issued on January 9, 2022, by the Michigan Department of Attorney General for this section. According to the report, a nurse was accused of seriously injuring a vulnerable adult’s physical and emotional health. The report claims that the nurse discovered two incorrect medication doses that had been given to a resident of the Grand Rapids home for veterans where she worked while carrying out her duties as a licensed practical nurse (LPN) (Michigan Department of Attorney General, 2021). However, the nurse decided not to notify her doctor or supervisor of the mistake right away, which resulted in the patient suffering severe bodily and psychological damage. The frequency of these pharmaceutical errors is not mentioned in the paper. Even though this was an isolated instance, incidents like this still happen frequently, and considerable work needs to be done to stop them from happening again. The incidence of such severe prescription errors jeopardizes the health and well-being of patients who are in danger, as the article reports (Michigan Department of Attorney General, 2021). Furthermore, according to Rodziewicz, Houseman, and Hipskind (2018), these disputes cost healthcare institutions thousands or even millions of dollars in legal fees and compensation. The inability to report a medication error upon discovering it could have been due to various reasons, such as the inability to take responsibility for the patient’s health decline, fear of hospital management’s repressive responses, fear of legal liability, fear of punishment, fear of being perceived as incompetent, or a combination of these (Rodziewicz, Houseman & Hipskind, 2018). This story highlights the need, in my healthcare setting, for an honest and open system that allows medical personnel to report prescription errors without fear of reprisal, blame, or ineptitude. The healthcare organization should implement a plan that guarantees healthcare workers’ freedom to disclose such incidents even when they accept accountability for their acts (Rodziewicz & Hipskind, 2020). It is advisable to promote the reporting of medication errors as it facilitates transparency and offers a foundation for quality improvement initiatives aimed at averting such incidents in the future. (Hernández etal., 2023). Instead than placing as much emphasis on stigmatizing and assigning blame, it would be better to fix system flaws or get rid of things that encourage prescription errors.

Conclusion

The provision of safe, effective, equitable, efficient, timely, and patient-centered care is the main goal of quality improvement activities. Reducing hospital readmission rates is one such effort, which is crucial since it improves patient outcomes, better patient satisfaction, lower medical expenses, and better care quality are a few benefits.An efficient reporting mechanism, open and honest contact with patients and their families, and the recording and documentation of such occurrences can all help manage adverse health impacts in healthcare more skillfully. Adhering to such protocols improves openness and helps healthcare organizations pinpoint areas where quality has to be improved (Gupta et al., 2019).

References

Gil-Hernández, E., Carrillo, I., Tumelty, M. E., Srulovici, E., Vanhaecht, K., Wallis, K. A., …

& Mira, J. J. (2023). How different countries respond to adverse events whilst

patients’ rights are protected.Medicine, Science and the Law, 00258024231182369.

Gupta, S., Zengul, F. D., Davlyatov, G. K., & Weech-Maldonado, R. (2019). Reduction in

hospitals’ readmission rates: role of hospital-based skilled nursing facilities.INQUIRY: The Journal of Health Care Organization, Provision, and Financing,56, 0046958018817994.

Michigan Department of Attorney General. (2021, September 1).Nurse charged over failure

to properly respond to medication error. SOM – State of Michigan.https://www.michigan.gov/ag/news/press-releases/2022/09/01/nurse-charged-over-

failure-to-properly-respond-to-medication-error

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. StatPearls. Treasure Island (FL): StatPearls Publishing

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and

prevention.

Wadhera, R. K., Yeh, R. W., & Maddox, K. E. J. (2019). The hospital readmissions reduction

program—time for a reboot.The New England Journal of Medicine,380

(24), 2289.

Young, I. J. B., Luz, S., & Lone, N. (2019). A systematic review of natural language

processing for classification tasks in the field of incident reporting and adverse event

analysis. International journal of medical informatics,132, 103971.

Sample Answer 2 for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

Introduction

Effective quality improvement initiatives demand a multifaceted approach, incorporating diverse strategies and involving various stakeholders. Root Cause Analysis (RCA) plays a pivotal role in this process, requiring a meticulous examination before implementing changes. By pinpointing the underlying causes of hospital readmissions, such as inadequate discharge planning, medication errors, or insufficient follow-up care, targeted interventions can be developed to address these issues. Interdisciplinary collaboration is crucial, recognizing that readmissions are influenced by medical, social, and behavioral factors. Working with a diverse team, including physicians, nurses, social workers, pharmacists, and other professionals, ensures a holistic approach to patient care and a comprehensive understanding of contributing issues.

Patient education and engagement are integral components of the initiative, necessitating the development of strategies to educate patients and their families on post-discharge care (Bergerum et al., 2020). Clear instructions regarding medications, follow-up appointments, and recognizing warning signs contribute to better adherence to treatment plans, ultimately reducing the likelihood of readmissions. Enhanced care coordination, involving improved communication within the hospital and with external care providers through tools like electronic health records (EHRs) and care coordination platforms, ensures seamless transitions of care (Bergerum et al., 2020).

Telehealth solutions, leveraging technologies for remote monitoring and virtual follow-up appointments, bridge the gap between hospital and home. This facilitates ongoing monitoring of patients’ progress, allowing healthcare providers to intervene early if issues arise. Continuous monitoring and evaluation, supported by a systematic approach to reviewing readmission rates and relevant metrics, establish a continuous improvement cycle, ensuring the ongoing relevance and effectiveness of implemented interventions (Comfere, Matulis & O’Horo, 2021).

Turning to the handling of adverse events, transparency and communication are emphasized. Open and honest communication about adverse events builds trust with both the public and internal staff (Comfere, Matulis & O’Horo, 2021). Clear communication regarding steps taken to address adverse events, reassuring patients and families, and outlining improvements to prevent recurrence are crucial (Comfere, Matulis & O’Horo, 2021). Providing emotional support to patients and families is essential, establishing a counseling department or support system to address concerns and assist in coping with the emotional impact.

Fostering a learning culture is paramount, encouraging healthcare professionals to report adverse events without fear of retribution. Adverse events should be viewed as opportunities for education and system enhancement, moving away from blame and towards continuous improvement. Acknowledging the potential legal and financial implications of adverse events, the implementation of risk management strategies is crucial to mitigate legal risks and ensure fair and efficient compensation and resolution processes.

Conclusion 

In summary, successful quality improvement initiatives necessitate continuous monitoring, collaboration, and a commitment to learning and improvement. Addressing root causes, engaging interdisciplinary teams, and handling adverse events transparently contribute to achieving sustained positive outcomes in healthcare quality.

References 

Bergerum, C., Engström, A.K., Thor, J. et al. Patient involvement in quality improvement – a ‘tug of war’ or a dialogue in a learning process to improve healthcare?. BMC Health Serv Res 20, 1115 (2020). https://doi.org/10.1186/s12913-020-05970-4

Comfere NI, Matulis JC 3rd, O’Horo JC. Quality improvement and healthcare: The Mayo Clinic quality Academy experience. J Clin Tuberc Other Mycobact Dis. 2020 Jun 13;20:100170. doi: 10.1016/j.jctube.2020.100170. Erratum in: J Clin Tuberc Other Mycobact Dis. 2021 May 06;24:100242. PMID: 32596515; PMCID: PMC7306605.

Sample Answer 3 for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

In health care systems, the need to address safe patient care necessitates various management responses with regard to the problem in question. Quality improvement initiatives (QI) are actions undertaken by the stakeholders in a health care facility to bridge the gaps in realizing the goals of service delivery (Sadegh et al., 2013). The premise can also entail the implementation of innovative approaches to model and design various strategies aimed at addressing complex care interventions. According to Cullen (2018), assessing quality improvement initiatives is important to measure the performance of a health system to enhance the safety of patients seeking care services. In the institutions of care, quality improvement initiatives also entail an evaluation of the staff capacity and the availability of resources to handle populations seeking medical attention (Mikhail & Langabeer, 2018). Often, nursing population can be used as the yardstick to assess the quality of care since they spend the longest period with the patients (Hickey & Brosnan, 2017).    Thus, the context of safe staffing with respect to nurse-to-patient ratios needs to receive attention.

Selected Quality Measures Identification

Safe nurse-to-patient ratio is a quality initiative that most hospital leaders take into account in a bid to ensure quality care for patients. Health facility administrators often formulate strategies that address safe, effective and efficient approaches that guarantee quality care to patients. Hill and DeWitt (2018) illustrate that one of the most important approaches is to recruit adequate nursing staff and other care professionals to address patient acuity. Certainly, an interplay of many factors concerning nurse-patient ratios has often hampered the efforts to bridge the staffing gap. In many cases, care facilities lack adequate financial resources to implement nursing staff (Shekelle, 2013). Besides, access to competent and experienced nursing staff is a challenge due to the shortage of specialist nurses.

In this regard, the present article delves into the quality measures related to safe nurse-patient ratios in care setting. The premise is guided by the argument that patient-centered outcomes are compromised by inadequate nursing staff. The present nursing staff in care facilities is also overwhelmed by the high patient population. The occasion of unsafe nurse staffing is also exacerbated by the high rate of nurse turnover most of whom seek further studies or opt for institutions that offer better remuneration packages. According to Shekelle (2013), the recommended rate for nurse to patient ratio is at 1:4. However, the present health facility indicates a ratio of 1:8, which is far below the required standards. The high nurse to patient ratio is detrimental to both the institution and the clients seeking care services. It results to missed care due to untimely administration of medication and poor pain management (Sadegh et al., 2013; Lee et al., 2017). A project on nurse staffing entails addressing nursing skill mix in addition to a response on care hours as a way to look into the working patterns of nurses. Thus, the health facility can also focus on attracting high-quality nurses through redesigning the practice environment to improve patient safety.

Data Collection Plan

Data collection plan is an important aspect and a straight forward approach to indicate the patterns of nurse staffing in a care facility. The collected data will reflect aspects of patient care, particularly concerning prompt care, increase in falls, bed sores, and other infections (Hickey & Brosnan, 2017). Data on safe nurse to patient ratios can be collected through different approaches and comprises five steps.

The first step entails identifying the perceived speculated results on nurse staffing results and the ways to measure their actual number. The second step relates to developing a data gathering approach to ascertain the problem of the unsafe nurse to patient ratios in a care facility. The third step involves the analysis of the data collected in a bid to reflect on the nurse staffing deficits with respect to patient population seeking health services at the institution. Step four, on the other hand, entails relating the data collected to establish the extent of an inadequate number of nurses when compared to the patient population seeking medical attention. In the final step, the four steps are repeated to ensure the accuracy of the information collected. This also provides information that can be used to compare data from known databases to reflect the pattern of the nurse to patient ratio with recommended standards.

The manual data collection plan will be determined by observing the lifestyle, body and the environment of patient care. This provides qualitative data to gauge on adequate or poor staffing nursing patterns in a care facility (Hickey & Brosnan, 2017). It can be deduced that the behavior and the overall outlook of patients depend on the decisions they make from the information they receive as per the advice of nurses. In the event of inadequate personnel, the quality of life of patients is likely to be compromised due to insufficient education on self-care (Hill & DeWitt, 2018). The environment of care can also be altered and expose patients to hospital-acquired infections as opposed to when there is adequate nursing staff.

The data collection plan is also based on the analysis of diagnosis-related groups (DRGs). The latter denotes a case-mix of patients which categorizes clients as per their diagnoses, demographic characteristics, and treatments administered to them. In a nutshell, the DRGs provide data on the number of doctors, nurses and medical products used to offer given care to patients (Woo, Milworm & Dowding, 2017). Further, the DRGs provides feasible data on the number of care providers required to support prompt as well as quality care. The project on safe nurse-patient ratios will rely on the data from DRGs to provide a measure and indicators on the minimum number of nurse staffing ratios that can affect the quality of patient care in a given facility.  

Nurse’s Role in Correct Data Collection

Nurses are integral in providing information related to patient safety in a care facility. The professionals avail data that can be used in the analysis of staffing by acuity indicators. In other words, nurses are the health professionals that have close proximity to patients, and as such, they provide actual information on the number of patients under their care. They can inform hospital administrators if the number of patients they attend to are more or less based on their ability to provide the service. Acuity in a care setting is ranked as per the severity of illness rated based on minor to major and extreme conditions. A nurse ratio of 1:4 is the recommended scale to solve thrilling severity of patient conditions. The measure indicates the level of flexibility of a hospital to provide care to patients with complicated illnesses. Studies by Hill and DeWitt (2018) and Lee et al. (2017) affirm that nurse leaders and advanced registered nurses use aggregate data to measure as well as monitor the trends in quality care to patients. The information gathered is incorporated into data collected from administrative and multiple clinical databases from the facility, which will further be used to analyze the trends or to support research in the given health facility.

Professional, Ethical, and Regulatory Standards Implementation

The project implementation requires quality improvement actions based on the ethical and regulatory standards of nurse staffing. Related standards and criteria need to conform to the federal regulations on a number of health professionals required in care facilities (Woo, Milworm & Dowding, 2017). The safe nurse-to-patient ratios program as well addressing the number of licensed registered nurses and practical nurses that conforms to the regulatory requirement of health facilities of a state become necessary. The effectiveness of a quality improvement initiative depends on the employment of nurses with competency in their area of specialty to optimize patient outcomes (Mikhail & Langabeer, 2018). However, confidentiality of the sensitive information reported by nurses on the administrative practices of a given facility must be guaranteed as a remedy to victimization.

The American Nurse Association (ANA) recommends specific rates of nurse-to-patient ratios in different departments of a health facility. In the critical unit, a ratio of 1:2 is recommended while at the emergency department the regulatory body expects 1:4. Further research by Lee et al. (2017) suggests that the standard criteria of the ANA guide on the implementation of the quality initiative. The stipulated recommended ratios will guide nurse staffing.

Communication to Stakeholders

Implementation of the quality improvement initiative can be well achieved through effective communication to stakeholders. The initial process will require the provision of accurate and adequate information for justification on the implementation of safe nurse-to-patient ratios (Wong, 2015). Stakeholders will be informed on the current state of the nurse-to-patient ratios so that they evaluate the need for quality improvement. As part of the quality improvement team, I will schedule a meeting with the stakeholders where the facts and figures related to the safe patient care will be availed. I will also collect feedback from key stakeholders regarding the program and compile a report that will steer the implementation process. 

Interprofessional Collaboration

The implementation of the safe nurse-to-patient ratios will depend on the leadership skills emulated by the stakeholders in the given health facility. According to Laureani, Brady and Antony (2013), nurse leaders and the project management team must display leadership skills to inspire other nurses as they strive to improve patient care. Besides, the leaders need to create a staffing plan that aims to respond to unpredictable nursing turnover as part of the improvement initiative to address patient acuity. The stakeholders will also be expected to communicate progress to all team members and highlight areas where the program should be given priority (Laureani, Brady & Antony, 2013). However, as part of stakeholder engagement, leaders must portray interprofessional collaboration so that the program is accepted within the care facility. Cullen (2018) posits that successful implementation of the program depends on how the leaders define the financial requirement, emulate time management skills and address potential challenges that might impede achievement of safe patient care.

Conclusion

In conclusion, the need to improve quality in healthcare necessitates the introduction of systematic approaches to prioritize on actions required for care delivery. Safe nurse staffing in health facilities is essential in improving the well-being of patients. However, in addressing the nurse staff deficit, the stakeholders will need to employ skilled and competent professionals. Further, it will be vital to assess the acuity in the selected hospital and allocate nurses based on the severity of patients’ illnesses. All these approaches are aimed at minimizing medication errors as well as to improve the quality of health outcomes.

References

Cullen, L. (2018). Translating EBP into the Reality of Daily Practice: Leadership Solutions for Creating a Path Forward. Journal of PeriAnesthesia Nursing, 33(5), 752-756.

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.

Hill, M., & DeWitt, J. (2018). Staffing Is More Than a Number: Using Workflow to Determine an Appropriate Nurse Staffing Ratio in a Tertiary Care Neurocritical Care Unit. Journal of Neuroscience Nursing, 50(5), 268-272.

Laureani, A., Brady, M., & Antony, J. (2013). Applications of lean six sigma in an Irish hospital. Leadership in health services, 26(4), 322-337.

Lee, A., Cheung, Y. S. L., Joynt, G. M., Leung, C. C. H., Wong, W. T., & Gomersall, C. D. (2017). Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study. Annals of intensive care, 7(1), 46.

Mikhail, O., & Langabeer, J. (2018). Strategy and Performance Management. In Performance Improvement in Hospitals and Health Systems (pp. 39-60). New York, NY: Productivity Press.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations. Burlington, MA: Jones & Bartlett Publishers.

Shekelle, P. G. (2013). Nurse-patient ratios as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(5_Part_2), 404-409.

Wong, P. S. P. (2015). To learn or not to learn from project monitoring feedback: In search of explanations for the contractor’s dichromatic responses. In The Soft Power of Construction Contracting Organisations (pp. 141-164).

Woo, K., Milworm, G., & Dowding, D. (2017). Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 14(6), 440-446.

Sample Answer 4 for NURS 8302 Week 6: QUALITY IMPROVEMENT INITIATIVE

Multimorbidity, defined as two or more chronic medical conditions, resulting in polypharmacy, which is often described as the long-term use of five or more prescribed drugs daily (Sivasamy et al., 2023).  Pharmacokinetics: Drugs commonly prescribed to older people, such as antihistamines, can reduce oral secretions, and PPI, which reduce gastric acid secretion, both of which affect drug absorption.  Pharmacodynamics: Haloperidol and amitriptyline together can cause major anti-cholinergic side effects.

Having a centralized national repository of medical records allows medical practitioners to be informed of the medications the patient is taking, so to avoid polypharmacy or even a prescribing cascade.  A prescribing cascade occurs when additional adverse events are mistaken as a new medical condition, which leads to the addition of new drugs to treat it.  This, in turn, places patients at risk of experiencing additional adverse drug events from the unnecessary treatment (Chen et al., 2019).

The US was one of the first countries to establish the National Medication Errors Reporting Program (MERP) to monitor medication error (Chen et al., 2019).  Human error is inevitable.  The best we can do is educate and train healthcare staff and patients about the use of medications.  We currently utilize Omnicell at my organization.  To be certain that I am giving the correct medication to the right patient, when I pull the medication, I make sure that it is exactly the medication I need.  I scan the patient, and I go through the 5 rights: right name, right medication, right time, right dose, right route.

As healthcare staff, we must be vigilant and advocate for our patients by being careful what we give them is exactly what they need.  For example, a new nurse pulled Narcan instead of Norco by pressing the wrong button.  She was asking for a waste for the Norco from another nurse who thought that maybe there was a liquid Norco, so she looked and realized the new nurse pulled Narcan out instead.

References:

Chen, Y., Wu, X., Huang, Z., Lin, W., Li, Y., Yang, J., & Li, J. (2019). Evaluation of a medication error monitoring system to reduce the incidence of medication errors in a clinical setting. Research in Social and Administrative Pharmacy, 15(7), 883–888. https://doi.org/10.1016/j.sapharm.2019.02.006

Vignesh Sivasamy, King Fan Yip, Kaysar Mamun, & Kiat Wee Lim. (2023). A review of the effectiveness of interventions to reduce medication errors among older adults in Singapore. Proceedings of Singapore Healthcare, 32. https://doi.org/10.1177/20101058231172232