Running head: MEDICATION ERRORS 1

Medication Errors

Jessica Te

Delaware Technical Community College

November 19, 2019

Nurses play an important role when it comes to medication administration, and nurses are

usually the patient’s first line of defense and are the ones to catch any issues that can happen.
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When it comes to medication administration, errors are bound to occur and it’s important as

healthcare providers to be able to prevent this from happening. Medication errors can lead to

tragic consequences and studies have shown that the most common causes for medication errors

is the lack of patient identification and medication verification and that includes checking the 7

rights. The 7 rights of medication administration is the right patient, dose, route, drug, time, rea-

son, documentation, and all 7 rights needs to be confirmed before medications are given and if

one of these are missed it can lead to medication errors. Studies have showed that approximately

20% of medication errors are life threatening, and medication errors alone have contributed to

7,000 deaths annually, not only that it can also result in tremendous financial cost about $7.5 bil-

lion per year nationwide in hospital costs alone and this includes malpractice insurance premi-

ums and losses in worker productivity. (Barcode Medication Administration, 2019).

There are five stages of medication administration process, and they are ordering/pre-

scribing, transcribing/verifying, dispensing/delivering, administration and monitoring/reporting.

During these five stages medications can occur anytime, the first stage which is prescribing/or-

dering, errors can occur by patients receiving orders for the wrong drug, dose, or route and some-

times during this stage nurses often feel uncomfortable questioning orders because sometimes

they are confronted with aggressive behavior and this inhibits future questioning and seeking

clarification which contributes to medication errors. (Hughes, R. G., & Belgen M.A, n.d.). The next

stage is transcribing/verifying; nurses and pharmacists are mostly involved transcribing/verifying

medications, but yet at this stage pharmacists plays more of an important role and studies have

found that while dispensing errors that 14% of the total adverse drug events, pharmacists inter-

cepted 70% of all physician orders. The third stage is medication administration, and this is one

of the most important tasks that nurses are responsible for. Nurses are administering medications
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to help treat various illnesses and sometimes even for prophylactic therapy and this is usually

where most medication errors occur. Studies have found that the most common type of medica-

tion error were drug overdoses and second most common type was administering the wrong drug

to the wrong patient. (Hughes, R. G., & Belgen M.A, n.d.). For nurses when it comes to medication

administration, the 7 rights of medication administration is critical. By healthcare providers fol-

lowing the 7 rights of medication administration this can greatly reduce the likelihood of medica-

tion errors occurring, especially by catching the error sooner before they reach the patient.

Luckily, nursing informatics has been a great source for healthcare providers to incorpo-

rate into their practices, it doesn’t replace our critical thinking and judgment skills but it does

have analytical sciences to help support healthcare providers in their job by making certain tasks

much easier and more efficient. One great example of informatics system is the Barcode Medica-

tion Administration Technology (BCMA), this system is an electronic scanning system that can

significantly help reduce medication errors, helps with the 7 rights, and ensures patient safety.

The way BCMA works is by the nurse scanning the patient’s identification band, which ensures

that the patient has been accurately identified, and then the nurse proceeds to scan the barcode on

the prescribed medication to verify that it is indeed the right medication, right dose, right route

and the right time. BCMA helps reduce human error and it also works great by crosschecking

with the patient’s electronic medication administration record (eMAR). When BCMA and

eMAR work together in conjunction it works well together, the eMAR is easily accessible for

healthcare members to be able to look up and pull up information, it also has real time infor-

mation and it is much more organized. Using these two together has significantly shown to de-

crease medication errors, studies have reported that within six months of the introduction of

BCMA technology at trauma centers, nurse’s contentment were relatively higher compared to
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those who uses non-BCMA administration, this is due to the fact that nurses perceived that the

BCMA technology had made it easier to avoid medication errors and help improve patient

safety. (Baiden, D., 2018). Other studies have shown that incidences of medication administration

errors were reduced by 54% when BCMA systems were implemented in both the cardiac units

and medical-surgical units, it was also observed that there was a 50% drop in medication admin-

istration errors post BCMA on these units and also there was a 56% decrease in medication er-

rors classified as wrong time administration with the use of BCMA on the units. (Baiden, D.,

2018). By using both BCMA and eMAR side by side it has provided great results with patient

safety and significantly reduced the rate and occurrence of errors.

Regardless of these systems aiding nurses with patient care, it is important that as nurses

to understand that using informatics is only a great resource to have and to not solely rely on

technology to do our jobs for us. Nurses still play a crucial role in the patient care and they still

require to be able to critically think to solve specific situations and not everything that the com-

puters claims to “correct” is always going to be correct because technology is programmed to

work in a specific matter but they are not program to critically think for us and even technology

will have their own faults at times too. There are times where technology will be not able to help

us nurses, some examples include administering antihypertensive medications, when a nurse

scans a blood pressure medication, and the BCMA system will only confirm the 7 rights of medi-

cation administration, but it will not know the parameters for blood pressure medications. This is

where the nurse’s critical thinking skills come into play. If a nurse is administering a blood pres-

sure medication they should be aware of the parameters so if the parameters for the medication

states to not administer for a systolic pressure <110 or heart <60 the nurse should first check the

blood pressure before administered the medication, if the medication meets the parameters then
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the nurse should not administered the blood pressure medication because this could lead to ad-

verse effects causing the patient blood pressure to drop lower. Another example would be, when

nurses are administering blood thinners, when nurses are scanning these blood thinners, the com-

puter is not going to tell the nurse that patient is going down for a surgical procedure and the

nurse goes right away and administered the medication it will result in a serious consequences

like putting the patient at risk for increasing bleeding, it it critical for the nurses need to be aware

of what is also happening to their patients and if any procedures are done. But, sometimes shifts

can be busy and we start relying on the computers because it is fast and saves time, but if nurses

take an extra minute to critically think it can prevent these errors and nurses should always be

aware of medication policies. Nurses administered different types and forms of medications, one

of the most common form of medication would be intravenous (IV) medications, and this is

where medications errors can commonly occur as well. When it comes to giving out IV medica-

tions there are multiple things to consider besides the 7 rights of medications administration,

nurses need to consider the rate of the IV just because the order specifies a certain rate does not

mean it is necessarily the correct rate because some IV medications require a slower push or

maybe it needs to run slower so that it does not cause serious side effects to the patient. For ex-

ample when nurses hang up potassium riders the order might state to run the K rider at a faster

rate and the IV pump settings will also automatically program itself to run at the adjusted rate of

the K rider but as for the nurses they have to consider that K riders can cause irritation to the

veins and it is better to run the medication at a slower rate and to infuse the medication with nor-

mal saline to avoid complications. Even when administering IV medications, the nurses need

look at lab levels like when administering IV Lasix because Lasix can drop potassium levels and
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if the patient’s potassium levels are already low then the nurses are putting the patient’s at a

higher risk for cardiac related issues if the potassium levels gets any lower.

In conclusion, BCMA systems has been a wonderful tool for healthcare providers to use

especially for nurses. Documentation has come a long way and it has greatly improved overall

patient safety, worker satisfaction, and better quality of care. BCMA and electronic health rec-

ords are easy, and quick to use that it helps healthcare team members be able provide and share

information with other providers within seconds and it allows for all every health care team

members to be work together and be in sync. Technology has been a beneficial factor, but keep

in mind that even though these recourses make our job easier and quicker, they are not here to

replace our judgement and critical thinking, there are things that these resources cannot do for us

because they are limited to certain tasks and are only built to assist us with our critical thinking

skills. This is why it is important for nurses and providers to be aware of their facilities policies

and still follow these policies and procedures and never be afraid to go against what the com-

puter says because it is not always going to be correct and the computers are not the ones who

are physically by the patient’s bedside majority of the time.

References
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