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Empowering Nurses to Address the Persistent Challenge of Medication Errors

November 15, 2016
by Katherine Kenny, D.N.P., R.N., associate dean of academic affairs, College of Nursing and Health Innovation, Arizona State University
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According to the National Quality Forum, serious preventable medication errors occur in 3.8 million inpatient admissions every year
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Nursing’s role in healthcare today is more important than ever before. The family practitioner is no longer solely responsible for overseeing care. Nurses today are playing a critical role in ensuring patients receive quality care at all points on the continuum. They are at the forefront of patient care and heavily influence the patient experience, serving at the intersection of patients, physicians and family. Managing medications properly, improving transitions of care, preventing medication errors, and communicating effectively with patients and their at-home caregivers are all critical components of the nurse’s role. It’s no coincidence that these are also key areas that impact quality and satisfaction.

It has been estimated that medication errors impact 1.5 million Americans annually at an industry cost of $21 billion, according to the National Quality Forum. On an annual basis nearly 7,000 patient deaths are attributable to medication mistakes, according to a report by the Institute of Medicine of the National Academies. And, the Medicare Payment Advisory Commissions (MedPAC) reports that almost 20 percent of all patients discharged from the hospital experience an associated adverse event within five weeks, with two-thirds of those attributable to medications. For something that is largely preventable, these numbers are staggering.

According to the National Quality Forum, serious preventable medication errors occur in 3.8 million inpatient admissions every year. Healthcare organizations that lack a consistent protocol for medication therapy within their organizations could potentially and unwillingly foster an environment where medication mismanagement or error is more likely, especially during a transition of care. In fact, a study published by the Network for Excellence in Health Innovation (NEHI) indicates that 66 percent of preventable medication reconciliation errors happen during these transitions.

Medication learning solutions, which include evidence-based, unbiased, clear-cut, and current drug therapy and medication management recommendations, are ideal resources to answer the questions nurses encounter on a daily basis. To do their job effectively nurses need to be current on important drug interactions, medication side effects, and dosing recommendations. Medication learning tools provide nurses with the tools and technology that help them better recognize potential for medication error before the point of need.

Katherine Kenny, D.N.P., R.N.

More often than not nurses juggle many responsibilities and multiple patients. Traditionally, pharmacists serve as an effective and useful source of medication knowledge at the point of need. However, there isn’t always time or opportunity to consult with a pharmacist. In some cases nurses may not even know the right questions to ask because they don’t even know it’s a question that should be asked. They may also consult with a medication database—a cumbersome and time-consuming tool that can be overwhelming if you are unsure of what to look for.

Medication learning resources can be more effective than a traditional database because it takes only the most relevant and current information and delivers it in an easy to review format. This better enables nurses to identify what they need to know before they need to know it. These resources are as valuable as having a pharmacist at the nurse’s side because it provides key medication data based on timely evidence, along with recommendations and education about drug therapy and medication management. Access to this information before the point of need supports the augmentation of patient care with informed knowledge and instruction, which can result in decreased errors.

Having this information accessible before the point of need helps create a more standardized system for medication therapy practices, which can reduce mistakes and variability of care. It also allows nurses to communicate in a more consistent manner with patients and their at-home caregivers, increasing patient understanding and comfort level with medications, which can lead to improved overall care.

Once a patient leaves the hospital, maintaining proper adherence to their medication treatment plan is critical to preventing a readmission. More effective communication, and shared decision making during discharge can greatly alleviate patient anxiety, and impact whether they successfully manage medications once leaving the safety and security of the hospital. It can also help prevent instances where a patient simply refuses to fill a prescription due to the high financial cost. For serious conditions, failure to adhere to prescribed medication therapies can have serious and even deadly consequences.

Medication learning tools provide valuable knowledge about medication therapies that nurses can share with their patients, including cost information and alternatives. By giving nurses clear and concise medication information they can have more informed and meaningful conversations with their patients before they leave the hospital. This encourages and helps improve medication adherence, ultimately reducing unnecessary readmissions.

Nurses spend more time with patients than any other member of the care team. Empowering them with resources like medication learning tools can help them become more effective and deliver better patient care. Tools that help create a change in performance and a change in outcomes have the potential to generate the greatest benefit for both the patient and the organization. This is especially significant in a value-based care system where organizational success and the Centers for Medicare & Medicaid Services (CMS) reimbursements are measured by quality outcomes.

 

 

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