NURS FPX 4020 Assessment 1 Enhancing Quality and Safety
NURS FPX 4020 Assessment 1 Enhancing Quality and Safety
NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Sample 1
Name
Capella university
NURS-FPX 4020 Improving Quality of Care and Patient Safety
Prof. Name
Date
Enhancing Quality and Safety
Patient safety utilizes safety science techniques to establish a reliable healthcare delivery system (Brigitta & Dhamanti, 2020). Medication administration errors (MAEs) pose a threat to patients’ lives and, if not fatal, can result in treatment setbacks leading to prolonged hospital stays. Consequently, patient trust in healthcare systems diminishes, accompanied by increased treatment costs. This study aims to examine the factors contributing to MAEs and propose strategies for enhancing patient care quality.
Factors Leading to Patient Safety Risks
Before delving into the primary contributors to patient safety risks in healthcare settings, an incident involving medication error in a hospital will be discussed. In a busy hospital, Nurse Ella was responsible for diabetic patient care in her ward. Mr. Wallace, diagnosed with Diabetes type 2, was prescribed two insulin pens: one with rapid-acting insulin for pre-meal administration and the other with long-acting insulin for once-daily administration. Despite her intentions, Ella mistakenly administered a higher-than-normal dose of rapid-acting insulin to Mr. Wallace instead of the prescribed long-acting insulin dose. This error led to symptoms of hypoglycemia in the patient, requiring prompt intervention from healthcare staff.
Nurses, entrusted with drug administration, play a crucial role in delivering safe and accurate treatment. They are frequently the primary source of medication administration errors due to their frontline involvement in patient care. A cross-sectional study conducted in institutional settings revealed a 57.7% prevalence of MAEs among participant nurses, with 30.4% committing errors more than three times (Tsegaye et al., 2020). Major factors contributing to medication administration errors by nurses include insufficient training, prescribing errors, stress, burnout, and communication gaps among healthcare professionals.
Lack of Knowledge and Training
Inadequate experience and knowledge regarding drug doses, interactions, contraindications, and potential adverse effects significantly contribute to medication administration errors. Research indicates that 78.7% of medication errors stem from nurses’ inadequate training (Hassen et al., 2022). Nurses with advanced pharmaceutical knowledge and appropriate training demonstrate reduced likelihood of medication administration errors.
The Communication Gap Between Healthcare Professionals
Inadequate communication and collaboration among healthcare staff, including pharmacists, physicians, and nurses, can lead to medication errors. Studies have shown a higher incidence of medication administration errors in hospitals with communication gaps among healthcare staff (Ghasemi et al., 2022).
Prescribing Errors
Prescription errors occur when healthcare professionals inaccurately prescribe medications, resulting in incorrect dosages, inappropriate instructions, and other serious issues. Incompletely written prescriptions contribute to 71% of prescription-related errors, while transcription errors account for the remaining 29% (White et al., 2019).
Stress, Burnout, and Mental Health Challenges Among Healthcare Workers
Excessive workloads, long shifts, moral dilemmas, perceived job instability, and lack of social support elevate stress levels among nurses, leading to psychological distress, burnout, and other illnesses. A study assessing registered nurses’ burnout found that 30% exhibited high burnout levels, increasing the likelihood of patient care and medication errors by five times (White et al., 2019).
Evidence-Based Best Practices Solutions
To enhance patient safety and reduce medication administration costs, evidence-based best practice solutions are imperative. Several techniques supported by academic or professional sources include:
Technique |
Description |
|---|---|
| QSEN Approach | Focuses on six fundamental skills: patient-centered care, teamwork, evidence-based practice, quality improvement, patient safety, and informatics (Watanabe et al., 2021). |
| Medication Reconciliation | Contrasting a patient’s current medication regimen with prescriptions enhances patient safety during care transitions (Koprivnik et al., 2020). |
| Computerized Physician Order Entry (CPOE) Systems | Electronically submitting medication orders reduces adverse drug events (Skalafouris et al., 2022). |
| Barcode Medication Administration (BCMA) Systems | Ensures correct medication delivery through patient identification and barcoded labels, preventing errors (Ye, 2023). |
| Clinical Decision Support System (CDSS) | Provides research-based suggestions to healthcare practitioners, alerting them to possible medication errors or allergies (Manias et al., 2020). |
| Value-Based Formulary Management Strategies | Selecting medications based on clinical efficacy, cost-effectiveness, and safety enhances healthcare quality while reducing costs (Weinmeyer et al., 2021). |
Nurse-Led Coordination to Optimize Patient Safety
Enhancing medication administration entails nurse collaboration with healthcare stakeholders. Clear communication between nurses and physicians, along with coordination with pharmacists and IT personnel, reduces medication errors and improves patient safety. Nurses’ collaboration with pharmacists reduces prescription errors, ensuring accurate medication administration (Koprivnik et al., 2020).
Conclusion
Medication administration errors pose significant risks to patient safety and increase treatment costs. However, these errors can be mitigated by identifying contributing factors and implementing appropriate solutions. Best practices such as medication reconciliation, technological advancements, teamwork promotion, and value-based approaches play vital roles in error prevention. Collaboration between nurses and stakeholders further enhances patient care quality and safety.
References
Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Abu Farha, R., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/jphsr/rmaa025
Ghasemi, F., Babamiri, M., & Pashootan, Z. (2022). A comprehensive method for the quantification of medication error probability based on fuzzy SLIM. PLOS ONE, 17(2), e0264303. https://doi.org/10.1371/journal.pone.0264303
Hassen, A., Abozied, A., Mahmoud, E., & El-Guindy, H. (2022). Mental health nurses’ knowledge regarding patients’ rights and patients’ advocacy. NILES Journal for Geriatric and Gerontology, 5(2), 307–324. https://doi.org/10.21608/niles.2022.243510
Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., Taboada-López, R. J., & Rodríguez-Penín, I. (2020). Improving patient safety through a pharmacist-led medication reconciliation program in nursing homes for the elderly in Spain. International Journal of Clinical Pharmacy, 42(2), 805–812. https://doi.org/10.1007/s11096-020-00968-8
Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309
Skalafouris, C., Reny, J.-L., Stirnemann, J., Grosgurin, O., Eggimann, F., Grauser, D., Teixeira, D., Jermini, M., Bruggmann, C., Bonnabry, P., & Guignard, B. (2022). Development and assessment of PharmaCheck: An electronic screening tool for the prevention of twenty major adverse drug events. BMC Medical Informatics and Decision Making, 22(1). https://doi.org/10.1186/s12911-022-01885-8
Watanabe, Y., Claus, S., Nakagawa, T., Yasunami, S., & Teshima, M. (2021). A study for the evaluation of a safety education program for nursing students: Discussions using the QSEN safety competencies. Journal of Research in Nursing, 26(1-2), 97–115. https://doi.org/10.1177/1744987121994859
Weinmeyer, R. M., McHugh, M., Coates, E., Bassett, S., & O’Dwyer, L. C. (2021). Employer-led strategies to improve the value of health spending: A systematic review. Journal of Occupational & Environmental Medicine, 64(3), 218–225. https://doi.org/10.1097/jom.0000000000002395
Ye, J. (2023). Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Perioperative Medicine, 6(1), e34453. https://doi.org/10.2196/34453
NURS FPX 4020 Assessment 1- Enhancing Quality and Safety Sample 2
Student Name
University Name
NURS FPX 4020 Improving Quality of Care and Patient Safety
Instructor Name
Date
Enhancing Quality and Safety
Patient safety uses the technique of safety science to build a dependable healthcare delivery system (Brigitta & Dhamanti, 2020). Medication administration errors (MAEs) can endanger the patient’s life and if not always fatal tend to cause losses in terms of treatment leading to a longer patient’s stay in the hospital. This, in turn, leads to a reduced patient’s trust towards healthcare systems and practitioners, as well as a rise in the treatment cost. The purpose of this study is to analyze the factors contributing to MAEs and discuss the strategies that can be employed to improve the quality of patient care.
Factors Leading to Patient Safety Risks
Before analyzing the primary elements that contribute to patient safety risks at healthcare institutions, a medication error incident that happened in a hospital will be discussed here. In a bustling hospital, Nurse Ella was responsible for the care of diabetic patients in their ward. The patient Mr. Wallace was diagnosed with Diabetes type 2 and was prescribed two insulin pens, one containing rapid-acting insulin to be administered before meals and the other containing long-acting insulin to be administered once daily. Despite her best intentions Ella mistakenly administered rapid-acting insulin, with a higher-than-normal dose, to Mr. Wallace instead of a once-daily dose of long-acting insulin. After some time the patient started to develop symptoms of hypoglycemia. Upon noticing the symptoms, the nurse realized her mistake and notified the charge nurse and the physician. They quickly intervened to address Mr. Wallace’s symptoms.
Nurses being responsible for drug administration are the key to providing safe and accurate treatment services to the patients. Being the front line in patient care, nurses are often the most common source of medication administration errors as well. In an institutional-based, cross-sectional study the prevalence of MAEs was found to be 57.7% among the participant nurses and 30.4% of them made it more than three times (Tsegaye et al., 2020). The main factors leading to medication administration errors by nurses include lack of adequate training, prescribing errors, stress, burnout, and communication gap between healthcare professionals.
Lack of Knowledge and Training
Lack of experience and inadequate knowledge about drug doses, interactions, contraindications, and potential adverse effects is a leading factor of medication administration errors. Research suggests that 78.7% of medication errors are due to poor training of nurses (Hassen et al., 2022). Nurses possessing advanced pharmaceutical knowledge and subsequent training are less likely to make medication administration errors.
The Communication Gap Between Healthcare Professionals
Lack of communication and collaboration between the healthcare staff i.e. the pharmacist, physician, and nurses can lead to medication errors. A study suggests a higher incidence of medication administration in hospitals where there is a communication gap between the healthcare staff (Ghasemi et al., 2022).
Prescribing Errors
Prescription errors occur when healthcare professionals inaccurately prescribe medications leading to incorrect dosage, inappropriate instructions, and other potentially serious issues. In a study, it was found that incompletely written prescriptions accounted for 71% of the total prescription-related errors while errors during transcription of the prescription contributed to the remaining 29 % of the errors (White et al., 2019).
Stress, Burnout, and Mental Health Challenges Among Healthcare Workers
Owing to excessive workloads, long shifts, moral dilemmas, perceived job stability, and a lack of social support, the elevated stress level among the nurses often results in psychological distress which can lead to burnout, depression, anxiety disorders, and other illnesses. In a study conducted to assess the correlation of registered nurses’ burnout with the quality of patient care it was found that 30% of the registered nurses exhibited high levels of burnout, and nurses with burnout were 5 times more likely to cause patient care and medication errors (White et al., 2019).
Evidence-Based Best Practices Solutions
To accomplish the objectives of enhancing patient safety and lowering costs in the administration of medications, evidence-based and best practice solutions are essential. Here are several techniques backed by academic or professional sources:
- The QSEN (Quality and Safety Education for Nurses) approach focuses on six fundamental skills of patient-centered care, teamwork, evidence-based approach, focus on quality improvement actions needed, patient safety, and the use of informatics and technology in healthcare provision. Quality and safety education for nurses is found to have been improved by up to 75% by including QSEN competencies in the nursing curriculum (Watanabe et al., 2021).
- By implementing medication reconciliation procedures which entail contrasting a patient’s present pharmaceutical regimen with what had been prescribed for them, patient safety during care transitions can be dramatically improved (Koprivnik et al., 2020).
- Using Computerized Physician Order Entry (CPOE) systems, healthcare professionals can electronically submit medicine orders, lowering the chance of adverse drug events (Skalafouris et al., 2022).
- Barcode Medication Administration systems ensure correct medication delivery by the use of patient identification and barcoded labels on pharmaceuticals, thus enhancing patient safety by preventing drug errors (Ye, 2023).
- Clinical decision support system (CDSS) offers suggestions based on research to healthcare practitioners right at the point of care. To prevent negative outcomes, these systems can notify healthcare professionals about possible medication combinations, dosage mistakes, or allergies.
- Value-based formulary management strategies help keep healthcare quality high while cutting expenditures related to pharmaceuticals. This methods entails choosing medicines based on their clinical potency, cost-effectiveness, and safety (Weinmeyer et al., 2021).
Nurse-Led Coordination to Optimize Patient Safety
The medication administration can be significantly improved via coordination of nurses with other healthcare administrators. In the medication administration error discussed above the nurses’ coordination with physicians, pharmacists, charge nurses, and IT personnels of the hospital setting can significantly decrease the chances of error in healthcare settings. The clear communication between nurses and physicians with special emphasis on the treatment regimen required and the guidelines to be followed results in enhanced accuracy during administration of the drugs. Double checking by the nurses themselves or charge nurse creates an environment where the probable causes of adverse events can be prevented (Alrabadi et al., 2021). The prevention of adverse events by using these interventions in turn reduces the cost incurred on hospitals and patients by the long stay of patients at the hospitals. Nurses can work in collaboration with pharmacists to reduce the errors of prescription transcribing and filling thus ensuring the five rights of medication administration (Koprivnik et al., 2020).
Enhancing Quality and Safety
Nurses can help in improving cost effectiveness at hospitals by collaborating with pharmacists in the development of value based formulary (Weinmeyer et al., 2021). The mutual working of nurses and IT personnel of hospital staff can result in the effective use of technology tools such as CPOE, BCMA and CDSS to prevent MAEs to occur (Ye, 2023). These interventions could have prevented Ella from administering wrong insulin to Mr. Wallace. Holistic care approach promoted by working with interdisciplinary teams and in accordance with regulatory requirements reduces risk of errors and thus ensuring patient safety and cost effectiveness in halthcare.
Nurses’ Coordination with other Stakeholders
To improve medicine delivery, nurses collaborate with physicians, pharmacists, patients, and nursing leadership. The quality improvement teams and nursing staff can work together to effectively evaluate the challenges arising in healthcare settings and implement suitable strategies and processes in action. NURS FPX 4020 Assessment 1- Enhancing Quality and Safety. The correct use of informatics requires efficient collaboration between nurses and IT personnel within the organizations. Better adherence and patient satisfaction can be enabled by involving patients and their families. Patient safety is prioritized at the organizational level by the involvement of medication safety officers and administrators. Professional associations offer crucial tools for advancing medical practices continuously.
Conclusion
Medication administration errors are potentially fatal errors that pose a risk to the patient and increase the cost of the treatment as well. However, these errors can be prevented by identifying the factors contributing to medication administration errors by the nurses and putting suitable remedial plans into action. NURS FPX 4020 Assessment 1- Enhancing Quality and Safety. The best practice solutions that can be used for this purpose include the use of medication reconciliation, benefitting from technological advancements in healthcare systems, incorporation of teamwork in healthcare setups, and by using value-based approaches. Incorporation of the QSEN approach in nurses’ training also reduces the risk of medication administration errors by giving quality patient care practice skills to the nurses. Efficient collaboration between nurses and other stakeholders such as clinicians, pharmacists, and IT personnel significantly enhances the quality of patient care provided by the nurses.
References
Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-rabadi, D., Abu Farha, R., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/jphsr/rmaa025
Ghasemi, F., Babamiri, M., & Pashootan, Z. (2022). A comprehensive method for the quantification of medication error probability based on fuzzy SLIM. PLOS ONE, 17(2), e0264303. https://doi.org/10.1371/journal.pone.0264303
Hassen, A., Abozied, A., Mahmoud, E., & El-Guindy, H. (2022). Mental health nurses’ knowledge regarding patients’ rights and patients’ advocacy. NILES Journal for Geriatric and Gerontology, 5(2), 307–324. https://doi.org/10.21608/niles.2022.243510
Koprivnik, S., Albiñana-Pérez, M. S., López-Sandomingo, L., Taboada-López, R. J., & Rodríguez-Penín, I. (2020). Improving patient safety through a pharmacist-led medication reconciliation program in nursing homes for the elderly in Spain. International Journal of Clinical Pharmacy, 42(2), 805–812. https://doi.org/10.1007/s11096-020-00968-8
Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309
Skalafouris, C., Reny, J.-L., Stirnemann, J., Grosgurin, O., Eggimann, F., Grauser, D., Teixeira, D., Jermini, M., Bruggmann, C., Bonnabry, P., & Guignard, B. (2022). Development and assessment of PharmaCheck: An electronic screening tool for the prevention of twenty major adverse drug events. BMC Medical Informatics and Decision Making, 22(1). https://doi.org/10.1186/s12911-022-01885-8
Watanabe, Y., Claus, S., Nakagawa, T., Yasunami, S., & Teshima, M. (2021). A study for the evaluation of a safety education program for nursing students: Discussions using the QSEN safety competencies. Journal of Research in Nursing, 26(1-2), 97–115. https://doi.org/10.1177/1744987121994859
Weinmeyer, R. M., McHugh, M., Coates, E., Bassett, S., & O’Dwyer, L. C. (2021). Employer-led strategies to improve the value of health spending: A systematic review. Journal of Occupational & Environmental Medicine, 64(3), 218–225. https://doi.org/10.1097/jom.0000000000002395
Ye, J. (2023). Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Perioperative Medicine, 6(1), e34453. https://doi.org/10.2196/34453
Assessment 01 – Enhancing Quality and Safety
For this assessment, you will develop a 3–5-page paper that examines a safety quality issue in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.
Before you complete the instructions detailed in the course-room, first select one of the safety quality issues below to analyze for this assessment. After you have selected one of the issues from the list below, return to the detailed instructions in the courseroom to complete your assessment.
- Staffing Shortages in Healthcare: The adequacy of staffing in healthcare settings directly impacts the quality of care, safety, and overall functioning of the institution. Here’s why understanding the implications of staffing shortages is crucial:
- Patient Safety and Quality of Care: With fewer staff members, each individual is often required to manage a larger number of This increased workload can lead to oversights, missed care, delayed responses to patient needs, and a higher likelihood of errors in medication administration or treatment.
- Burnout and Mental Health: Continuously working in understaffed conditions places immense stress on healthcare The constant pressure, long hours, and emotional toll of not being able to provide optimal care can lead to burnout, depression, and other mental health issues.
- Physical Health Risks: Extended shifts and fewer breaks due to staffing shortages can result in physical exhaustion. Over time, this can lead to chronic health issues, increased susceptibility to illnesses, and a higher risk of workplace
- Decreased Patient Satisfaction: Patients are keenly aware when staff are rushed, unavailable, or too busy to attend to their needs. This can lead to feelings of neglect, dissatisfaction, and a lack of trust in the healthcare
- Increased Turnover: Chronic staffing shortages can lead to a vicious cycle where overwhelmed staff members leave their positions in search of better working conditions, further exacerbating the This turnover also means a loss of experienced staff, which can impact the quality of care.
- Economic Implications: While it might seem counterintuitive, staffing shortages can lead to increased costs for healthcare institutions. Costs associated with hiring and training new staff, overtime pay, and potential lawsuits or penalties due to errors can add up.
- Educational and Mentorship Opportunities: For nursing students and new graduates, mentorship from experienced nurses is invaluable. However, in understaffed settings, experienced nurses may not have the time or energy to provide guidance, potentially impacting the quality of training and professional development for newer nurses.
- Team Dynamics and Morale: Working in a consistently understaffed environment can strain team dynamics. The constant pressure can lead to tensions, miscommunications, and conflicts, further impacting the quality of care and the workplace environment.
- Medication Errors in Healthcare: Medication administration is a fundamental aspect of patient care, and errors in this process can have severe, sometimes life-threatening, consequences. Understanding the gravity and implications of medication errors is essential. Here’s why:
- Patient Safety and Well-being: The most immediate concern with medication errors is the potential harm to the patient. Administering the wrong medication, dosage, or route can lead to adverse reactions, exacerbate existing conditions, or introduce new health complications.
- Complexity of Modern Medicine: With the advancement of medicine, patients often receive multiple medications, sometimes with intricate dosing schedules. This complexity increases the potential for errors, making vigilance and thorough knowledge essential for healthcare providers.
- Loss of Trust: When patients or their families experience or witness a medication error, their trust in the healthcare system and professionals can be severely This mistrust can hinder therapeutic relationships and make patients hesitant to adhere to future medical advice.
- Professional and Legal Implications: Medication errors can have significant repercussions for healthcare professionals. These might include disciplinary actions, loss of licensure, legal consequences, and damage to one’s professional
- Economic Costs: Medication errors can lead to extended hospital stays, additional treatments, and potential lawsuits, all of which result in increased costs for healthcare institutions.
- Emotional Toll on Healthcare Providers: Realizing that one has made a medication error can be emotionally devastating for healthcare providers. Guilt, anxiety, and fear of potential consequences can lead to burnout, self-doubt, and even deter some from continuing in the profession.
- Systemic Implications: Frequent medication errors can indicate deeper systemic issues within a healthcare institution, such as inadequate training, poor communication, or insufficient checks and balances. Addressing these root causes is crucial for preventing future errors.
- Educational Opportunities: Every medication error, while unfortunate, provides an opportunity for learning and Analyzing the causes of errors can lead to better training programs, improved protocols, and the implementation of safety measures to prevent recurrence.
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Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
- Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. NURS FPX 4020 Assessment 1 Enhancing Quality and Safety
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Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
- Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
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The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
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