The demand for quality and effective healthcare continues to grow in the presence of technological advancements coupled with population growth. With the growing health challenges, patients and the community must work alongside providers, which includes shared decision-making, integrated and individualized care, plus self-management support. However, research hints at patient safety as a global problem, burdensome in developed and developing countries alike. Melnyk et al. (2021) estimate that 250000 deaths occur in the United States annually because of medical mistakes. Communication gaps between caregivers and patients, diagnostic errors, surgical accidents, plus issues in medication administration like wrong medical dosage or prescription. Consider the Louise H. Batz Patient Safety Foundation, which advocates for individualized care and patient safety following the death of Louise Batz due to wrong medication administration (Sharp, 2014). The healthcare system continues to become complex making patient safety more critical and thus, nurses should meet safety and quality competencies.
Patient-Safety Risk Factors
Patients’ health and safety remain at higher risk because of the prevalence of preventable medical errors. Organizational and human factors largely contribute to safety and quality issues in the care system. Valaitis et al. (2018) define organizational factors as processes or operational attributes affecting collaboration, including clinical governance and culture, infrastructure, financial resources, and communication mechanisms. The scholars established that resource limitations, poor leadership, and accountability issues adversely affect the collaboration between primary care and public health. In addition, organizational factors like financial resources, including remuneration affect the performance of all healthcare providers toward delivering quality, efficient and effective care. Given the labor-intensive nature of healthcare, inadequate staffing can contribute to poor standardization of operations and procedures, workload pressure, and limited time for effective care (Glette & Wiig, 2021). Subsequently, these factors potentially increase the risk for medication administration errors, including wrong medication or dosage. Likewise, inadequate resources, including poor documentation, unsafe clinical facilities, and lack of necessary equipment can result in inaccurate diagnoses leading to unnecessary or wrong medication administration. Therefore, organizational factors merit lean, timely, efficient, and safe healthcare systems.
Nonetheless, a sustainable healthcare system remains cognizant of human factors like employee and leadership engagement, plus effective communication. However, ineffective communication or poor engagement between a healthcare professional and patient causes medical mistakes and lapses. Karimi‐Shahanjarini et al. (2019) imply that negligence, incompetency, inattention, and poor motivation among nurses adversely affect patient safety. In care delivery, competency relates to skills, knowledge, and attitude. Nurses should incorporate interpersonal skills to ensure reliable, quality, continuous, and safe care. For example, communication, collaboration, and cooperation between nurses and patients help limit medical errors. Fostering flexibility, adaptability, time management, strong work ethic, and technical skills like administering medication, and taking vital signs are equally crucial (Karimi‐Shahanjarini et al., 2019). On the other hand, knowledge refers to nurses’ ability to recognize potential patient safety risk factors and understand best practice solutions like correct drug prescription (QSEN, 2020). Most importantly, nurses must possess a positive attitude toward patient safety and health outcomes; nurses should value their role in preventing medication administration errors by following standard procedures.
Evidence-Based and Best Practice Solutions to Improve Patient Safety
A weak healthcare delivery system, from poor management to limited equipment, contributes to medication administration errors. Thus, the Institute of Medicine (IoM) and the Quality and Safety Education for Nurses (QSEN) lays out core competencies necessary for improving the safety and quality of care systems, including knowledge, attitudes, and skills. The competencies guide curricular development for education programs and practice transition, which are further elaborated in terms of evidence-based practice and best practices, including patient-centered care, safety, informatics, quality improvement, and teamwork. As per the QSEN, patient-centered care recognizes patients’ preferences and needs for coordinated health outcomes. Therefore, baccalaureate nurses should demonstrate a comprehensive understanding of patient preferences while examining cost-effectiveness, safety, and quality of healthcare (QSEN, 2020). Additionally, nurses need to initiate effective skills by facilitating informed care plans and removing barriers based on patient needs and preferences. The QSEN further stipulates that nurses should acknowledge and respect shared decision-making with patients plus value continuous skill development for effective and efficient care delivery.
Another best practice solution for improving patient safety is teamwork and collaboration. Nurses work more effectively when they foster effective communication, shared decision-making, and mutual respect with other healthcare professionals, patients, and the community. As part of their key competencies, baccalaureate nurses should recognize the contributions of other professionals in helping patients achieve positive health outcomes (QSEN, 2020). While nurses must possess the ability to identify system barriers and suggest strategies for improvement is crucial, they should demonstrate awareness of their limitations and strengths, plus a commitment to safe and quality care. In addition to actively participating in designing system solutions, nurses should value their impact on team functioning. Similarly, quality improvement by use of improved care processes and methods is central to safe, quality and cost-effective care. Nurses play a central role in the care process and thus, actively use tools to identify gaps in their practice while appreciating the role of continuous quality improvement and teamwork in improving health outcomes.
Nonetheless, safety remains central to individual performance and overall system performance. Baccalaureate nurses should be knowledgeable in identifying medication administration errors in care for candid discussions on the impact of patient safety initiatives and resources. Subsequently, nurses must demonstrate skills in the effective use of standard practices, technology, and other strategies in supporting patient safety and care quality. In the same view, they must appreciate the cognitive limitations of human performance and thus, value the importance of monitoring and vigilance by other healthcare providers, patients, and the community (QSEN, 2020). Monitoring requires the effective use of information and technology to mitigate errors. As such, baccalaureate nurses should identify and seek knowledge about the impact of informatics in care settings and take part in designing and implementing information technologies supporting safe and quality care.
However, nurses should coordinate quality and safe care by adopting evidence-based practices in which patient preferences and values, integrated medical evidence, and clinical expertise improve patient outcomes while considering associated costs. Furthermore, the goal is to deliver quality, safe and affordable care. For one, interdisciplinary team interventions that involves all stakeholders, including nurses, physicians, patients, the government, insurance companies, the community, and other provider institutions can help ensure detailed assessment, sustainable and lean care delivery. According to Giuliante et al. (2018), interdisciplinary team intervention interacts with organizational, societal, and collective factors for sustainable health outcomes. The approach will limit medication administration errors, and in turn, saving on overall cost. Additionally, streamline and rationalized clinical structures and programs can help hospitals adjust care fluctuations by addressing patient safety issues while decreasing cost pressures. In simple terms, pragmatic strategies that navigate healthcare challenges can help reduce medication administration errors and unnecessary costs and procedures.
Conclusion
Despite innovation plus research and development programs in the healthcare systems, medical errors continue to surge. Medication administration errors particularly results in significant poor health outcomes and even death because of wrong drug or dosage. Baccalaureate nurses are at the center of quality and safe care and should adopt evidence-based or best practice solutions to minimize medication administration error for positive health outcomes. Nonetheless, safe and quality care should be affordable despite associated costs in terms of quality improvement and informatics. For example, interdisciplinary team interventions plus rationalized and streamline clinical programs can significantly improve patient safety while saving on costs. Generally, baccalaureate nurses should acquire necessary competence to provide safe and quality care in a constantly changing healthcare system.
References
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Glette, M. K., & Wiig, S. (2021). The role of organizational factors in how efficiency-thoroughness trade-offs potentially affect clinical quality dimensions–a review of the literature. International Journal of Health Governance, 26(3), pp.250-265.
Karimi‐Shahanjarini, A., Shakibazadeh, E., Rashidian, A., Hajimiri, K., Glenton, C., Noyes, J., Lewin, S., Laurant, M. and Colvin, C.J. (2019). Barriers and facilitators to the implementation of doctor‐nurse substitution strategies in primary care: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (4), pp.1-107.
Melnyk, B.M., Tan, A., Hsieh, A.P., Gawlik, K., Arslanian-Engoren, C., Braun, L.T., Dunbar, S., Dunbar-Jacob, J., Lewis, L.M., Millan, A. and Orsolini, L. (2021). Critical care nurses’ physical and mental health, worksite wellness support, and medical errors. American Journal of Critical Care, 30(3), pp.176-184.
Quality and Safety Education for Nurses. (2020). QSEN competencies.
Sharp, C. (2014). The story of Louise H. Batz from tragedy to hope. [Video]. YouTube.
Valaitis, R., Meagher-Stewart, D., Martin-Misener, R., Wong, S. T., MacDonald, M., & O’Mara, L. (2018). Organizational factors influencing successful primary care and public health collaboration. BMC health services research, 18(1), pp.1-17.