The effective administration of medication is detrimental to ensuring the successful management of a disease or illness, its slowed progression, as well as improved patient outcomes if done without errors. However, when there is a mistake in medication administration, unintended consequences may arise, potentially causing adverse health conditions among patients and even death (Allen, 2013). Patient allergies are a current issue that remains relevant as a medical administration healthy risk. Managing patient allergies is challenging for institutions because failures can take place during the process of medication use (Grissinger et al., 2019). A quality improvement (QI) initiative concerned with addressing the problem is concerned with following a step-by-step medication administration system, which includes such steps as (1) collecting information on patients, (2) carefully documenting all allergies in the record, (3) medication ordering, (4) verifying orders, (5) administering medication, and (6) following up (Grissinger et al., 2019). Most mistakes occur when information about allergies is obtained from patients, which is why verification and follow-up are crucial. A system-based strategy for medication administration is the recommended QI initiative that can help improve the medication-use process for patients with certain allergies.
Factors Leading to Patient Risks
Even in healthcare implementation, errors are inevitable because they are a part of the process that involves humans. However, the main issue lies not in the incidence of errors but in the strategies aimed at the mitigation of mistakes and their prevention (Kohn et al., 2000). Therefore, it is essential to understand the factors leading to a specific patient-safety risk in medication administration. When it comes to patient allergies, the significant factors are the failure to communicate with the patient, the inappropriate review of their chart, inaccurate charting, as well as technological limitations such as the lack of a reliable software system that tracks medications and patient allergies. The mistakes occur when there is not enough vigilant review for drug-drug, drug-disease, and drug-nutrient interactions (Tariq et al., 2022). In addition to the mentioned risk factors, it is necessary to consider pharmacists’ mistakes, which can be mechanical or judgmental. The latter include mistakes such as the failure to detect drug interactions, inadequate drug utilization review, failure to counsel patients, or inappropriate monitoring. Mechanical errors are mistakes in dispensing or preparing prescriptions, such as incorrect dose administration, improper directions, or wrong quantity or strength.
Best-Practice QI Initiative
Taking into account the main risk factors, at the core of the QI initiative for preventing medication errors relating to patient strategy is improving patient communication and education, which is the first step. Patient reports must be verified with the records of previously prescribed medications and any reports on allergies in case if a patient had forgotten about their allergies. Besides, it is crucial to ask patients about any current medications they are taking to check for drug-drug interactions. The second step of the QI is that the allergies must be documented in the record because most failures to meet patients’ care needs occur when personnel does not record known allergies in medical records (Grissinger et al., 2019). The allergies must be documented in a way that would trigger an electronic alert in the system when ordering, verifying, or administering the medication.
The third step is medication ordering, during which the practitioners must get to know all warnings of allergies and order medications accordingly, which is why precision and attention are crucial at this stage. An allergy review must be conducted before medication order to ensure that all factors are considered. The fourth step entails better coordination between nurses, patients, and pharmacists during medication order verification. Before verification, a pharmacist must look at all data provided by nurses while the nurse must verify with the patient that they have mentioned all allergies and that nothing was missed. While this process is lengthier, it is more cost-effective because there will be lower numbers of incorrect orders and adverse patient outcomes (Grissinger et al., 2019). During the fifth step, which entails administration, it is necessary to provide patient education to explain the difference between adverse reactions and allergies. Thus, patients must follow up with their health provider regarding the impact of medication and keep a current record of allergies, the date of reactions, and their nature.
Collaboration for Safety Enhancement
Safety enhancements with medication administration can occur when nurses coordinate with clinical pharmacists and IT personnel. Collaboration with clinical pharmacists is essential for assisting with cohesive and up-to-date recording of all patient allergies and the quick identification of possible efforts. Nurses may work together with pharmacists to establish standardized allergy collection forms that are accessible to both categories of providers so that there is no data missing. Nurses are likely to be responsible for documenting allergy information and ensuring that the documentation takes place before administration or any procedural intervention. On their end, pharmacists should communicate the importance of checking all documentation on patient allergies before ordering, verifying, and administering medications.
A reliable and skilled team of IT professionals at a healthcare facility could significantly improve the process of medication administration. IT personnel could help install reliable software that meets the needs of practitioners within the facility, configuring EHR systems that require the mandatory submission of patient allergy information before a medication order entry is made. While exceptions for urgent medication entries can be made for emergencies, a system that does not allow medications to be ordered before allergy information is cleared could help reduce many errors. In such a system, there has to be an option to access and incorporate allergy information from archives or other organizations in case of patient transfers. The records must be reconciled to the best possible degree to make sure that they are as full and detailed as possible.
To conclude, errors in medication administration are inevitable in health care because there is no perfect system that could eliminate all of them. When it comes to patient allergies, at the point of patient communication, mistakes may happen because of gaps and insufficient reporting, patients not remembering their allergies, as well as the failure to communicate any drug-drug interactions. Therefore, it is important that nurses follow a step-by-step plan of medication administration to avoid errors leading to allergies. At every step of the system, several demands must be met before the next step can be accomplished. Collaboration between nurses, their patients, pharmacists, and IT personnel is recommended to facilitate effective medication error prevention. Overall, effective and correct prescription of medication is possible when practitioners double-check information and have the fullness of data that can be taken into account before medication is ordered and administered to patients with allergies.
Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? NPR. Web.
Grissinger, M., Gaunt, M., & Shilman, A. (2019). Allergy-related medication error reports submitted to a large patient safety reporting system. Patient Safety, 1(1), 19-27.
Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. National Academy Press.
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. StatPearls Publishing.