How to prevnt Medication Administration Errors

[NurseMike9111]

I need some help. The administration at my facility is looking for ways to cut down on the amount of Med Admin errors. We're not going to computerized order entry yet and no bar coding is on the horizon so were trying to focus on the nurse directly.

One of the biggest issues we seem to have is distraction during the Med Admin process. Does anyone have any ideas on how to minimize these distractions. We have talked about signs, and orange bands and the like but im looking to my colleges for any input.

[nurs4kids]

I came here searching for this exact thread. My facility is researching "Med Admin Distractions" and we will initiate an action plan sometime this year. I found the attached file and thought you may find it useful. I too would love to hear what other facilities have done to address this issue.

Environmentworkflowstaffingpatternsmederrors.pdf

[eriksoln, BSN, RN]

You can wear a red, yellow or hot pink hypoallergenic antimicrobial vest all you want. If you truly want to cut down on med errors you need to cut down the nurse/patient ratios. THAT is the distraction. Decreasing the amount of patients a nurse is responsible for will decrease the distraction. All these annual med error classes, group hugs, bar coding, etc... are for the most part a waste of facility funds. Nurses who graduate and become licensed should understand pill passing and they should have an understanding of the 5 right gimmick. These "mandatory" classes do nothing more than rehash what nurses have already learned. It is unfortunate that hospital administrations do not do the right thing. Unfortunately, because nurses are a negative cash flow for healthcare institutions, I believe it is something that will never be adequately addressed.

Actually, better ratios are not always the answer. We all know, this is the staff nurses answer to every problem.........better ratios. And we all also know, administration would sooner give you their first born. Its just not an option to have more nurses around with the way things are right now. The midical field is dollar driven, we are a debt in their eyes.

A place I worked at though focused a lot on leaving the nurse alone period, not just at med time.......to do NURSING duties (dressing changes, D/C planning, pain management......whatever) instead of playing phone operator and fetching Pepsi for family members.

First thing they did was create a phone number for families to use when calling to ask about patients. The line went to the operator first who made sure the call was connected to the proper unit (who among us has not picked up the phone and spent 10 minutes explaining to some lady who cant hear you that "there is not pt by that name here"). Then the secretary first gave the call to the charge nurse (this unit used charge nurses with no pt. assignment, but they received report on each pt. and could answer simplistic questions....."Is my father going to be D/C'd today?" and stuff.

Thats just one example of attacking one of the distractions off that was used. It cut down on phone time for the daylight nurses significantly. Secondly, the daylight nurses were more in control and less.............PO'd at family already.......when people came to the unit and the interaction with family there was better.

They kept analyzing and minimizeing the distractions one by one. Things did improve. :pThen, they saw how much better we were doing and raised the ratios. Typical.

[MomRN0913]

Ok, seriously, we have the time to don vests so people don't interrupt? I think it is actually really ridiculous. How about a verbal "I'm passing meds now, I'll be with you when I'm done"

[Angie O'Plasty]

How about a better way to identify patients/residents on LTC units? I am temporarily doing agency nursing in these facilities and this is a huge problem--the residents very often do not have their wristbands on (they take them off, especially the dementia patients who are the ones that NEED them on the most!!!) leaving me to rely on regular staff to identify patients which makes for a very inefficient med pass and is not foolproof in itself (had somebody mix up two residents with the same first name once...resulted in one of them getting the other's pills; fortunately no harm done. Probably didn't help that these two residents were roommates.). The facilities do put pictures of the residents in the MAR book but this isn't always reliable either, if the pictures aren't updated or even if the resident has her hair done differently, doesn't have their glasses on when they did in the picture...you get the idea. Short of tattooing names on arms (which obviously wouldn't work as there are problems with that idea), what can we do to fix this?