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The Eighth Leading Cause of Death in the U.S. is...

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by Anxious Patient Anxious Patient (Member) Member

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You are reading page 5 of The Eighth Leading Cause of Death in the U.S. is.... If you want to start from the beginning Go to First Page.

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They work cheap.

So do LPNs... ;)

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lamazeteacher specializes in OB, HH, ADMIN, IC, ED, QI.

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Any medication error usually occurs as a chain event. MAR incorrect, correct med not in Pyxis, wrong med in the wrong drawer, IV mixed with the wrong medication, unclear orders, hectic floor with multiple patients requiring complex medication passes. Nurses cannot accept blame for all errors. However, as we are the end of the chain, we are the last check on the route. I am VERY careful about IV bags mixed by the pharmacy. I never trust that what they say is in the bag is what is really in there. Also, I NEVER give a medication drawn up by another nurse.

What do you do, to make sure the ordered medication is in the IV bag, when it's labelled as such? :nurse:

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BradleyRN is a BSN, RN and specializes in Med Surg, LTC, Home Health.

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I can count on 0 hands how many med erros I've made in a little over a year. How about you?

I have made zero errors in ten years, but i have almost made at least two, both while people were talking to me while i was passing meds. I learned from those near-errors though. I guess i have been lucky. I cant say that i am better than someone that made a few errors though, because people make mistakes.

I also cant say that back when i was a CNA, if someone said "how would you like to pass meds instead of doing your normal duties", that i would have said no. Im sure i would have jumped right on board, and like you would have defended my abilities once i was comfortable with them. I have said in the past that i dont fault CNA's for choosing this path since it exists, but my opinion remains that it should not, and all nurses should share this view if they wish to protect the skills that they went through so much to obtain. Patient safety is the #1 reason, our jobs are #2.:)

.

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Jolie is a BSN and specializes in Maternal - Child Health.

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BON's make profit? Who knew... ;)

They are influenced by plenty of profit-making entities: Hospitals, nursing homes and ALFs, to name a few.

They are also influenced by not-for-profits that are pressured to keep their expenses at a minimum in order to keep their doors open, and utilize unskilled and cheap labor to do so, such as hospitals, nursing homes, clinics and schools.

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2,098 Posts; 16,162 Profile Views

They are influenced by plenty of profit-making entities: Hospitals, nursing homes and ALFs, to name a few.

They are also influenced by not-for-profits that are pressured to keep their expenses at a minimum in order to keep their doors open, and utilize unskilled and cheap labor to do so, such as hospitals, nursing homes, clinics and schools.

I can agree with that I guess Jolie.

But, to say we all work cheap. If I work on the floor (not currently working as a med aide) I make a dollar less than what we pay LPNs. I've worked in this facility less than 2 years. Not that cheap IMHO.

Of course, med aide is only but a stepping stone and not the final destination.

Maybe we should leave it be before the topic police get us...

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Jolie is a BSN and specializes in Maternal - Child Health.

6,373 Posts; 34,752 Profile Views

But, to say we all work cheap. If I work on the floor (not currently working as a med aide) I make a dollar less than what we pay LPNs. I've worked in this facility less than 2 years. Not that cheap IMHO.

That measley dollar an hour difference is significant to your employer, otherwise they would simply pay the dollar and hire licensed staff for this duty.

we should leave it be before the topic police get us...

Nah, I'll behave today :)

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herring_RN specializes in Critical care, tele, Medical-Surgical.

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They don't always lose their license AND can get it back. Not offense to addicts but once an addict always an addict. An addict will always present a high danger.

Whether or not there is a med aide the nurse would still pick this up. Nurses, at least here have to check in meds and have to do the QA checks on the charts and order the meds and do the POS. By the time the med aide passes a med there should be no error. If there is it went through to Dr., pharmacist and nurse. Can't blame the med aide for that.

In a LTC facility when the nurse has like 30 or more patients each getting 10-14 pills plus treatments plus vents plus g-tubes plus whatever else they have you can't tell me they are assessing each and every patient.

The usual scenario is the nurse is crazy busy and it's the CNAs that are reporting changes in the patient to the nurse. THEN the nurse assesses. As the med aide IS a cna this doesn't change the formula at all.

See above...

The main arguments used against med aides are usually baseless. In assisted livings patients are supposed to be able to self medicate. If 80 or 90 year old granny can self medicate a med aide can assist her.

In a nursing home, especially the usual large understaffed ones, all the interventions you mention only happen after then CNA tells the nurse of the change in status or the nurse happens to walk in on it.

No nurse with 30+ patients gives the meds and sticks around. They give the meds and bounce on their way.

As for that... Many prepour, prechart and then fly down the hall. MANY... All the behaviors people here accuse med aides of being culpable happen just as often with nurses.

There has yet to be a legitimate argument against med aides and "I don't like them!" isn't a legitimate argument except when dealing with 3 year olds.

Where's the research or studies to back up these frivolous claims?

This is a good reason to mandate staffing ratios in skilled nursing facilities.30 plus patients with vents and G tubes is simply unsafe.

And it's been allowed to go on too long.

Time for all caring people to start the organizing to STOP unsafe staffing.

The acuity of many patients on skilled nursing facilities now used to be med/surg not too many years ago.

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2,098 Posts; 16,162 Profile Views

This is a good reason to mandate staffing ratios in skilled nursing facilities.30 plus patients with vents and G tubes is simply unsafe.

And it's been allowed to go on too long.

Time for all caring people to start the organizing to STOP unsafe staffing.

The acuity of many patients on skilled nursing facilities now used to be med/surg not too many years ago.

I second that!

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Maybe medication administration in institutions should be taken over by pharmacists or pharm techs. There have been many other duties of the nurse which have been permanently relegated to others: respiratory, physical, occupational therapists, cna's etc...

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meluhn has 16 years experience and specializes in acute rehab, med surg, LTC, peds, home c.

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Maybe medication administration in institutions should be taken over by pharmacists or pharm techs. There have been many other duties of the nurse which have been permanently relegated to others: respiratory, physical, occupational therapists, cna's etc...

I think its more like the other way around. Many positions have been eliminated and nurses have been cross trained to do these things. Blood draws, for example, used to always be done by phlebotomists until the hospitals figured they could save a buck by making nurses draw blood. Hospitals used to have IV teams that would come and start your IVs. Now, if a person is a hard stick and you cant get a line in them, you waste alot of precious time trying. I dont know about anywhere else but in my hosp the nurses do the mini nebs that resp used to do.

They are never going to pay a pharmacists hourly wage to pass meds.

For some reason they haven't caught on to the fact that it is cheaper to pay cnas to do basic pt care and free up the nurses to do the assessments and critical thinking part of the job.

I guess this is what happens when people who are not nurses are making the rules. Nurses are probably the most numerous employee that the hospital has, wouldn't it make sense to have someone who knows what they do calling the shots so that labor is divided up in the most cost efficient way?

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3 Posts; 606 Profile Views

[color=#d16349]stats

—over 770,000 patients are injured because of medication errors every year.

[color=#d16349]—medication errors account for at least 7,000 deaths in the united states each year.

[color=#d16349]—medication errors occur in nearly 1 of every 5 doses given to patients in the typical hospital

[color=#d16349]—reported rates of adverse drug events (ades) range from 2.4 to 6.1 ades per 100 admissions or discharges, or 9.1 to 19 ades per 1000 patient days.

(4-12)

[color=#d16349]—it is estimated that the annual national costs of preventable adverse drug events is $2 billion.

[color=#d16349]—56% of medication errors are associated with iv medications.

[color=#d16349]—61% of the serious and life-threatening errors are associated with iv medications.

percentages of med errors at different phases of medication the administration process.

[color=#d16349]--physician ordering: 39-49%

[color=#d16349]--nursing administration: 26-38%

[color=#d16349]--transcription: 11-12%

[color=#d16349]--pharmacy dispensing: 11-14%

Edited by Phil136
Some more Stats

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ImMrBill3, RN has 2 years experience and specializes in ICU, Home Health Care, End of Life, LTC.

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[color=#d16349]stats

—over 770,000 patients are injured because of medication errors every year.

[color=#d16349]—medication errors account for at least 7,000 deaths in the united states each year.

[color=#d16349]—medication errors occur in nearly 1 of every 5 doses given to patients in the typical hospital

[color=#d16349]—reported rates of adverse drug events (ades) range from 2.4 to 6.1 ades per 100 admissions or discharges, or 9.1 to 19 ades per 1000 patient days.

(4-12)

[color=#d16349]—it is estimated that the annual national costs of preventable adverse drug events is $2 billion.

[color=#d16349]—56% of medication errors are associated with iv medications.

[color=#d16349]—61% of the serious and life-threatening errors are associated with iv medications.

percentages of med errors at different phases of medication the administration process.

[color=#d16349]—physician ordering: 39-49%

[color=#d16349]—nursing administration: 26-38%

[color=#d16349]—transcription: 11-12%

[color=#d16349]—pharmacy dispensing: 11-14%

thanks for the stats phil but where did you get them? as a bsn student i am used to checking the source and actually reading the original study critically. those stats list "nursing administration" what is the operational definition of that for the source preparing the statistic, does it include med aides, does it refer to all medications administered where a nurse is present? to my knowledge the rn is responsible for the medication administration if it is actually carried out by an lpn/lvn or med aide, what about in assisted living is self medication by patients considered "nursing administration". this set of statistics does not have any category indicating patient administration, i am sure some percentage of medication errors are due to patients. this is an example of the type of critical thinking rns an bsns are taught to engage in. this level of consideration and analysis is important when administering medications. another important peice of information not revealed by those statistics is how many prescribing errors or dispensing errors did not result in a medication error because a nurse caught them.

when i give a med i am expected to know quite a bit more than indications and adverse reactions. particularly, the other drugs with which it might react, what the contraindications are, what the normal dose is and what the side effects are. but most importantly i have been taught the physiology and pharmacology behind how the drug works in the body and the developmental, pathological and other factors that affect that.

the original article cited has blatant errors that have already been pointed out. several other posters have indicated upon examination that medication errors in some studies include when the medication is in the consumers possession and control.

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