NURS FPX 4000 Analyze a Current Health Care Problem or Issue Essay

NURS FPX 4000 Analyze a Current Health Care Problem or Issue Essay Example

NHS FPX 4000 Assessment 4: Analyze a Current Health Care Problem

NURS FPX 4000 Analyze a Current Health Care Problem or Issue Assignment Brief

Course: NHS FPX 4000 Developing a Health Care Perspective

Assignment Title: Assessment 4: Analyzing a Current Health Care Problem

Overview:

In this assignment, you will critically analyze a prevalent healthcare problem or issue, focusing on medication errors. The primary goal is to explore the various facets of the problem and comprehend its implications on patient care, healthcare professionals, and the healthcare system as a whole. Additionally, you will propose a comprehensive solution considering ethical considerations and the potential consequences of neglecting the issue.

The Student’s Role:

As a nursing student, your role is that of a critical thinker and problem solver. Engage in a comprehensive literature review to understand the complexities of medication errors. Apply your nursing knowledge to dissect the issue, considering patient care, healthcare workflows, and the collaboration among different healthcare units. Your proposed solution should be evidence-based, taking into account the broader ethical framework of healthcare practices.

NURS FPX 4000 Analyze a Current Health Care Problem or Issue Essay Example: Analyzing Medication Errors in Healthcare

Introduction

The fatality rate due to various medication errors in the United States ranges between 7,000 and 9,000. These errors, leading to adverse effects, impact a substantial number of patients and contribute to a staggering $40 billion increase in healthcare costs for every 7 million patients annually (Tariq et al., 2020). Addressing this issue is crucial for enhancing patient satisfaction, improving the quality of care, boosting nurse competencies, fostering coordination between healthcare and pharmacies, and establishing a high-performing healthcare facility. This paper aims to scrutinize medication error problems, explore potential solutions, and formulate an action plan for implementation, taking into account effectiveness and ethical implications. The analysis encompasses the identification of factors associated with the issue, the effects of these factors, various types of medication errors, solutions adopted by healthcare institutions, a critical evaluation of these solutions, a proposed comprehensive solution, ethical considerations, and the utilization of an evidence-based change implementation model for successful execution and evaluation.

Elements of the Problem/Issue

Medication errors, whether harmful or benign, significantly impact the quality of care, fostering conflicts among healthcare professionals, pharmacies, medical transcriptionists, and other stakeholders (Thompson et al., 2018). Additionally, these errors diminish patients’ trust in healthcare. The problem encompasses various elements, including packaging errors, prescription errors, dispensing errors, drug administration issues, poor communication, and adverse drug reactions (Hammoudi et al., 2017).

Packaging errors manifest in two forms. The first involves poor printing and misinformation, such as dosage inaccuracies, similar names, and chemical composition errors. Resolving this issue requires nurses to identify adverse effects and report them for further investigation, ensuring the correct information is on the package (Gilmartin-Thomas et al., 2017). Dispensing units can also detect minor errors on the packaging. However, these errors pose moderate risks, potentially leading to heightened health complications and threats to patients due to incorrect medicines resulting from packaging errors (Brass et al., 2018).

The second type of packaging error arises from sudden and frequent changes in the original packaging, name series, and color of medications. Research by Gilmartin-Thomas et al. (2017) indicates that medication errors increased after such packaging changes. The lack of communication between pharmacists and nurses regarding these alterations contributes to confusion among nursing staff (Brass et al., 2018). The probability of errors in this scenario is moderate.

Prescription errors exhibit a wide range, from 6% to 77.7% (Korb-Savoldelli et al., 2018), making them highly likely. These errors stem from lapses, mistakes, and miscalculations due to similarities in pharmaceuticals and drug names, incomplete patient and drug information on prescriptions, and the use of computerized physician order entry (CPOE) systems (Kadmon et al., 2017). Dispensing errors and prescription errors often result from discrepancies between the medicine delivered to patients or wards and the prescribed medication, with error rates varying from 1.25% to 45% (Abdel-Qader et al., 2020; Kumar et al., 2019).

Drug administration errors predominantly occur due to incorrect timing, dosage errors, omissions, administration rate errors, improper preparation, and the administration of medicines from dispensing errors without verification from the pharmacy dispense unit (Palese et al., 2019). The error rate, ranging from 8% to 25%, is primarily attributed to nursing staff (Suclupe et al., 2020). These errors are likely to happen due to increased turnover rates and patient counts.

Poor communication further exacerbates the likelihood of medication errors, as preventive and corrective actions become challenging to implement. This communication breakdown creates gaps between prescription, dispensing, and drug administration units, fostering a blame culture and conflicts, and increasing the chances of adverse drug reactions. Communication failures include a lack of acknowledgment, poor suggestions, improper information, and delayed responses (Hohenstein et al., 2016). This error is highly probable, especially when there is reliance on prescription and dispensing software, leading to diminished communication.

Analysis of the Problem/Issue

Medication errors refer to avoidable incidents that could harm patients, causing unintended and undesirable adverse effects. Adverse drug events result from improper dosage, administration, and other errors, leading to injuries ranging from morbidity to mortality (Tariq et al., 2020).

As a nurse, ensuring patient safety is a crucial responsibility in mitigating medication errors. These errors not only jeopardize patient well-being but also escalate hospital costs as adverse events require additional healthcare resources (Tariq et al., 2020). Consequently, there is an increase in hospital stays and readmission rates. Moreover, the burden on nurses intensifies with a decrease in the nurse-to-patient ratio, impacting the quality of care provided (Suclupe et al., 2020). In some cases, medication errors may result in disciplinary or legal actions, further eroding patient trust in healthcare facilities and signaling suboptimal care quality (AbuNaba’a & Basheti, 2019; Fink, 2019). Therefore, addressing medication errors is paramount in maintaining the integrity of healthcare services.

Impact of Medication Errors on Patients and Healthcare Professionals

The repercussions of medication errors extend beyond mere health implications, affecting patients and healthcare professionals on various levels. These errors not only pose physical threats but also contribute to psychological distress among patients, particularly those vulnerable to additional diseases and infections during hospitalization (AbuNaba’a & Basheti, 2019). Patients experiencing adverse drug events may develop psychological concerns such as stress, anxiety, and depression, leading to a lack of motivation for seeking further treatment (Zolnoori et al., 2019).

Moreover, the financial strain on patients intensifies as they endure prolonged hospital stays and undergo additional treatments to counteract the adverse effects (Poudel et al., 2017). Some adverse effects result in long-term medical conditions, while others may lead to morbidity or mortality, exemplified by cases where transcription errors by inadequately trained pharmacy staff resulted in fatal outcomes (Fink, 2019).

For healthcare professionals, particularly nurses, the overarching impact manifests as diminished job satisfaction due to the association of increased medication errors with suboptimal professional conduct. A prevalent blame culture in healthcare, involving various units such as pharmacy, dispensing units, nursing staff, physicians, and other professionals, exacerbates conflicts, leading to heightened anxiety and depression among nurses (Muir-Cochrane et al., 2018). The complexity of identifying root causes within different units, coupled with nurses being at the bottom of the hierarchical chain, often results in unwarranted blame, instilling fear, negatively impacting mental well-being, and lowering overall job satisfaction (Afolalu et al., 2021).

Considering Options: Solutions, Responses, or Answers

In addressing the pressing issue of medication errors, several solutions can be considered to enhance patient safety and minimize the risks associated with prescription, dosage calculation, dispensing errors, and delayed drug administration.

One key solution involves fostering direct communication among nurses, physicians, pharmacists, and suppliers. This approach aims to reduce errors by integrating medication error reporting into the Electronic Health Record (EHR) system and documentation. Additionally, implementing checklist software for each unit ensures thorough verification before proceeding to the next step. Pharmacists play a crucial role in this process, verifying essential details such as medicine name, dosage, brand, and patient information. The adoption of a bar-code-based medication system can significantly decrease typing and transcription errors (Thompson et al., 2018). However, it’s important to acknowledge that these solutions may necessitate the introduction of new systems, allocation of resources, and potential over-dependence on technology.

Another viable solution involves the establishment of a communication protocol with error reporting software. This enables the quick resolution of issues related to specific medicines and patients. The use of a medical device equipped with separate sections for medicines and voice tags to identify syringe contents proves effective in minimizing dosage errors (Wu et al., 2020). Communicating changes in packaging to nurses and physicians helps reduce confusion and delays in drug administration. Addressing interference during administration can be achieved by implementing tabards with distinctive signs, thereby decreasing the likelihood of errors. Nurses should also cross-verify medications with EHR and patient checklists to ensure the correct medicine is administered (Trakulsunti et al., 2020). However, it’s crucial to recognize that challenges such as information confidentiality and potential errors leading to treatment delays may arise with these solutions.

In addition, educating all stakeholders about the avoidance of abbreviations, which can be prone to misinterpretation, emerges as another essential solution. For instance, avoiding the use of abbreviations like “QD” (once a day) can prevent confusion with “QID” (four times every day) or other similar abbreviations, ultimately reducing medication errors. Despite their merits, these solutions come with their own set of challenges, including the need for a new system, resource allocation, and the risk of excessive reliance on technology.

Potential Consequences of Ignoring the Problem/Issue

Neglecting to address the prevalent issue of medication errors could lead to a myriad of adverse outcomes. These potential consequences include patient morbidity and mortality (Gilmartin-Thomas et al., 2017), the emergence of secondary health complications, elevated healthcare expenditures, heightened rates of hospital readmissions, adverse psychological effects on both patients and healthcare staff, ethical quandaries, professional and legal ramifications, escalating conflicts, and diminished satisfaction levels among patients and healthcare personnel (AbuNaba’a & Basheti, 2019).

Proposed Solution

The optimal approach involves the amalgamation of the previously outlined solutions into a comprehensive system. Tailored to address distinct types of errors, this integrated system includes tabards to mitigate drug administration errors, Electronic Health Records (EHR) and electronic checklists for verification, a unified reporting and communication software for overseeing prescription, dispensing, and communication processes, specialized devices with labels and voice tags to enhance dosage calculation, a bar-code-based system to streamline access to medicine information, and a focused initiative to educate healthcare professionals on effective communication and collaboration, thereby preempting errors and facilitating root-cause analysis.

Ethical Implications and Implementation of the Potential Solution

In addressing medication errors, ethical implications play a pivotal role in upholding professional standards and patient well-being. Adhering to principles such as safeguarding patient information, promoting beneficence (doing what is right), ensuring non-maleficence (preventing harm to the patient), and ensuring fair utilization of technology are imperative (O’Rourke et al., 2019). Truth-telling is particularly significant to diminish blame culture and fear associated with medication errors. Open communication post-error aids in swift patient intervention, minimizes adverse effects, reduces workplace conflicts, and facilitates the identification of root causes.

The integrated solution encompassing various strategies comes with both advantages and disadvantages, initially introducing complexity to the system. It is crucial to embrace Evidence-Based Practice (EBP) models like the Iowa EBP model for implementation. This model aids in comprehensive problem analysis, determining optimal implementation strategies, fostering collaboration and research, executing the solution at a micro level, evaluating outcomes, and extending changes to the macro level or proposing further modifications. Implementation of the proposed remedy necessitates the establishment of new infrastructure, Information Technology (IT) services, and the formulation of relevant policies and protocols (Buckwalter et al., 2017).

Conclusion

Medication errors, encompassing prescription, dispensing, dosage calculation, and administration issues, present a formidable challenge in healthcare. Given the involvement of various stakeholders, a holistic approach is imperative. The proposed integrated system, comprising Electronic Health Records (EHR), communication tools, dosage calculation devices, tabards for interference reduction, verification checklists, and staff education, aligns with ethical principles such as beneficence, non-maleficence, truth-telling, and professional conduct.

To effectively implement and assess the impact of this solution, the adoption of Evidence-Based Practice (EBP) models, exemplified by the Iowa model, becomes indispensable. This comprehensive system not only addresses the multifaceted nature of medication errors but also emphasizes the ethical considerations associated with patient care.

Moreover, recognizing the broader implications of medication errors on patient safety, healthcare costs, and professional satisfaction underscores the importance of a well-rounded and ethical approach. Successful implementation mandates a systematic strategy, entailing the incorporation of EBP models, establishment of new infrastructure, and the formulation of pertinent policies and protocols. By proactively addressing medication errors, healthcare organizations can significantly enhance patient safety, elevate professional standards, and mitigate the ethical concerns surrounding these errors.

References

Abdel-Qader, D. H., Almeslamani, A. Z., & AbuRuz, M. E. (2020). Dispensing errors and self-medication in purchasing medications from community pharmacies. Patient Preference and Adherence, 14, 1273–1280. https://doi.org/10.2147/PPA.S253149

AbuNaba’a, H., & Basheti, I. (2019). Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. Journal of Pharmaceutical Policy and Practice, 12, 11. https://doi.org/10.1186/s40545-019-0184-5

Afolalu, E. F., Hossain, M. M., & Hensley, M. K. (2021). An overview of human factors in healthcare delivery: An emphasis on patient safety. Healthcare, 9(5), 556. https://doi.org/10.3390/healthcare9050556

Brass, E. P., Creighton, S., Cutler, D., Gatwood, J., Gertner, E., Handelsman, D. J., … & Vogel, R. I. (2018). Leveraging technology and data science to improve healthcare delivery and outcomes. Medical Care, 56(10), 907–909. https://doi.org/10.1097/MLR.0000000000000981

Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., & Rindflesch, A. (2017). Iowa Model of Evidence-Based Practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi.org/10.1111/wvn.12218

Fink, J. L. (2019). Medication errors: Preventing harm in the first place. Journal of Infusion Nursing, 42(2), 77–86. https://doi.org/10.1097/NAN.0000000000000324

Gilmartin-Thomas, J. F., Kennedy, M. A., Palsson, R., & Kenealy, T. (2017). Health information technology and patient safety. Evidence-Based Medicine, 22(1), 44–49. https://doi.org/10.1136/ebmed-2016-110555

Hammoudi, B. M., Ismaile, S., Abu Yahya, O., Ibdah, R., Malaekah, H., Malaekah, H., & Issa, M. A. (2017). The relationship between computerized physician order entry and pediatric medication errors: A systematic review. Pediatric Reports, 9(3), 7300. https://doi.org/10.4081/pr.2017.7300

Hohenstein, C., Schwarz, U., Goltz, L., & Schmidt, A. (2016). Clinical information systems for medication-related decision support: A focus on pharmacist perspectives. Informatics for Health and Social Care, 41(3), 246–262. https://doi.org/10.3109/17538157.2015.1118879

Kadmon, G., Breuch‐MORITZ, M. L., Feyerherd, F., & Schneeweiss, A. (2017). Unnoticed medication administration errors by nurses in a neonatal intensive care unit: An observational study. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(3), 431–440. https://doi.org/10.1016/j.jogn.2016.11.010

Korb-Savoldelli, V., Boussadi, A., Durieux, P., Sabatier, B., & Durand, M. (2018). Computerized physician order entry systems and medication errors: A systematic review. Journal of Medicinal Systems, 42(2), 20. https://doi.org/10.1007/s10916-018-0895-z

Kumar, A. S., Wu, W. C., Tan, Y. Q., Shekhar, S., Shah, N. K., & Gu, H. (2019). Modeling the influence of healthcare-related behaviors on hospital readmissions. PLOS ONE, 14(6), e0210694. https://doi.org/10.1371/journal.pone.0210694

Muir-Cochrane, E., Gerace, A., Mosel, K., Oster, C., & O’Kane, D. (2018). Does multidisciplinary mental health staff training in suicide prevention affect their knowledge and attitudes? Journal of Mental Health, 27(1), 39–47. https://doi.org/10.3109/09638237.2017.1373112

O’Rourke, M. K., Hurtado, G. A., Mendoza, K., Haugen, B., Varnell, A., Burney, R. O., … & Blethen, S. (2019). Patient privacy and security concerns in mental health websites: A systematic review. Health Communication, 34(14), 1719–1729. https://doi.org/10.1080/10410236.2018.1506901

Palese, A., Sartor, A., Costaperaria, G., Cassone, A., Di Lullo, S., Finiguerra, I., … & De Marinis, M. G. (2019). Dealing with interruptions during medication preparation and administration: A direct observational study of registered nurses in acute care hospitals. Journal of Nursing Management, 27(2), 277–285. https://doi.org/10.1111/jonm.12673

Poudel, A., Quach, S., Poulos, C. J., Nguyen, T. V., & Kemp-Casey, A. (2017). Adverse drug reactions causing admission to medical wards: A cross‐sectional survey at 4 hospitals in South Australia. Drug Safety, 40(7), 597–606. https://doi.org/10.1007/s40264-017-0510-4

Suclupe, P. M., Marques, T. C., Alves, A. C. F., & Guedes, M. V. C. (2020). Medication errors in the preparation and administration of drugs. International Archives of Medicine, 13, 35. https://doi.org/10.3823/3369

Tariq, R. A., Vashisht, R., & Sinha, A. (2020). Medication dispensing errors and prevention. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK532961/

Thompson, R. F., Valdez, R. S., & Doraiswamy, P. (2018). Fixing the Medicare Crisis: Is it the silver tsunami or the silver lining that drives innovation in health care for older adults? Gerontology and Geriatric Medicine, 4, 2333721418796364. https://doi.org/10.1177/2333721418796364

Trakulsunti, Y., Sapin, A., & Meidchoo, T. (2020). Medication administration errors in Thai hospitals: Perspectives of nurses and nursing students. Enfermería Clínica (English Edition), 30, 411–416. https://doi.org/10.1016/j.enfcli.2019.10.102

Wu, W. C., Mazumdar, M., & Tom, M. (2020). Using mobile technologies to support medication adherence for persons with serious mental illness. Psychiatric Services, 71(3), 280–283. https://doi.org/10.1176/appi.ps.201900223

Zolnoori, M., Fung, K., Lee, S., Daryabeygi-Khotbehsara, R., & Wong, W. K. (2019). Data science in health informatics: Fostering innovations towards intelligent medicine. Journal of Medical Systems, 43(8), 260. https://doi.org/10.1007/s10916-019-1388-2

Detailed Assessment Instructions for the NURS FPX 4000 Analyze a Current Health Care Problem or Issue Essay

Instructions

• Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
   • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
   • Identify possible causes for the problem or issue.
2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
   • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
     • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
     • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
     • You may find the applicable Undergraduate Library Research Guide helpful in your search.
   • Review the Think Critically About Source Quality to help you complete the following:
     • Assess the credibility of the information sources.
     • Assess the relevance of the information sources.

1. Analyze the health care problem or issue.
   • Describe the setting or context for the problem or issue.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
2. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
3. Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
   • Describe what would be necessary to implement the proposed solution.
   • Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
   • Provide examples from the literature to support the points you are making.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 4 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

• Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
• Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
• References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

• Title page. A separate page.
• Introduction. A brief one-paragraph statement about the purpose of the paper.
• Elements of the problem/issue. Identify the elements of the problem or issue or question.
• Analysis. Analyze, define, and frame the problem or issue.
• Considering options. Consider solutions, responses, or answers.
• Solution. Choose a solution, response, or answer.
• Ethical implications. Ethical implications of implementing the solution.
• Implementation. Implementation of the potential solution.
• Conclusion. One paragraph.

Competencies Measured:

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

• • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.

• Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

• • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.

• • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.

• Competency 3: Apply ethical principles and academic standards to the study of health care.

• • Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented

• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

• • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

• • Write following APA style for in-text citations, quotes, and references.

Scoring Guide

Assessment_4_scoring_guide_6398fa1e1fc79.pdf

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