My+learner+Activity

Preventing Errors and Promoting Safety in Medication Adminstration

studying Pharmacology
Designed by Ann Marie Paraszczuk aparaszczuk@molloy.edu Image courtesy: CDC In this WebQuest, nursing students will learn about the issues in medication administration and what can be done to prevent errors and promote safety.

**Introduction**
Imagine that plans are being developed to open a new hospital. While the architects and engineers work on the blueprints for the building, teams of healthcare providers are being assembled to assist in the development of policies and procedures for the various services that will be provided. Registered nurses from different roles have been assigned to groups that will address medication administration. Since this will be a teaching hospital, nursing faculty at affiliated universities have also been included. As the work of these groups is about to commence, the main question on everyone’s mind is: How can RNs promote safety in medication administration and prevent medication errors? This is an opportunity for you to have input into the guidelines that direct your practice. Together with your group, you will have six weeks to research the issues in medication administration and develop and present a plan for safe medication practice in this institution.

The Task
As nurses, we are responsible to keep our patients safe in all aspects of the care we provide. Since nurses serve an important role in medication administration, our input is vital to the development of safe medication administration practice. As part of a nursing advisory group, you will be assigned to critically examine one aspect of this process by analyzing and evaluating information included in the resources listed. You will then work collaboratively with the others to develop a comprehensive written proposal that outlines safe medication management in the new hospital. This document should address various aspects of the process and include factors that contribute to errors, recommendations for procedures to maintain safe practice, suggestions for research to monitor progress and identification of ongoing education needed to accomplish the goals. Each group will work independently to produce its own proposal. The groups will also use Web 2.0 tools to map their plan using Webspiration and create a slide presentation on Zoho Show to report the highlights of their recommendations to the hospital’s governing board.

The Process
The issue of maintaining patient safety in medication administration will be explored from various nursing  role perspectives so that a comprehensive plan for administering medications can be developed.   Phase 1- The Research 1.  You will be divided into groups of four students. The groups will consist of one member  from each of the following nursing role perspectives; nurse manager, staff nurse, nurse  researcher and nurse educator. <span style="font-family: "Times New Roman","serif";"> <span style="font-family: "Times New Roman","serif";">2. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">Each member will be assigned to research an aspect of medication administration important to developing the final proposal. <span style="font-family: "Times New Roman","serif";"> <span style="font-family: "Times New Roman","serif";">3. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">You will utilize the resources listed or other related sites of your choosing to obtain <span style="font-family: "Times New Roman","serif";"> information that addresses the aspect assigned to your role as described: <span style="font-family: "Times New Roman","serif";"> <span style="font-family: "Times New Roman","serif";">a. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The Nurse Manager will research the problems with medication administration and identify various causes that compromise safety in this process. Issues that involve nurses at the point of care should be emphasized. <span style="font-family: "Times New Roman","serif";">b. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The Staff Nurse will access the suggested resources and describe the findings regarding best practices for safe and effective medication management. Procedures within healthcare systems as well as individual nursing actions to promote safety should be included in this information. <span style="font-family: "Times New Roman","serif";">c. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The Nurse Researcher will review current research and describe how the recommended <span style="font-family: "Times New Roman","serif";"> medication administration process will be evaluated. Both ongoing monitoring and error <span style="font-family: "Times New Roman","serif";"> analysis should be incorporated into this evaluation. <span style="font-family: "Times New Roman","serif";"> <span style="font-family: "Times New Roman","serif";"> d. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The Nurse Educator will examine the role of education for both students entering nursing <span style="font-family: "Times New Roman","serif";"> as well as practicing RNs and identify key competencies and continuing education <span style="font-family: "Times New Roman","serif";"> needed to promote safe and effective medication management. <span style="font-family: "Times New Roman","serif";">Phase 2 – The Proposal and Presentation <span style="font-family: "Times New Roman","serif";">1.<span style="font-family: "Times New Roman"; font-size-adjust: none; font-size: 7pt; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> <span style="font-family: "Times New Roman","serif";">As a team you will develop a proposal that outlines the process for medication administration that you recommend. To begin this endeavor, the group will create a visual map of proposal on the Webspiration website. Group members will add components to the map they have identified as necessary to the plan. This will serve as an outline to develop the written proposal. <span style="font-family: "Times New Roman","serif";"> <span style="font-family: "Times New Roman","serif";">2.<span style="font-family: "Times New Roman"; font-size-adjust: none; font-size: 7pt; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> <span style="font-family: "Times New Roman","serif";">This document should be formatted in APA style and have an introduction, four main sections that include the areas explored by the different team members, a conclusion and a reference page. The document should be organized as follows: <span style="font-family: "Times New Roman","serif";">a. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The first section should provide an overview of the problem with medication safety and causes of errors. <span style="font-family: "Times New Roman","serif";">b. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The second section should include a description of the process for safe and effective medication administration with rationales. <span style="font-family: "Times New Roman","serif";">c. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The third section should explain the evaluation process that will be used to monitor progress and analyze problems. <span style="font-family: "Times New Roman","serif";">d. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">The fourth section should describe how education will address medication safety within the nursing programs as well as with practicing nurses. Both the content and the strategies should be outlined. <span style="font-family: "Times New Roman","serif";">3. <span style="font-family: "Times New Roman","serif"; font-size: 7pt;"> <span style="font-family: "Times New Roman","serif";">Your group will then develop a Zoho slide show that highlights the key components of the proposal. Use images and hyperlinks to create an interesting and engaging presentation. Together you will present the slide show on the date indicated.

Resources
[|To err is Human 1999 report brief]

[|Crossing the Quality Chasm] <span style="font-family: "Times New Roman","serif";">[|Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually] <span style="font-family: "Times New Roman","serif";">[|2008 Hospital National Patient Safety Goals | Joint Commission] <span style="font-family: "Times New Roman","serif";">[|American Nurses Association - Near Misses] <span style="font-family: "Times New Roman","serif";">[] <span style="font-family: "Times New Roman","serif";">[] <span style="font-family: "Times New Roman","serif";"> [|VA National Center for Patient Safety - Root Cause Analysis] <span style="font-family: "Times New Roman","serif";">[|Institute for Safe Medication Practices] <span style="font-family: "Times New Roman","serif";"> [|AHRQ Innovations Exchange | Search Results] <span style="font-family: "Times New Roman","serif";"> [|Medication administration: does the teaching metho...[J Nurs Educ. 1998 - PubMed Result]] <span style="font-family: "Times New Roman","serif";"> [|Teaching baccalaureate nursing students to prevent...[J Nurs Educ. 2003 - PubMed Result]] <span style="font-family: "Times New Roman","serif";">There are also two print documents at the reserve desk in the library that you may want to utilize. These are: <span style="font-family: "Times New Roman","serif";">Teaching IOM: Implications of the Institute of Medicine reports for nursing education by Finkelman and Kenner. <span style="font-family: "Times New Roman","serif";">The essentials of baccalaureate education for professional nursing practice by American Association of Colleges of Nursing (AACN).

Evaluation
||  Beginning 1 ||   Developing 2 ||   Accomplished 3 ||   Exemplary 4 ||   Score  || <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Quality and organization of Information  || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Information has few details not related to the main topic and lacks organization. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Information has few details, relates to the main topic and is somewhat organized. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Information is detailed, clearly relates to the main topic and is very organized. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Information is detailed, clearly relates to the main topic and is very organized. || || <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Proposal Map || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Map is disorganized; components of the proposal are missing. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Map is somewhat organized; some components of the proposal are missing. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Map is organized; components of the proposal are included. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Map is very organized; all components of the proposal are included || || <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Written Proposal <span style="font-family: "Times New Roman","serif"; font-size: 11pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">The proposal is disorganized; information is not arranged by paragraphs and subheadings are lacking. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Proposal is organized, but paragraphs are not well-constructed; subheadings not used appropriately. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Proposal is organized with well-constructed paragraphs; some use of subheadings || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Proposal is very organized with well-constructed paragraphs and subheadings. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> || || <span style="color: #ffc000; font-family: "Calibri","sans-serif"; font-size: 11pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Presentation || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Not logically presented, fails to engage audience, no evidence of preparation and organization. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Logically presented, not very interesting or engaging, lacks evidence of preparation and organization. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Logically presented; interesting and engaging, some evidence of preparation and organization. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Logically presented; very interesting and engaging; good preparation and organization evident. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || || <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Collaborative Effort <span style="font-family: "Times New Roman","serif";"> <span style="color: #ffc000; font-family: "Calibri","sans-serif"; font-size: 11pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Team members do not interact or collaborate; one member dominates the project. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Team members rarely interact with each other; two members manage most of the project. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Team members regularly collaborate with each other; at least three members manage the project. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Team members frequently collaborate; all members manage the project and support each other. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || || <span style="font-family: "Calibri","sans-serif"; font-size: 11pt;">Mechanics <span style="font-family: "Times New Roman","serif";"> <span style="color: #ffc000; font-family: "Calibri","sans-serif"; font-size: 11pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Many grammatical, spelling, punctuation or format errors. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> Some grammatical, spelling, punctuation or format errors. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">Almost no grammatical spelling, punctuation or format errors. || <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;">No grammatical, spelling, punctuation or format errors. <span style="font-family: "Times New Roman","serif"; font-size: 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 10pt;"> || || <span style="font-family: "Times New Roman","serif";">The group project will be graded using this rubric. There will be one grade assigned to each group; this grade will be entered for all the students in that group.

Conclusion
Medication safety is a multidimensional issue that requires a comprehensive and systematic approach to address the various aspects. Through your participation in this project, you worked with others, as you would in a real-life situation, and used available information to develop a unique plan of action to maintain medication safety. Your contribution to this issue is and will continue to be important as you move from student to RN. Continue to update your knowledge of common problems that undermine medication safety and strategies to address these issues to increase you own awareness. Incorporate safety measures into your own practice and share what you learned with other heath care professionals so that the goal of maintaining safe medication practice can be realized. .