The clinical care in the ICU has to be properly implemented, it requires from the medical staff careful planning in advance, knowing the patient’s current condition and from nurses knowing how nursing care can be provided, if the patient’s condition has lowered significantly. The patient’s condition can change fast due to many factors, metabolism changes, respiratory failure, overall condition lowers, acute bleeding or heart-related issues.
Since most of the patients that are placed in ICU due to their lowered health condition nurses need to be aware of the patient’s vitals and condition all the time until the patient can be sent to another hospital department. Because of the patients critical or lowered condition medication error can easily lower or even more of their overall condition or in the worst case be fatal.
The more medication there are the it is more likely to make a medication error. This can also apply to specialized medication when it is given without training and it is done wrong way.
Overall consequences of medication error
The possible medication error can increase the patient admission time in the hospital which will also increase more clinical work for the staff in the hospital and this will add more budget spending. Because of the long-term hospital stay for the patient, there are more clinical treatments that are required to be done and this will increase the patient chance of morbidity or even mortality. Medication errors are happening more in the ICU comparing to other hospital departments due to more complicated patients (Goldsworthy & Waters 2017).
There are medication errors about 1 per 100 admissions and the cost of the error varies from $8400 up to $8890 (Choi, Lee, Flynn, Kim, Lee, Kim, Suh 2016).
It is important to prevent these costly medication error mistakes since it can cause permanent damage to the patient leading to impairment in their work capability permanently or lead to long-term treatment.
Preventing medication errors
Preparing the medication in advance is the easiest way of preventing medication mistakes. Since when preparing medication in a hurry there is a chance of doing something wrong in the process. That is why medication syringes should be prepared in beforehand and in the acute situation, it can be taken too long time to prepare the medication (Adapa & et al 2012).
According to the World Health Organization Medication Errors 2016 findings, there are many factors that cause medications treatment errors and these mistakes can happen in any type of environment in a hospital or even at home.
What I noticed what can prevent medication errors in ICU are: The staff should have enough training and awareness in pharmaceutical products that are used in the ward, enough knowledge of patient, staff should have enough rest so that they would not make mistakes, good social work environment between staff this would set low boundaries to ask help when needed, communication between nurse and patient can be difficult if the patient can’t talk with respiratory machine or they are sedated, staff should have chance to prepare medication without any unnecessary distractions this would decrease chance of mistakes, access to information should be provided so it is possible to check information related to the disease or medication.
Gaining experience decreases chances of making mistakes in medication, but it is very important to also learn from those made mistakes. The mistake can be an important way to understand what when wrong, how this situation can be prevented and how to next time proceed correctly.
It is very important not to blindly trust all the information in the patient files, for example, there can be human error a staff member filed patient medication information wrong in the patient medical record file before sending the patient to the ward. The nurse that received the patient read the patient medical record and checked the patient medication list and the medication didn’t match at all to the patient medical record. This small mistake could have led to the acute situation due to human error.
For extended learning to happen in hospital or any work environment there has to be new situation that makes it possible for cognitive thinking, if there aren’t any new situations and the environment stays all the time in about the same level learning can’t happen and in medication errors learning situations shouldn’t be learned from mistakes since it can be very harmful or even lethal to the patient.
Adapa, R., Mani, V., Murray, L., Degnan, B., Ercole, A., Wheeler, D., et al. 2012. Errors during the preparation of drug infusions: a randomized controlled trial. BJA: The British Journal of Anaesthesia. 109(5): 729-734. http://search.ebscohost.com.ezproxy.jamk.fi:2048/login.aspx?direct=true&db=rzh&AN=104373994&site=ehost-live
Choi, I., Lee S., Flynn L., Kim C., Lee S., Kim N., Suh Dc. 2016. Incidence and treatment costs attributable to medication errors in hospitalized patients. Research in Social and Administrative Pharmacy, 3, 428-437. https://www.ncbi.nlm.nih.gov/pubmed/26361821
Goldsworthy, S., Waters, D. 2017. Medication Errors in the Intensive Care Unit (ICU): Exploring Why Mistakes Happen and Strategies for Prevention. Canadian Journal of Critical Care Nursing, 28(2): 35-36. http://search.ebscohost.com.ezproxy.jamk.fi:2048/login.aspx?direct=true&db=rzh&AN=123094897&site=ehost-live
World Health Organization. 2016. Medication Errors. http://apps.who.int/iris/bitstream/10665/252274/1/9789241511643-eng.pdf