At Hampton VA Medical Center, Community Living Center (CLC), there is a high risk of medication error during drug administration to dementia patients due to many interruptions by nurses. Prescribing and managing drugs for dementia patients is necessary to control the symptoms but quite complicated, as it requires attention to many details (Lim & Sharmeen, 2018).
In the CLC, the nurse needed to administer several medications for each patient but was interrupted throughout this complex process. At the time of observation, it was noted that interruptions during medication occurred two or three times daily. Following the Centers for Medicare & Medicaid Services (CMS, 2017), providers must ensure the safe and effective use of drugs. CMS (2017) also describes consequences or events related to medication as a severe problem. CMS’s (2017) evidence-based policy requires healthcare facilities to take the necessary measures to minimize adverse events. Therefore, the current situation does not comply with the adopted pharmacological services policies and procedures.
Modern research also recognizes interruptions as a widespread and dangerous problem. Spinewine et al. (2021) note that interruptions can occur up to 14 times per hour. A study by Wang et al. (2021) describes an even higher rate of interruptions – up to 23 per hour and notes that 90% of them lead to negative consequences. At the same time, the problem is widely explored to find solutions (Panduwal & Bilaut, 2020). For example, the collection of nurses’ testimonies showed that some policies and procedures, such as barcodes, checklists, quiet zones, and nurse vests, can be used for effective drug administration (Alteren et al., 2021).
Other studies have also tested the effectiveness of various procedures experimentally to ensure they affect interruptions (Huckels-Baumgart et al., 2021; Kavanagh & Donnelly, 2020). Thus, reducing the risk of medication errors is essential for the patient’s health.
References
Alteren, J., Hermstad, M., Nerdal, L., & Jordan, S. (2021). Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals,-a qualtiative interview study.BMC Health Services Research, 21(1), 1-10. Web.
Centers for Medicare & Medicaid Services. (2017). State operations manual appendix PP – guidance to surveyors for long term care facilities. U.S. Department of Health & Human Services. Web.
Huckels-Baumgart, S., Baumgart, A., Buschmann, U., SchĂĽpfer, G., & Manser, T. (2021). Separate medication preparation rooms reduce interruptions and medication errors in the hospital setting: A prospective observational study.Journal of Patient Safety, 17(3), 161-168. Web.
Kavanagh, A., & Donnelly, J. (2020). A Lean approach to improve medication administration safety by reducing distractions and interruptions.Journal of Nursing Care Quality, 35(4), 58-62. Web.
Lim, R. H., & Sharmeen, T. (2018). Medicines management issues in dementia and coping strategies used by people living with dementia and family carers: A systematic review.International Journal of Geriatric Psychiatry, 33(12), 1562–1581. Web.
Panduwal, C. A., & Bilaut, E. C. (2020). The effectiveness of interventions to reduce the nurses’ distractions during medication administration: A systematic review.Jurnal Ners, 14(3), 132–140. Web.
Spinewine, A., Evrard, P., & Hughes, C. (2021). Interventions to optimize medication use in nursing homes: A narrative review.European Geriatric Medicine, 12(3), 551-567. Web.
Wang, W., Jin, L., Zhao, X., Li, Z., & Han, W. (2021). Current status and influencing factors of nursing interruption events.The American Journal of Managed Care, 27(6), 188-194. Web.