PRINCETON, NJ – A new study reveals the clinical reasoning practices and processes used by nurses that best identify and avoid medication errors.
The interdisciplinary study, funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative and published in this month’s Qualitative Health Research, identifies nursing care practices and work environment management practices used by nurses on medical-surgical units that prevent medication errors and improve patient safety.
Those practices are:
• educating patients about the medication prescribed for them
• taking into consideration all factors related to the patient
• advocating for patients with the pharmacy
• coordinating care with physicians
• independently reconciling medications with patients’ records
• verifying medications and doses with colleagues
• coping with interruptions and distractions
• interpreting physicians’ orders
• documenting near misses
• communicating openly with physicians, pharmacists and other team members
“Nurses and patients, working together, are the best line of defense to prevent medication errors from reaching the patient,” said Linda Flynn, RN, PhD, in a statement.
Flynn, a professor and associate dean for graduate nursing education at Rutgers, was one of those who conducted the survey. “By ensuring that their patients know what medication they’re receiving, in which doses and why, nurses not only empower and inform their patients, they involve them in the healthcare process and their own care,” she continued. “When patients ask questions about changes in medication dosages or mention that they’ve never been given a particular medication before, it can raise a red flag for the nurse to double-check charts and records, and to check in with her or his physician and pharmacist colleagues.”
[See also: Study: Increased nurse staffing decreases costs.]
Flynn and her colleagues conducted interviews for the survey with 50 staff nurses from medical-surgical units at 10 hospitals that were taking part in a larger study on the impact of nurses’ care on the number of medication errors on medical-surgical units.
[See also: Studies show higher nurse staffing levels benefit patients.]
Based on their research, the researchers also identified a model of medication safety practices and processes that can help prevent system medication errors. They suggest that health provider education be overhauled to foster a team approach to care including learning the basics of errors theory and participating in clinical problem-solving exercises and encouraging nurses to use clinical reasoning beyond application of the “five rights” of medication administration.
Follow HFN associate editor Stephanie Bouchard on Twitter @SBouchardHFN.
