Improving Medication Administration Safety Assignment
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages
Improving Medication Administration Safety Assignment
Article is attached
This is an academic, professionally written exercise consisting of a minimum of 3 to 4 paragraphs in length.
article is the only reference nothing else
Each paragraph to contain of a minimum of 4 to 5 sentences.
To consist of 750 to 1000 words. (No Less no more.)
No other reference, can only use article, 0 plagiarism
Example: INTRODUCTION: First review and summarize the journal article. Describe what the article is about. Present a clear, non-biased understanding of the article’s topic. Mention the article name and source. What makes the article important? “The main topic of this journal article is ….”
MAIN BODY: Critically review the article. Analyze the evidence. Was the research presented in the article objective or bias? Describe the article’s strength and weakness. Highlight the positive or negative points. “This article presents the material (well / not well) because …
” Do not give your opinion on the article’s topic, we are not experts. Why should or should not the article be recommend reading? Was the article successful or a failure in relaying information based on the topic? “I (recommend/ don’t recommend) reading this article because…”
CONCLUSION: Conclude with what you learned from analyzing the article. What knowledge was gained from reading this article? What do the results cited in the article indicate? Do not present new or additional information in the conclusion, stay focused on the article topic at hand. “After reading and analyzing this article I learned that …. “
November-December 2017 • Vol. 26/No. 6374
Janet Tompkins McMahon, DNP, RN, ANEF, is Clinical Associate Professor of Nursing, Towson University, Towson, MD; and Nurse Educator-Integration Specialist, ATI Nursing Education.
Improving Medication Administration Safety in the
W ork interruptions create danger at the bedside, particularly during med-
ication administration. A work interruption can be as simple as a telephone call, noise, or an invita- tion to conversation by a member of the healthcare team, patient, or family member while the nurse is preparing medications. Medication errors are a major concern for patients and can lead to unneces- sary safety risks (Karavasiliadou & Athanasakis, 2014). Reduction of interruptions and associated errors with medication administration is essential.
Project Site and Reasons for Change
The identified need for change was reduction of errors and distrac- tions during medication administra- tion. The current use of a no-inter- ruption zone on a medical-surgical unit was identified by the project leader as an area for improvement based on repeated observations of nurses’ nonadherence to the zone during eight random visits. Nurses, other unit staff, and interprofession- al team members appeared unaware of or ignored the purpose of the no- interruption zone.
Some institutions have adopted use of medication safety vests for nurses to wear to alert colleagues and patients of their involvement in medication administration. Accord – ing to Williams, King, Thompson, and Champagne (2014), safety vests, posted signs, highlighted decorative aprons, and sashes have been used to reduce work interruptions. The project leader decided to incorpo- rate situation awareness (SA) with the use of a medication safety vest and
signage on the nursing unit and within patient rooms (“Do Not Disturb the Nurse during Medicat – ion Admini stration”). SA refers to a practitioner’s conscious awareness of a circumstance or situation (Stub – bings, Cha boyer, & McMurray, 2012). An educational in-service reinforced the purpose and rationale for the project.
Program The project leader, a student in a
Doctor of Nursing Practice (DNP) program, was interested in develop- ing a capstone project for continu- ous quality improvement (CQI). She requested a meeting with the chief nursing officer (CNO) and unit nurse manager to address the observed clinical problem. The CNO encouraged pursuit of this CQI opportunity. Project planning began after the project leader received approval from the facility administrator.
Clinical nurses on the unit were advised of the project 3 months before its initiation through com- munication during staff meetings. The project leader attended meet- ings the day before the launch to provide education regarding project implementation, including creation of SA, use of the medication safety
vest and signage, and completion of surveys about adherence to the no- interruption zone. According to Sitterding, Ebright, Broome, Patter – son, and Wuchner (2014), the need to understand interruptions with medication administration is neces- sary.
Disposable medication safety vests (Riskologic, LLC) were donat- ed to the project leader for use by the registered nurses (RNs) identi- fied as responsible for medication administration after the education- al session was completed. A vest labeled Do Not Disturb was used as a visual prompt to people who might approach nurses during medication administration. “Do Not Disturb the Nurse During Medication Administration” signage also was placed in medication preparation areas and all 28 patient rooms. Surveys regarding distractions, use of a medication safety vest and sig- nage, and evaluation of the project leader’s educational program were included.
MADOS Survey RNs completed a pretest/posttest
survey on types of distractions. The Medication Administration Dis trac – tion Observ ation Sheet (MADOS) identified 10 sources of distractions and interruptions (Pape, 2003).
Continuous Quality ImprovementContinuous Quality Improvement
Janet Tompkins McMahon
Work interruptions during medication administration are a serious problem negatively impacting patient safety. Using a medication safety vest and signage during medication administration improves situation awareness, reducing the potential for interruptions.
November-December 2017 • Vol. 26/No. 6 375
pleted and placed in a designated locked box on the nursing unit for the project leader’s collection. To ensure communication for the proj- ect, the anticipated time frame and overall project information were documented in minutes from the nursing unit meetings each time the project leader shared additional information. After completion of the 4-week project, the MADOS sur- vey was administered by the project leader to RNs on both 12-hour shifts. Those not present for the final meeting again were given the survey in their mailboxes with instructions to place completed sur- veys in the designated locked box located on the nursing unit.
Adherence Survey During the initial meeting about
the project, an adherence survey tool was introduced to RNs. The survey was a new tool developed by the project leader to evaluate previous adherence to use of the medication safety vest. The project leader’s DNP committee provided feedback re – garding content of the new tool before its initial use. The nurse unit had designated nursing leaders in place with resource nurses staffed on every 12-hour shift. Resource nurses (baccalaureate-prepared nurs es) were invited and encouraged to be cham- pions for the project.
Champions evaluated medication safety vest use on 12-hour shifts daily by completing The Medication Safety Vest Compliance Report. Designated cham pions collected data every 12- hour shift each day for the project as requested by the project leader during orientation to the pilot study. The report listed percentage ratings (100%-90%, 89%-80%, 79%- 70%, 69%-60%, 59% and below) cor- responding to a grade of A, B, C, D, or E, respectively. Champions assigned a letter grade to RNs admin- istering medications to patients every 12 hours for the 4-week period. Completed daily reports were placed in designated locked boxes located in the areas identified on the nursing unit during the educational in-ser- vices at the nurses’ station.
Perceptions Survey A perceptions survey was dis-
cussed and reviewed during staff meetings, and administered after
Literature Summary • Cooper, Tupper, and Holm (2016) found 63% of medication passes
(n=30) were caused by interruptions during medication administration at a 271-bed Magnet® facility, resulting in decreased efficiency.
Medication errors occur often within nursing practice compared to other types of errors (Tzeung, Yin, & Schneider, 2013).
An integrative review by Hopkinson and Jennings (2013) found various interventions can be implemented to reduce work interruptions during medication administration, noting future research would be beneficial.
Keers, Williams, Cooke, and Ashcroft (2013) found slips and lapses were common during medication administration. Other influences included written communication errors, perceived workload, and distractions and interruptions.
Williams, King, Thompson, and Champagne (2014) found safety vests, posted signs, and use of highlighted decorative aprons and sashes reduced work interruptions during medication administration.
According to Sitterding, Ebright, Broome, Patterson, and Wuchner (2014), a gap in knowledge and understanding of situation awareness exists during medication administration.
CQI Model Plan, Do, Check, and Act (PDCA) model (Russell, 2010)
Quality Indicator with Operational Definitions & Data Collection Methods • The number of medication errors on the unit was examined with data
extrapolated from the hospital medication variance reporting system. • The number of distractions was evaluated by the Medication
Administration Distraction Observation Sheet (MADOS). The MADOS identified 10 sources of distractions and interruptions (Pape, 2003). The MADOS was used pre- and post-project.
Adherence to use of the medication safety vest was documented on the Medication Safety Vest Report each day during the 4-week project period.
Effectiveness of the medication safety vest use, signage, educational ses- sions, and reference binder was evaluated after the project. A survey tool (Nurses Perceptions of the Medication Safety Vest, Signage, and Education Survey) also was used.
Clinical Setting 28-bed medical-surgical unit (average daily census 25-28 patients) in a 251- bed regional medical center
Program Objectives • Decrease number of medication errors on the designated nursing unit. • Create situation awareness to reduce distractions and medication errors
during medication administration with use of the medication safety vest and unit signage.
Examples in cluded telephone calls, interactions with patients and visi- tors, wrong dose, missing medica- tions, physicians, and external nois- es. The modified survey tool (used with permission from the publisher) identified nurses’ perceptions of the reasons and frequency of distrac- tions during the medication admin- istration. Nurses also were asked to identify the 10 most frequent dis- tractions (1=most frequent, 10=least frequent). This was ex plained to RNs
during the in-service by the project leader, and was reinforced on the MADOS form for RNs to see when following the directions. Descriptive statistics were used to examine these categorical data.
Improving Medication Administration Safety Assignment
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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