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Decreasing Medication Administration Errors: Bedside Nursing Involvement is the Key
e26 Decreasing Medication Administration Errors: Bedside Nursing Involvement is the Key Kimberly Peterson MSN, APRN-PCNS-BC, CPN Children's Hospital and Medical Center, Omaha, NE
Objectives: • Describe the process used to improve medication administration error rates. • Recognize the beside nurses role in decreasing medication errors. Target Audience: RNs, advanced practice nurses. Background/Problem: One of the hospital safety initiatives was to decrease the rate of medication errors that reached the patient. A multidisciplinary task force was formed to review trends in medication errors and make recommendations for process improvement. Medications errors were divided by the medication delivery steps of prescribing, transcribing, dispensing, and administration. Because most medications are administered by nurses, a nursing subgroup consisting primarily of bedside nurses was developed in April 2009 to review administrationrelated errors. Purpose: The purpose of this medication administration error subgroup was to review administration errors, identify trends, identify potential process or practice contributing factors, and make recommendations for change. The overall objective was to decrease the medication administration error rate by 50%. Methods: In the third quarter of 2009, the medication administration subgroup began receiving a detailed medication administration error report and met quarterly to review the report. During the meetings, members openly identified issues, discussed possible solutions, and made recommendations for immediate actions to prevent further like errors. Both nursing practice changes and recommendations to the task force were made. Outcomes: The hospital-wide medication administration error rate decreased from 4.3 per 10,000 doses dispensed in the third quarter of 2009 to 1.3 per 10,000 doses dispensed in the first quarter of 2010. Implications: The bedside staff nurses' involvement, teamed with appropriate support staff, created a successful process that resulted in improved outcomes. doi:10.1016/j.pedn.2011.01.278 Improving the Discharge Planning Process: Communicating Discharge Needs as Part of Daily Nursing Practice Frahnie Pierre RN, BSN, CPN The Children's Hospital of Philadelphia, Philadelphia, PA
Objectives: • Identify common issues affecting discharge planning for nurses. • Explain how a nursing-facilitated discharge planning process was used on a pediatric medical unit. • Review feedback data and audits based on the initiated discharge planning process. • Identify efforts to help improve this discharge planning process. • Review the plan to help achieve more interdisciplinary involvement in the discharge planning process.
Abstract Purpose: The purpose of this study is to evaluate the effectiveness of a nursing-facilitated discharge planning process within a pediatric medical–surgical unit. Background/Significance: Nurses deal with discharge planning among many other competing priorities in an acute inpatient environment. Research has shown that there is a disconnect between what is observed and what is documented in these discharge planning efforts. The lack of integration between these efforts poses a challenge to the timeliness and quality of a patient's discharge. Methods/Design: A nursing-facilitated discharge planning process was initiated on a 24-bed pediatric hospital unit. On admission, patient-specific discharge needs and goals were identified and addressed. The “discharge criteria” (DC) section in the patient's electronic health record was utilized to communicate and track these needs and goals. Staff feedback survey were reviewed, along with the tracking of discharge delays and errors before and after the process was started. Results: More than 80% of staff felt that the use of the DC helped to facilitate their patient's discharges. More than 90% of staff felt that the DC section was helpful in RN-to-RN communication. In addition, there was a decrease in discharge delays and errors by 66% after the process was initiated. Discussion and Implications for Nursing Practice: To improve discharge planning, discharge needs and goals must be addressed and communicated effectively throughout a patient's hospitalization. By doing so, nurses can directly improve the quality of a patient's discharge. Efforts for improvement include reeducating nurses and encouraging interdisciplinary involvement.
doi:10.1016/j.pedn.2011.01.279 Magnetic Resonance Imaging:Challenging Environment for the Critical Care Population and the Innovative Response From Radiology Nurses Theresa Fitzpatrick RN, BS, CPN, Marjean Cefaratti BSN, RN, CPN Children's National Medical Center, Washington, DC
Objectives: • Promote a safe transfer to the magnetic resonance imaging (MRI) enviroment • Streamline “preliminary” process. • Facilitate a safe return to the critical care unit. MRI: Challenging environment for the critical care population and the “innovative” response from radiology nurses. Introduction/Problem: The “continuum of care” for critically ill patients is a challenge for intensive care unit (ICU) nurses in the MRI environment. The MRI environment demands “zoning for safety” and includes specialized nursing equipment. ICU nurses verbalized their decreased “comfort” level when MRI studies are ordered for their patients. The following issues were identified related to the MRI environment. These included a changing patient acuity and the requirement of many resources to transfer patient to MRI. The unexpected complications, additional protocols, and delays with prior patients can result in scan time changes and or postponement for the ICU patient. The preparation of the ICU patient before entering ZONE III of the MRI suite must include MRI compatible equipment and insure safe complex transfer to the scanning table.
Objectives: • Describe the process used to improve medication administration error rates. • Recognize the beside nurses role in decreasing medication errors. Target Audience: RNs, advanced practice nurses. Background/Problem: One of the hospital safety initiatives was to decrease the rate of medication errors that reached the patient. A multidisciplinary task force was formed to review trends in medication errors and make recommendations for process improvement. Medications errors were divided by the medication delivery steps of prescribing, transcribing, dispensing, and administration. Because most medications are administered by nurses, a nursing subgroup consisting primarily of bedside nurses was developed in April 2009 to review administrationrelated errors. Purpose: The purpose of this medication administration error subgroup was to review administration errors, identify trends, identify potential process or practice contributing factors, and make recommendations for change. The overall objective was to decrease the medication administration error rate by 50%. Methods: In the third quarter of 2009, the medication administration subgroup began receiving a detailed medication administration error report and met quarterly to review the report. During the meetings, members openly identified issues, discussed possible solutions, and made recommendations for immediate actions to prevent further like errors. Both nursing practice changes and recommendations to the task force were made. Outcomes: The hospital-wide medication administration error rate decreased from 4.3 per 10,000 doses dispensed in the third quarter of 2009 to 1.3 per 10,000 doses dispensed in the first quarter of 2010. Implications: The bedside staff nurses' involvement, teamed with appropriate support staff, created a successful process that resulted in improved outcomes. doi:10.1016/j.pedn.2011.01.278 Improving the Discharge Planning Process: Communicating Discharge Needs as Part of Daily Nursing Practice Frahnie Pierre RN, BSN, CPN The Children's Hospital of Philadelphia, Philadelphia, PA
Objectives: • Identify common issues affecting discharge planning for nurses. • Explain how a nursing-facilitated discharge planning process was used on a pediatric medical unit. • Review feedback data and audits based on the initiated discharge planning process. • Identify efforts to help improve this discharge planning process. • Review the plan to help achieve more interdisciplinary involvement in the discharge planning process.
Abstract Purpose: The purpose of this study is to evaluate the effectiveness of a nursing-facilitated discharge planning process within a pediatric medical–surgical unit. Background/Significance: Nurses deal with discharge planning among many other competing priorities in an acute inpatient environment. Research has shown that there is a disconnect between what is observed and what is documented in these discharge planning efforts. The lack of integration between these efforts poses a challenge to the timeliness and quality of a patient's discharge. Methods/Design: A nursing-facilitated discharge planning process was initiated on a 24-bed pediatric hospital unit. On admission, patient-specific discharge needs and goals were identified and addressed. The “discharge criteria” (DC) section in the patient's electronic health record was utilized to communicate and track these needs and goals. Staff feedback survey were reviewed, along with the tracking of discharge delays and errors before and after the process was started. Results: More than 80% of staff felt that the use of the DC helped to facilitate their patient's discharges. More than 90% of staff felt that the DC section was helpful in RN-to-RN communication. In addition, there was a decrease in discharge delays and errors by 66% after the process was initiated. Discussion and Implications for Nursing Practice: To improve discharge planning, discharge needs and goals must be addressed and communicated effectively throughout a patient's hospitalization. By doing so, nurses can directly improve the quality of a patient's discharge. Efforts for improvement include reeducating nurses and encouraging interdisciplinary involvement.
doi:10.1016/j.pedn.2011.01.279 Magnetic Resonance Imaging:Challenging Environment for the Critical Care Population and the Innovative Response From Radiology Nurses Theresa Fitzpatrick RN, BS, CPN, Marjean Cefaratti BSN, RN, CPN Children's National Medical Center, Washington, DC
Objectives: • Promote a safe transfer to the magnetic resonance imaging (MRI) enviroment • Streamline “preliminary” process. • Facilitate a safe return to the critical care unit. MRI: Challenging environment for the critical care population and the “innovative” response from radiology nurses. Introduction/Problem: The “continuum of care” for critically ill patients is a challenge for intensive care unit (ICU) nurses in the MRI environment. The MRI environment demands “zoning for safety” and includes specialized nursing equipment. ICU nurses verbalized their decreased “comfort” level when MRI studies are ordered for their patients. The following issues were identified related to the MRI environment. These included a changing patient acuity and the requirement of many resources to transfer patient to MRI. The unexpected complications, additional protocols, and delays with prior patients can result in scan time changes and or postponement for the ICU patient. The preparation of the ICU patient before entering ZONE III of the MRI suite must include MRI compatible equipment and insure safe complex transfer to the scanning table.