Author: Lacey Petersen, MSN, RN
Institution: Blessing-Rieman College of Nursing
Calculate accurate medication dosages using the
Discuss the various types of adverse drug reactions.
Recognize the role and responsibilities of a nurse in near-miss and medication error reporting.
Examine the relationship between human factors and unsafe medication administration practices.
Discuss medication errors and prevention strategies through the completion of an error reporting system for near-miss and error reporting.
Discuss medication errors and prevention
The Medication Error Reporting Form was created to help students link the process of medication math problems in the classroom with potential patient outcomes as a result of calculation errors. Entry-level student’s that have minimal exposure to the clinical setting often have a difficult time understanding how medication math errors on a quiz or exam in the classroom are directly related to clinical patient safety. As a result, many students may make the same errors repeatedly because they fail to understand the dangers that exist for the patient related to their error.
Strategy Implementation: Students are given medication math questions on selected quizzes and exams in their corresponding nursing course. If a student calculates a medication math question incorrectly, the question is treated as a medication error incident with a simulated patient, Susie Smith. The student must complete a medication error reporting form. The medication error reporting form requires the student to calculate the safe and correct dose which is verified by the course instructor. The student is then required to investigate what the medication is commonly given for and what are the potential adverse effects that Susie Smith may experience as a result of their medication error. Students are asked to identify safety measures that may help to prevent similar medication errors from occurring again and the student must reflect on how the medication error reporting form has changed their view of medication calculations and medication administration to patients. In conclusion, the student must sign the medication error reporting form to take accountability for the error just as a registered professional nurse would be required to sign a hospital incident report.
Selected quizzes and exams that include medication math calculation problems are given to students in their corresponding nursing course. If a student makes a medication calculation error, the student is required to complete a Medication Error Reporting Form as a method of remediation for making the error. The student can earn up to 10 assignment points for each Medication Error Reporting Form that they complete on selected math problems that were answered incorrectly. A maximum of five medication error reporting forms are completed each semester per student. Students that do not make medication calculation errors on the selected quizzes and exams are not required to complete the medication error reporting form. These students are awarded the 10 assignment points for not making a medication error. A maximum of 50 points can be earned by each student per semester for this teaching strategy.
Faculty members that have implemented this strategy find it a useful tool to emphasize the importance of correctly calculating safe medication dosages. This assignment has been effective to introduce students to human factors and unsafe practices that can cause patient harm. It is a valuable teaching tool that has been successful to help entry-level nursing students to link education in the classroom to nursing practice in the clinical setting. The strategy provides an introduction to quality improvement measures including the analysis of medication errors and system improvement methods. In addition, the assignment is a lesson in responsibility and accountability for their own nursing practice and provides a unique opportunity to introduce concepts of Just Culture in healthcare. Students consistently report that this is one of the most valuable assignments in the course. Examples of student remarks after completing the assignment that were written on the form include:
“I’ve learned how important precision in in administering medications. If too little is given, the medication won’t help them. If too much is given, there could be serious adverse effects or even death.”
“I will be more aware and double check my math every time. It has also opened my eyes to see what my mistakes can do to a patient.”
“Completing the medication error form has changed my view on medication calculations and administration because I see that even the smallest mistakes can cause much larger problems. Just one mistake can put the patient’s life at risk, cause a longer hospital stay for them, and possible a lawsuit for the hospital.”
“By doing this report it forces us to look at the real possibility of over/under-dosing a patient and the consequences. I am lucky that this drug, if under-dosed, would have a minimal effect on the patient. It still doesn’t excuse the fact that the patient was under-dosed and as such, forces me to look more closely to the question and ask questions if I have any.”
“Completing this form helped me to realized why we try are the last line of defense for the patients so it is extremely important to ensure all calculations are correct.”