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Introduction
Medication errors can occur at any stage of the medication therapy process. This article covers a review of literature on medication safety from a global perspective. It discusses how the drug therapy process has influenced, changed, and enhanced medication safety. It highlights medication safety in the nine stages of the drug therapy process. These stages of the medication therapy process are; physician making a decision on patients right treatment, prescription of drugs, pharmacists reviewing doctors prescription, drug preparation and dispensation, delivery of right drug to a patient, nurses preparation in order to administer drug, administration of drugs to patient , recording of drugs administered to patients drug on chart and monitoring of patient progress to this medication ( Pathways for medication safety: Assessing bedside bar coding readiness, 2006). Finally, a conclusion to emphasize on maintaining proper two-way communication between physician and pharmacist, intensive education for both patient and health workers on medication safety and the need for continuous research on medication safety (Sandra, Michael & Spingarn, 2007).
Discussion
Medication errors are the mistakes of any form during medication be it oral, or intravenous solution committed in the medication therapy process. Instance of these medication errors include; administration of wrong drug to patient, use of expired drugs, administering drug through the wrong route, taking of contraindicated drugs, or physician prescribing wrong drug to patient (Karen & Maralyn, 2006). These errors of commissions or omissions contribute to illness and deaths in the hospitals or some in some instances at home settings. Global studies indicate that in acute care, 2% to 3% of patients admissions are related to drugs errors. Additionally, intravenous drug administration errors range from 14.9% to 32.4%. This is because its preparation errors stand at 26% and that of administration at 32.4% (Libby, R. & Susan, 2008). In every five drugs administered, one has error either ranging from prescription, preparation and administration. Globally, many health sectors have in past years stepped up fight against medication administration errors in order to promote medication safety. In Australia, medication safety groups and organizations rose up in early 1990s triggering review on the existing focus on drug safety (Medication safety in the community: A review of the literature, 2008). In 2003, New Zealand did adopt the same strategic move as Australia regarding drug safety. This strategic plan accommodates nurses to contribute their initiatives level of national policy to improve the quality of patient care (Libby, R. & Susan, 2008).
The drug therapy process influences, change, and enhance medication safety. Each of these aspects is covered in the nine stages of the drug therapy process. Medication safety can be influenced by physicians decision on the appropriate treatment for a patient. This will depend on weather physician has right information to make right and decisive prescription, protocol of right drug dose, the route of administration, duration of drug action, its side effects and patients factors such as age , allergic reaction and weight (Sandra, Michael & Spingarn, 2007). Alteration or misrepresentation of the above information can change or enhance medication safety (Pathways for medication safety: Assessing bedside bar coding readiness, 2006).
Also, physician prescription can influence, change or enhance medication safety. To promote medication safety prescription orders should be eligible and not ambiguous. A physician should avoid the use of abbreviations which can lead to misinterpretation. Pharmacist review of prescription before dispensing medication can influence, change or enhance medication safety. Pharmacists should have information pertaining to patients age, and weight. In addition, he should consider patients clinical judgment and information regarding anticipated intervention (Sandra, Michael & Spingarn, 2007).
They way a drug is prepared and dispersed can influence, change or enhance medication safety. Drug preparation and dispersition should be justified by checking drug accuracy and ensure the right medication is administered. Double checking of drugs should be done especially on look alike medication. Additionally, pharmacists screening for drug interaction, ensuring right dose and drug labeling affect medication safety too. Also, Safe drug storage, delivery of right drug to the right ward, at right time and to the right patient influence, changes and enhances medication safety (Day, Hindmarsh & Ventimiglia, 2009).
Nurses preparation during drug administration affects medication safety. To promote drug safety, nurses should inform prescribing doctor of any detected errors, ensure conformity to five rights; that is right drug, right dose, right route, route time and to the right patients (Libby, & Susan, 2008). It is also crucial for nurse to check routes like intravenous line before drug administration. Technical issues like intravenous line kinking and tissue should be ruled out. Patients medication record keeping is essential aspect in promoting medication safety. Additionally, it curbs chances of confusion in course of patient treatment. It is also important to monitor patients response to medication (Sandra, Michael & Spingarn, 2007).
Consumer education is a key aspect in promoting medication safety. This is to create knowledge on right drug use, side effects, and the dangers linked to misuse. I also advocate for intensive training and education of health workers on this important health safety practices (Pathways for medication safety: Assessing bedside bar coding readiness, 2006). Continuous research is also crucial in determining and coming up with data about incidences on medication administration errors. To improve on drug safety it important that patients follow up is done. Other factors which may affect medication safety are; age with those at advanced age experiencing more drug adverse reactions. Patients with critical illness and those combining several therapeutic drugs are also at high risk. In addition, studies show that patients on transit to health facilities are also at risk. Poor communication, either due any communication barrier or poor drug documentation is a contributing factor to drug therapy errors (Libby, R. & Susan, 2008).
Drug therapy process has been reviewed over years in order to promote medication safety. The main aim of these changes in medication process are; to create awareness on current issues with bed side bar coded administration system in addition to determining the preparedness of health institution in providing health services. To develop pathway for medication safety tool which includes assessing bedside bar coding readiness in order to make it simpler and effective for health institution and staff to achieve their anticipated therapeutic intervention by being able to trace , locate and utilize materials most appropriate to patients needs. This approach technology has helped towards eliminating drug related adverse effects and errors (Pathways for medication safety: Assessing bedside bar coding readiness, 2006). Leading a strategic planning effort which has the following components; comparative data, culture surveys, model plan of action, time frame, questionnaire for staff, and guidelines on policies is another approach geared to assist hospital management and the personnel to exercise effective medication safety strategic plan (Day, Hindmarsh, & Ventimiglia, 2009). Looking collectively at risks is another form of approach change which has come up to ensure medication safety. This approach change is made to assist health service providers to choose potential medication safety risks. Health staff can employ this approach to distinguish particular areas which require amendment in the drug delivery system. It also provides avenue for various health sectors to collaborate and be in a position to deliver quality medical care to its clients (Karen & Maralyn, 2006).
Medication safety has influenced the setting up of organizations to monitor and maintain detailed data on medication errors in the community setting. This has evident in United States where medication errors data organizations serve that purpose. Setting of these organizations address the issues of medication safety at community setting since high population receive medication from dispensing pharmacists (Medication safety in the community: A review of the literature, 2008).
Conclusion
To addresses on medication administration errors communication improvement is of essence. This aspect of communication touches on maintaining and observing of accurate communication between the doctor, pharmacist and patient. Consumer education is a key aspect. This is to create knowledge on right drug use, side effects, and the dangers linked to misuse. I also advocate for intensive training and education of health workers on this important health safety practices (Pathways for medication safety: Assessing bedside bar coding readiness, 2006). Continuous research is also crucial in determining and coming up with data about incidences on medication administration errors. To improve on drug safety it important that patients follow up is done. This could be helpful to patients who high risk drugs. Drugs should be double checked as opposed to single checking before administration to promote drug safety (Libby, R. & Susan, 2008).
References
Day, G., Hindmarsh, T., & Ventimiglia, N. (2009). Improving medication administration through an enhanced occurrence reporting system. Journal of nursing care and quality, 9(1), 51-56.
Karen, M. & Maralyn, F. (2006). Medication administration errors: understanding the issues. Pub med journal, 23(3), 33-40.
Libby, R. & Susan, S. (2008). Literature review: medication safety in acute care. Retrieved from www.unisa.edu
Medication safety in the community: A review of the literature. (2008). Web.
Pathways for medication safety: Assessing bedside bar coding readiness. (2006). Retrieved from www.medpathways
Sandra, k., Michael, j., & Spingarn, R. (2007). Prescription for improving patient safety. Journal addressing medication errors, 30(3), 1-20.
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