NHS FPX 4000 Assessment 4 Analyzing a Current Health Care Problem or Issue

NHS FPX 4000 Assessment 4 Analyzing a Current Health Care Problem or Issue

Various contributory human factors cause medication errors (MEs) in hospital pharmacies. These factors include individual elements like fatigue and emotional stress, organizational aspects such as support systems and communication, task-related challenges like high workload during specific shifts, and team dynamics, including interprofessional communication. It is crucial to deal with these human factors for enhancing patient safety within the framework of hospital pharmacy settings. (Faraj et al., 2020).

Another study by Kuitunen et al. (2020) describes avoiding safety procedures for high-alert drugs, drug knowledge gaps, calculation errors, double-checking lapses, and LASA medication confusion as systemic causes of medication errors. Addressing these flaws and standardizing processes are critical for improving medicine safety during administration, prescribing, and preparation.

Discusses Potential Solutions for Medication Errors

Medication errors require a wide range of approaches addressing their underlying causes. Potential solutions to ensure positive outcomes include integrated computerized pharmacy systems. Additionally, staff management and a process improvement approach are crucial. These solutions collectively aim to improve patient safety and reduce the risks associated with medication errors.

Integrated Computerized Systems at Pharmacies

Look-alike or sound-alike (LASA) errors constitute a significant part of total medication errors. These types of errors can create severe harm to patient health and safety. The approaches and solutions to reduce LASA include. To reduce medication-related errors, minimize interruptions, use ‘Tall Man lettering,’ and leverage barcode technology. One potential solution is using the technology of barcode medication delivery to ensure that the given medicine is correct.

Healthcare providers should be informed about LASA medication combinations and computerized physician order entry systems with notifications should also be used to minimize errors (Baryan et al., 2020). The pros and cons of this solution are that proactive measures such as technology integration and healthcare provider education enhance patient safety while neglecting LASA errors, which can lead to patient harm, legal issues, and increased healthcare costs. 

Management of Staff

Potential solutions for reducing hospital medication errors include training junior staff in medication prescribing and administration. Training should focus on being vigilant during duty hours to mitigate these errors. In these trainings, hospital management should also address environmental issues and workload management for new and old nurses.

Furthermore, interdisciplinary collaboration and curriculum evaluations on pharmaceutical safety can help avoid these errors (Isaacs et al., 2020). The pros and cons are that training junior staff can improve medication safety through increased vigilance, addressing environmental challenges, and fostering interdisciplinary collaboration. Ignoring this solution can create stress and anxiety within nursing professionals, which can enhance the chance of mistakes being made by nurses.

Process Improvement Approach

The implementation of Lean Six Sigma (LSS) in a =Thai hospital’s inpatient pharmacy was investigated by Trakulsunti et al. (2022) for the dispensing process. Some of the LSS tools used were cause-and-effect diagrams and brainstorming control charts. The study yielded significant improvements in the medication process. It streamlined the medication process, reduced dispensing errors, and improved overall patient safety.

Middle management’s active involvement, leadership, and problem-solving skills can ensure effective LSS implementation to reduce medication errors. The pros and cons are that these process improvement approaches are helpful in pharmacy practices, and ignoring them can increase the factors responsible for medication errors.

Ethical Principles of Recommended Potential Solutions

In addressing medication errors, the core ethical principles of beneficence, nonmaleficence, autonomy, and justice must be at the forefront of any proposed solution. Implementing Lean Six Sigma (LSS) in pharmacy practices emphasizes beneficence by enhancing patient safety. It adheres to nonmaleficence by pinpointing and rectifying medication error causes, as Ahmed et al. (2022) demonstrated.

Autonomy is championed by employing precise computerized prescriptions and “tall man” lettering, with Heck et al. (2021) underscoring their effectiveness in reducing errors, particularly with look-alike sound-alike (LASA) drugs.