Running head: TWENTY-SEVEN PERCENT 1

Twenty-Seven Percent

Jeanne L Zamith

University of South Florida

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Twenty-Seven Percent

In modern medicine, research and development is constantly improving technology to

increase effectivity and decrease medical errors. However, rather than combining these

innovations with the fundamental skills of each profession, health care providers tend to rely

solely on the technology. Unfortunately, this negligence comes at a high price both for

themselves and their clients. Health care professionals serve clients and their families in the most

vulnerable points in their lives; therefore, it is, and should be, their responsibility to work

diligently in preventing medical errors at all costs. Health care has transformed into an

interdisciplinary field in order to improve patient care, so each discipline plays an integral role in

the patients safety and health outcomes.

Discussion

In efforts to decrease medical errors specifically among the nursing profession, several

researchers examined patient safety during the lengthy, in-depth process of medication

administration. According to Grissinger (2015), nurses are distracted and interrupted as often as

once every two minutes while administering medications. Another recent study sought to

determine the association between these interruptions and medical errors, and they found that

each interruption of the medication process resulted in a 12.7% increase in medication errors and

as interruptions increased within a single drug administration, the greater the severity of error

(Westbrook, Woods, & Rob, 2010). Even with these risks associated with interruptions, nurses

continue to answer phone calls, help other nurses waste medications, and address other

patients needs, regardless of the priority level, during the medication administration process. At

what point in health care did the potential importance of an interruption outweigh the risks of the

interruptions themselves?
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Interventions

Communication

One way nurses can prevent medication and medical errors is by attempting to decrease

the number of interruptions while administering medications. While an obvious intervention

could be for nurses to turn off their phones during the process, this strategy is both unrealistic

and unsafe. Health care professionals cannot neglect a potential emergency because doing so

would pose a greater risk than that of an interruption; however, a more realistic solution could be

improving communication between the nurse and patient. For example, shortly before

medication administration, the nurse could state the importance of using the call bell only for

emergencies until the administration process is over (Hughes & Blegen, 2008). By providing this

communication, the nurse would be less likely to receive extraneous phone calls, and the patient

would have the opportunity to learn more about the type of care he or she is receiving.

Communication between the nurse and coworkers is important in reducing interruptions

as well. According to Arnado (2014), the most effective strategy for reducing interruptions by

other providers includes a combination of multiple interventions, some of which are: maintaining

quiet zones for medication preparation and requiring the nurses to wear a vest or lighted

lanyard. These interventions may seem drastic, but they provide understanding and

communication to the staff and other patients about the importance of the task being undertaken,

which could potentially decrease the amount of interruptions received.

Six Rights of Medication Administration

Nurses are the last line of defense between the doctors prescription and the patients

body, which also puts them at the greatest risk for directly harming, or helping, the patient.

According to Keohane et al. (2008), nurses spend about 27% of their shift performing medication
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administration, so it is a nurses responsibility, especially in the presence of interruptions, to

ensure the safety of the patient by utilizing the six rights of medication administration. These

rights include right: patient, drug, dose, time, route, and documentation and should be verified

at least three times throughout the process (Hughes & Blegen, 2008). Even though this method

does not directly address the interruptions, it could greatly decrease some of the associated risks,

since the interruptions themselves are not entirely preventable.

Personal Fear

As nurses, we are our patients greatest advocates. While we, in general, do everything

we can to prevent medical errors, it would be nave to assume that mistakes are never made. As a

student nurse who is interested in pediatrics, my greatest fear is giving an adult dose of a

medication to a child. Such an error could have catastrophic results for both the patients and their

families. To prevent this, I will discipline myself to utilize the six rights of medication

administration, despite the busyness associated with the nursing profession, and work diligently

to decrease interruptions during the administration process as much as possible.

Conclusion

Even though technology is constantly advancing to improve the quality of health care and

patient safety, nurses still have the responsibility to perform the fundamental skills of their

profession, which include safe medication administration, despite the temptation to rely on these

innovations to facilitate their lives. To prevent harming or even killing the patient, nurses should

work to prevent interruptions before starting the administration process, and, once the process

begins, they should utilize the six rights method. Technology can be a double-edged sword,

presenting both benefits and risks. Nurses must be diligent to maximize these benefits while

avoiding the potential harms.

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References

Anthony, K., Wiencek, C., Bauer, C., Daly, B., Anthony., M. K. (2010). No interruptions please:

Impact of a no interruption zone on medication safety in intensive care units. Critical

Care Nurse, 30, 21-29. doi:10.437/ccn2010473

Arnado, J. A. (2014). Minimizing avoidable interruptions during medication administration.

Masters Projects. Retrieved from

http://repository.usfca.edu/cgi/viewcontent.cgi?article=1069&context=capstone

Grissinger, M. (2015). Sidetracks on the safety express: Interruptions lead to errors and Wait,

what was I doing? Pharmacy and Therapeutics, 40(3), 145-190. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357347/

Hughes, R.G., & Blegen, M. A. (2008). Medication administration safety. In Patient Safety and

Quality: An Evidence-Based Handbook for Nurses (chapter 37). Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK2656/

Keohane, C. A., Bane, A. D., Featherstone, E., Hayes, J., Woolf, S., Hurley, A., Bates, D. W.,

Poon, E. G. (2008). Quantifying nursing workflow in medication administration. The

Journal of Nursing Administration, 38(1), 19-26. Retrieved from

http://www.patientsafetyresearch.org/journal%20articles/Original%20266.pdf

Raban, M. Z., & Westbrook, J. I. (2014). Are interventions to reduce interruptions and errors

during medication administration effective?: A systematic review. BMJ Qual Saf, 23(5),

414-421. Retrieved from http://qualitysafety.bmj.com/content/23/5/414.long

Westbrook, J. I., Woods, A., & Rob, M. I. (2010). Association of interruptions with an increased

risk and severity of medication administration errors. Arch Intern Med, 170(3), 683-690.

doi:10.1001/archinternmed.2010.65