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Reducing Medication Administration Errors in the Gerontology Population

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Introduction

It is essential to ensure the correct administration of prescription drugs to patients.

However, in clinical practice, it is challenging to eliminate all errors in the administration of

medications. One can only hope to reduce such errors and reduce the adverse effects of

erroneous drug administration. According to Pérez-Jover et al. (2018), the most common

misconception among the elderly or poly-medicated is skipping medication, taking medication in

irregular timeframes, taking the wrong medication, or mixing different medicines without a

doctor's authorization. This paper will analyze the adverse effects of wrongful administration of

drugs on the health of the elderly in our society and propound on interventions that day-day to

day nursing practice recommends to deal with this challenge.

Our central priority concept - reducing medication administration errors in the

gerontology population - marries preserving the patient population's physiological integrity

category of the NCLEX-RN examination blueprint. The latter type relates to the obligation of all

nursing professionals to take due care to make sure they do not administer drugs that harm the

internal or external constitution of the patients. According to Pfister et al. (2017), clinical

pharmacists have a role in averting mistakes such as wrong administration of drugs. Actions they

propose pharmacists take in cases where there are adverse effects of improper administration of

medication include reduction of the dosage of medicines, discontinuation of treatment through

drugs and the provision of alternative medication. In summary, nurses' or other medical

practitioners' role is to make sure that patients only ingest medicines and substances beneficial to

their health or those that do not cause harm. When they perform the nurse's tasks effectively, the

physiological integrity of their patient's bodies is maintained.

Importance of Reducing Medication Administration Errors

The yearly cost of medication and expenditure in hospitals are reduced. This results in

profits in hospitals due to the reduced hospitalization of the elderly being admitted to hospitals. It

was noted that there was a 264% profit gain in hospitals that used the Pharm2Pharm method

(Pellegrin et al., 2016). Pérez-Jover et al. (2018) highlighted those elderly patients were prone to

forgetfulness. Failure for physicians to correctly write down the rules to follow when taking the

medication would result in the overdose or death of a patient due to overdose; resulting in the

professional practice of physicians being regarded as careless and failing to observe due care

when dealing with patients (Pérez-Jover et al., 2018).

Healthcare Disparities, Inequalities and Interventions

If the wrong administration of drugs is not addressed, it will have adverse consequences

for all people seeking health care services. However, the people of advanced age will be most

affected. Additionally, people who take multiple medications for several ailments are at higher

risk of wrongly ingesting drugs than ordinary patients with a single medication regimen.

According to Pérez-Jover et al. (2018), the risk of wrongful administration of medication rises as

the number of prescriptions rises. Therefore, understanding the correct dosage of drugs decreases

as the number of medications rises. Various resources can be applied to reduce the wrong

administration of medicines. For instance, according to Pfister et al. (2017), the strategies that

can effectively mitigate improper medication administration include medication reconciliation,

medication review, and participation in ward rotations, all of which require adequate human

personnel and information technology resources.

The challenge of errors in the administration of drugs does not affect all people equally.

For instance, people with challenges related to memory loss tend to experience higher confusion

or errors concerning their medication (Pfister et al., 2017). Additionally, patients of advanced

age report a higher rate of mistakes in their medicine (Pellegrin et al., 2017). The other affected

people are people with multiple medications to cater to numerous health problems (Pérez-Jover

et al., 2018). Pellegrin et al. (2017) proposed a solution to address errors in medicine that

involved incorporating a Pharm2Pharm model in the healthcare system. This model allows

hospital pharmacists to transfer the responsibility of care to a community pharmacist for about

one year.

Several interventions can be applied to the problem of erroneous drug administration.

One of the most common solutions is personalized dosage systems (PDS), which guide patients

on the correct medication and correct time. In the modern-day, computerized apps act as PDSs

(Pérez-Jover et al., 2018). The second possible intervention is the requirement that doctors and

pharmacist write their prescriptions in clear and easily understandable language. Lastly, the

patients should be allowed sufficient consultation time with their doctors to ask all questions they

may have regarding medication (Pérez-Jover et al., 2018). Of the above interventions, the PDS

will be most effective because of the prevalence of smartphones in the modern age. The second

most essential intervention is the use of clearly written prescriptions because of their low cost.

The final intervention involving extended consultation time is expensive and time-consuming. In

addition to the stated interventions, patient education is also imperative to reduce errors in

administration. In the provision of that education, important considerations include the patient's

age and level of education. Generally, older patients have more education requirements related to
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medication than younger ones. The converse is true for patients with higher levels of education

when compared to those with lower levels of

education.

Legal & Ethical Considerations and Intervention

Urden, Stacy & Lough (2019) stated that nurses should respect the patient's decisions without

anyone making decisions on their behalf. Failure to give patients autonomy is contrary to

patients' ethical considerations, and it may put a patient's life in danger. The legal implication for

addressing reduction in errors in administration was stated by Urden, Stacy & Lough (2019),

where incompetent nurses and physicians would be fired following disciplinary actions for not

following their stated guidelines. Physicians who administer medication without instructions to

the patient could also be liable and could lose their job due to negligence (Pérez-Jover et al.,

2018). Understanding the prescription would prevent an ethical dilemma of being ignored in the

physician's decision-making; in cases where the elderly were not aware of the medication, it

would result in overdose or death (Pérez-Jover et al., 2018). In instances where different

physicians administer other medicines to the patient, the patient might not know which doctor

administered the drug. When the patient overdoses, one cannot identify which doctor to be

punished for the overdose as many doctors give medicines to the patient (Pérez-Jover et al.,

2018).

Participants and Interdisciplinary Approach

In the efforts to reduce errors in the administration of medication, several parties will be

involved. First on the list are pharmacists who are responsible for prescribing drugs. Secondly,

we have nurses and other caregivers accountable for giving patients drugs and care depending on

the doctor's instructions. Thirdly, we have doctors who prescribe the form of treatments to the
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patients. Lastly, we have patients who are involved as recipients of care. Two parties mentioned

(pharmacists and doctors) are from disciplines other than nursing. According to Pellegrin et al.

(2017), pharmacists help address the challenge of medication management amid inadequacy in

quality doctor's care. On the other hand, doctors play an important role because they serve as

primary care professionals with the assistance of nurses.

Quality improvement

Finding a solution to the problem of erroneous drug administration is beneficial to all parties in

medical practice. The patient will be the most positively affected. According to Pellegrin et al.

(2017), the efforts to reduce errors in drug administration resulted in reducing medication-related

hospitalizations by almost 36%. Additionally, the reduction in errors in the administration of

medicines results in a reduction in the workload of the nurses since they do not have to deal with

patients with medication-related complications. Notably, nurses are the primary human resources

that will lead to better health outcomes for patients since they are involved in the direct care of

patients. That is why they need increased education to ensure they perform their roles effectively.

Conclusion

In conclusion, this paper has addressed the problem of errors in medication administration and

proposed several solutions or interventions to address it. Since the challenge primarily affects

older adults and people with multiple illnesses, the solution suggested applying to the latter and

former. Examples of interventions identified include the use of personalized dosage systems

(PDS), properly written prescriptions and instructions by doctors and pharmacists, and improved

length and quality of doctor's consultations. Primary resources that will be applied in reducing

medication administration errors include human resources in the form of nurses and pharmacists

and information technology resources that will provide necessary data. In the end, reducing
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errors in medication administration promotes better health outcomes for patients and reduces the

workload for a nurse since it reduces the rate of overall hospitalization.

References

Pellegrin, K. L., Krenk, L., Oakes, S. J., Ciarleglio, A., Lynn, J., McInnis, T., ... & Miyamura, J.

(2017). Reductions in medication‐related hospitalizations in older adults with medication

management by hospital and community pharmacists: a quasi‐experimental

study. Journal of the American Geriatrics Society, 65(1), 212-219.

Pérez-Jover, V., Mira, J. J., Carratala-Munuera, C., Gil-Guillen, V. F., Basora, J., López-Pineda,

A., & Orozco-Beltrán, D. (2018). Inappropriate use of medication by elderly,

polymedicated, or multipathological patients with chronic diseases. International journal

of environmental research and public health, 15(2), 310.

Pfister, B., Jonsson, J., & Gustafsson, M. (2017). Drug-related problems and medication reviews

among old people with dementia. BMC Pharmacology and Toxicology, 18(1), 1-11.

Urden, L., Stacy, K., & Lough, M. (2019). Priorities in critical care nursing (8th ed.).

Wimmer, B. C., Cross, A. J., Jokanovic, N., Wiese, M. D., George, J., Johnell, K., ... & Bell, J. S.

(2017). Clinical outcomes associated with medication regimen complexity in older

people: a systematic review. Journal of the American Geriatrics Society, 65(4), 747-753.