NURS FPX 4020 Assessment 1: Enhancing Quality and Safety Evidence-based and best practice solutions

NURS FPX 4020 Assessment 1: Enhancing Quality and Safety

Evidence-based and best practice solutions

The first EBP solution is to train and educate nurses and health care staff to follow the guidelines provided by IOM and QSEN. The guidelines include being vigilant and verify medication with EHRs, check for allergies, assess the medication before administration, diligently calculate dosage (Armstrong, 2019), use memory aids and checklists, avoid workarounds, avoid conversations during administration, consider one patient at a time, clarify an unclear prescription, and avoid abbreviations (Pop & Finocchi, 2016). The process reduces cost as it prevents adverse effects of medication on patients. 

The second EBP is to implement a physician order entry system with medication error reporting and communication system to reduce prescription, dispensing, and administration errors (Thompson et al., 2018). The system is completely electronic where nurses, physicians, and pharmacists are directly connected to compare medication with prescription and EHR to detect any discrepancies. Further, implementing technology such as bar-code-based medication administration where each drug has a unique barcode helps in preventing dispensing errors and dosage errors (Thompson et al., 2018). Also, the use of voice tags to find the content of the syringe during dosage calculation reduces dosage errors (Wu et al., 2020). The process reduces cost as it prevents delay in care, hospital stay, wastage of medicine due to wrong dosage calculation, and morbidity. Trakulsunti et al. (2020) found that checklists and communication between nurses and pharmacists regarding the change in packaging information and dosage reduce confusion, which reduces delay in administration. 

The issue of interruptions can be solved by using different color tabards with messages on them. For example, red tabard with a sign “please do not approach, I am administering medication”, yellow tabards with a sign “only patients with an emergency can approach”, and a green tabard with sign “approach only after medication administration” help in preventing errors (Palese et al., 2019). Also, this increases the efficiency of nurses (Verweij et al., 2016). Apart from these EBP interventions, interprofessional collaboration strategies to promote effective and assertive communication and shared decision-making reduces medication errors (Manias, 2018). The protocol reduces cost as nurses will work efficiently with low medication errors. For example, nurses who are administering multiple patients are at higher risk of committing errors. 

Coordinated care among nurses to improve quality and patient safety

Burnout is common among nurses. As a result, communication and a supportive work environment are critical. Nurses can coordinate with each other during medication administration to handle any interruptions (Hammoudi et al., 2017). For example, a nurse can attend a patient of another nurse or external patient for the time being till the assigned nurse completes his or her administration to reduce mix-ups and confusion. Also, communicating with other nurses to identify allergies in a patient to create a patient-specific medication order prevents adverse effects (Huckels-Baumgart et al., 2017). For example, a patient might have an allergy to aspirin. A nurse can discuss with other nurses to find a suitable alternative to prevent allergies. This further reduces health care costs as the patient will not suffer from any negative outcomes (Bradley et al., 2016). 

Further, burden-sharing and shared decision-making increase throughput, which is critical in managing burnout. Coordinating with nurses regarding health complications, adverse effects, guidelines by organizations, and dosage calculation increases drug administration competencies and knowledge (Pop & Finocchi, 2016). Also, assisting and educating other nurses to understand the use of EHRs, medication error reporting systems, and other technology increases skills and knowledge (Huckels-Baumgart et al., 2017). It is important in decreasing costs and errors (Manias, 2018). For example, a nurse can assist another nurse in reporting and logging information regarding mismatch in prescription and dispensed drug result in adverse effect prevention. 

Stakeholders and safety enhancement

The nurse needs to coordinate between stakeholders such as informatics nurses, pharmacists, physicians, therapists, nurse leaders, patients, and nurse specialists such as anesthesiologists. Patients are important stakeholders as they help the nurses and physicians in assessing the condition by providing information relating to their health history, allergies, and other details (Abukhader & Abukhader, 2020). Also, their consent in selecting a