NURS FPX 4020 Assessment 3: Improvement Plan In-Service Presentation Process of safety outcome The first EBP solution is to train and educate nurses to follow guidelines Implement a physician order entry system Bar-code based medication scanning Implement an automated error reporting system  Checklists to double check the medication

• 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). 

• The next strategy is to implement an automated error reporting system that includes a patient-specific automated medication system (npsAMS) unit, barcode medication administration (BCMA), and a complex automated medication system (cAMS) with the automated dispensing unit to reduce human errors in communication and decision-making. As the process used an integrated system, the errors were reduced from 0.96 to 0.15 (Risør et al., 2018). 

• Koyama et al. (2021) proposed an EBP strategy to double-check medicine through the checklist, implementing hierarchical protocols, and educating interprofessional teams to reduce medication administration errors. The strategy reduced errors as double-checking reduced human errors. Also, recommendations by QSEN and IOM to train health care staff to communicate and collaborate aid in both error prevention and management (Abukhader & Abukhader, 2020).

NURS FPX 4020 Assessment 3: Improvement Plan In-Service Presentation

Process of safety outcome

• Encourage interprofessional collaboration

• Use of tabards to prevent interruptions

• Implement RCT process to eliminate blame culture

• Create a role-based work culture

• Reduce nurse burnout by increasing nurse-patient ratio

• The imprtant step is to develop a hospital-based protocol and hierarchical response system with a medication error alert system to quickly detect the errors and provide steps taken to report the error along with the responsibilities of different stakeholders (Huckels-Baumgart et al., 2017). This plan aid in solving the first root-cause where the pharmacist sent the wrong product. The outcome of this step is it increases knowledge and competencies along with better communication between the team (Korb-Savoldelli et al., 2018). 

• 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). 

Composition of safety team

• Decision-making
  • Nurse leaders
  • Nurse managers
  • Chief of unit (pharma, residents, surgeons, and others

• Team members
  • Nurses 
  • Physicians
  • Pharmacist
  • Informatics nurse
  • IT professionals

• Decision-making team includes nurse leaders, managers, and unit chiefs as they draft the policies and take decisions whenever there is an issue. Also, they monitor the resources and finances involved in the units. However, other members such as nurses and physicians provide their input in medication administration activities. 
• Medication administration includes nurses as they administer drugs, match the drug by comparing with EHRs, a