Safety Improvement Plan Toolkit Sample Paper Safety Improvement Plan Toolkit: Eliminating Medical Errors

Patient safety and healthcare service quality are inseparable elements. More importantly, efforts to ensure safe healthcare processes, reduce health hazards, and empower employees to enhance effective services are gaining popularity in healthcare contexts. The growing concern about patient safety emanates from the urge to eliminate process errors, patient injuries, and medical/economic burdens associated with medication errors. This safety improvement plan toolkit targets to expound on workplace safety parameters and provide insights about leadership obligations, potential strategies, and efforts to harness safe healthcare processes.

Annotated Bibliography

In this study. Mania et al. (2018) examines reported data on medication error trends in an Australian Pediatric hospital over a five-year period. The study utilized a retrospective audit to analyze five-year data submitted via an online voluntary reporting system and includes data between 1st July 2010 and 30th June 2015. The study established that a total of 3340 medication errors were reported over the said period, which, compared with combined admissions and presentations, represents an error rate of .56%.

The study further notes that among the identified communication-related factors associated with medication errors include trade name confusion, drug labeling and reference materials. The most common communication-related factor, according to the study, is problems with record documentation, which represented 17.9% of the sampled data.

Specifically, the study identifies failures to check patient documentation on allergies and weight confusion leading to medication errors. The study also identified instances where medication labelling and content were incorrect. The study thus concludes that communication-related factors contribute to medication errors reported in hospital settings.

In this article, Ooi et al. (2017) argue that incorrect or incomplete medication information in medical discharge summaries is prevalent. The study thus sought to investigate the extent to which medication information presented in pharmacist-prepared Discharge Medication Management Summary (DMMS) provides accurate medication information and changes to the general practitioners. The researchers intervened by requiring ward pharmacists to use the DMMS in communicating medication changes to GPs and leveraged a retrospective audit at baseline and post-DMMS implementation. At baseline, the researchers noted that doctors documented about 45.9 percent of medication changes in the discharge summary (DS).

However, the post-intervention audit revealed that pharmacist-prepared DMMS documented more medication changes than doctor-prepared DS, representing 72.8% versus 31.5% respectively. Further, the study revealed that most pharmacists documented increasingly more changes in medication classes, including analgesics, cardiovascular, endocrine, respiratory and endocrine drugs, and post-intervention.

Given the pharmacist’s efficacy in documenting medication information and changes, the researchers argue for the expansion of the roles of hospital pharmacists in preparing discharge medication information, specifically in partnership with doctors to ensure improved medication accuracy transmitted to the GPs.

Workplace Distractions and Medication Errors

This qualitative descriptive research paper aims to establish workplace distractions’ role in the prevalence of medication errors and compromised patient safety. The article explains distracted practices as growing concerns for healthcare professionals in today’s complex, technology-dominated, care-centered workplace settings. Practice distractions emanate from individual interactions with the environment and technologies when attempting to enhance their performance and realize set expectations. These considerations render process distractions detrimental to human functioning in situations that require adequate cognitive investment and appropriate utilization of professional expertise.

To explain the essentiality of understanding workplace distractions and their roles in contributing to increased medication errors, the researchers applied integrated observations and semi-structured interviews to obtain opinions from registered nurses (RNs), medical doctors (MDs), and pharmacists. The research paper utilizes a conceptual framework based on the distracted during the model. The framework includes several sub-strands like the availability of cognitive resources, cognitive wo