Reducing Medication Errors and Costs

Enhancing Quality and Safety
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Reducing Medication Errors and Costs 
Overprescribing is a standard medication error that poses a significant risk to patients during drug administration: the more medicine a clinician gives, the higher the chance the patient will suffer an unwanted or harmful effect. Various studies indicate that the most overprescribed drugs in America are opioids, PPIs, antibiotics, Levothyroxine, and antidepressants. Overprescribing is tied to poor assessment of the age of recipients, benefits versus adverse effects, usage patterns, treatment duration, and clinical trends (Gorgich et al., 2015). It is primarily the result of cognitive and interpretive errors rather than lack of knowledge, such as a clinician's attempt to simplify difficult decisions using pre-formed beliefs and expectations.
Some of the flaw-engendering cognitive influences include cultural beliefs that more is better, a false sense of security that overprescription is "risk-free," lack of confidence in one's diagnostic competency, defensive medicine, and fear of malpractice, undervaluing the long-term risks of overprescribing while overvaluing the immediate risk of inaction, patient-centered care where patients insist on specific dosages, and direct-to-consumer media by pharmaceutical companies that may create a misplaced need for overprescription (Wondmieneh et al., 2020). In high-pressure environments, doctors may resort to overprescription without fully understanding the patient's needs because the patient is in severe pain or simply because they want to attend to as many patients as possible.
One evidence-based way of reducing medication errors and costs is by focusing on high-risk agents (classes of medications that have a heightened probability of causing patient harm if wrongly prescribed) such as anticoagulants, opioids, insulin, and chemotherapeutic agents. A multipronged strategy to mitigating illegal prescription of high-risk drugs includes using protocolized prescribing, extensive documentation, simplified instruction, and standardized administration practices like dual nurse corroboration at the bedside. In addition, Double-check processes by a second nurse before drug administration can help improve error detection. Due to time burdens and excessive nursing workloads, independent checks should be advantageously targeted to high-risk drugs and include tracing infusion lines to ensure that the correct medication is attached and infused into the patient (Yousef & Yousef, 2017). Other additional strategies to prevent medication administration errors include facilitating precise storage requirements and standardized labeling. If high-risk drugs are stored and labeled consistently, there is reduced opportunity for administration errors. Moreover, optimizing nursing workflows to reduce error potential is another effective strategy for enhancing patient safety.
Distractors during medication administration increase the risk and gravity of errors and, therefore, minimizing interruptions through the optimized nursing workflow is critical. Ensuring minimal distractions in high-risk medication administration zones like the emergency department and the intensive care unit. Interpretive errors can be reduced by insisting on legible and unabbreviated writing of dosage, metric measures, the duration of treatment, and indications for the drug (Tariq & Scherbak, 2019). Another best-practice solution is employing medication safety rounds and pass audits to ensure correct prescription practice and even serve the crucial role of providing patients with "just in time" education. For instance, educating patients with anaphylaxis about correctly using the epinephrine auto-injector, which does not connect to an IV line and can therefore result in wrong administration, could help prevent accidental overprescription or underprescription.
Nurses can play a critical role in coordinating care to improve patient safety with medication administration and reduce costs by first supporting a safety culture. While prescription errors are not necessarily a professional or individual issue, they often indicate a breakdown in continuity of care between teams and systems. Medication errors cannot be eliminated, and therefore a collective and sustained commitment to careful organization of patient care activities and emphasizing patient safety is critical. In addition, nurses should cultivate a culture of transpare...