Nursing News

EduCaring 2001: Critical Thinking Key to Preventing Medication Errors

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By Kristin Rothwell, NurseZone Feature Writer

“A medication error is any preventable event which may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the health-care professional, patient or consumer.”
– National Coordinating Council on Medication Error Reporting and Prevention

In the age of technology it would seem that errors, including medication errors, would less likely occur. However, that is not the case. In fact, as many as 44,000 to 98,000 people die each year in United States hospitals as a result of medication errors – more than those who die from highway accidents, breast cancer or AIDS, according to a recent report by the Institute of Medicine titled, “To Err is Human: Building a Safer Health System.”

But there are ways to prevent medication errors from happening to more people. Bette Case, Ph.D., RN, and Jeff Zurlinden, RN, MSN, ACRN, told nurses March 14 at EduCaring 2001 in San Diego, Calif., that by incorporating critical thinking skills, they could help reduce, and even stop, the number of medication errors that take place on a day-to-day basis.

“When thinking critically, a nurse challenges rules and questions the assumptions we use to make sense of patient care and nursing practices,” said Case. “To bring critical thinking to life in the unit, make the question mark ubiquitous in your practice, at the bedside, in the nurses’ station, in the conference room and everywhere your practice takes you.”

For the safety of patients, Case suggests that nurses take proactive roles by questioning the purpose of any medicine they provide, in addition to familiarizing themselves with the patient’s medical history and double-checking the medication with another nurse and/or a pharmacist before administering.

“Often mistakes occur because something has been assumed,” said a conference attendee. “If we went by the premise ‘I presume nothing,’ we’d be in a lot less trouble.”

Medication Errors Highest Among Elderly

Those most affected by medication errors are elderly patients who often take more than six medications and often use seven times the number of over-the-counter medications than the general public, said Zurlinden.

“Drug interactions and seemingly minor overdoses that may go unnoticed in younger patients often land the elderly in the hospital,” he said. “The rate of reported adverse drug reactions is only about 2 percent to 10 percent for younger adult patients but jumps to 20 percent to 25 percent among the elderly.”

In his research, Zurlinden found that many elderly patients visit more than one doctor – who often aren’t aware of what the other has prescribed – and use more than one pharmacy, which increases their chance for redundant medications, overdoses and potential interactions. Likewise, he also found that medications are frequently prescribed but seldom stopped.

“To keep patients safe,” he said, “nurses need to remember to start drug doses low, go slow and monitor carefully.”

The EduCaring 2001 conference was sponsored by AMN Healthcare Inc., Professional Development Center. Nurses who attended received 7 contact hours.

For those interested in learning more about critical thinking and means to prevent medication errors, these were some of the resources used and/or referred to at the conference:

Click here to read “New Technology Designed to Track Medication Errors”

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