What is Healthcare Quality?
Healthcare quality is the degree to which healthcare services to an individual or population increase the likelihood of the desired outcome. Quality healthcare is characterized by improved safety, positive outcome, and enhanced patient satisfaction. Healthcare quality is measured by the effective use of medical imaging, timeliness of care, patient experience, readmissions, the safety of care, mortality, disability rate, and morbidity rate.
Healthcare quality can be applied to the work of many quality pioneers. One of the Quality pioneers is Dr. Joseph Juran (Crowe, 2021). He proposed the quality trilogy. The trilogy includes quality planning, quality control, and quality improvement. In quality planning, healthcare leaders and managers are required to create processes that will accomplish the desired goals. For example, to reduce medication errors, healthcare professionals should plan and allocate resources to eradicate the various issues that cause the errors. A plan will indicate how the organization will accomplish the desired healthcare goals. In quality control, healthcare professionals need to monitor and adjust the process. Monitoring is crucial in identifying whether the goals are being met or not. Additionally, it ensures that the individuals comply with the quality standards. Managers can also adjust the goals as the implementation continues. Finally, in quality improvement, the healthcare organization can implement the quality improvement intervention to accomplish its goals. It can be done by introducing a new way of providing care or improving the existing ones. The key points of quality improvement that can be applied to healthcare quality include creating awareness on the need for quality improvement, making quality improvement a priority, creating infrastructure for quality improvement, training organization, reviewing progress, recognizing winning teams, institutionalizing quality improvement, and concentrating on the internal and external customers.
Medication errors are one of the major healthcare problems in my practice causing adverse drug reactions to a patient in the healthcare setting. They occur when nurses fail to follow the five rights of medication administration(Martyn et al., 2019). The five rights of medication administration include right drug, right dose, right time, right route, and the right patient. A medication error is committed if a nurse administers the wrong drug, dosage, time, route, or to the wrong patient.
Practice Problem And Statistics
Various statistics globally and in my clinical practice indicate the cases of medication errors. On average, during medication administration, the rate of medication errors is about eight to twenty-five percent (SingleCare, 2022). The rate of medication errors at home is estimated to be around two to thirty-three percent. Lack of proper dispensing commonly results in medication errors in my setting. Specifically, dispensing errors result to upto 55% of the total medication errors. In the United States, one in every five American citizens has experienced medication errors in the healthcare setting. Similarly, almost one in every five medication doses is given in an error in the healthcare settings. In my practice setting, older patients are likely to be affected by medication errors due to polypharmacy. Intravenous medications are responsible for the high rate of medication errors in my practice setting.
My definition of healthcare quality applies to medication errors. According to the definition, one of the determinants of healthcare quality is patient safety. Medication errors reduce the safety of care of patients. It may result in adverse and other negative healthcare outcomes. Healthcare that is characterized by medication errors is far from being quality.
Solutions to medication errors using evidence-based resources
Medication error is a sentinel event that requires various evidence-based and best practice strategies to manage. The hospital needs to design and implement a safety improvement plan to prevent the sentinel event. The plan needs to involve policies, new actions, and processes that, if implemented, will address the root causes of medication errors. The hospital needs to initiate a new policy to ensure regular reviewing of drug containers and contents and double-check drugs’ names before administration (Litman, 2018). The policy will ensure the administration of the right medication to the patient. It is important to differentiate medications with similar appearances due to the difference in actions and indications for prescribing (Bonafide et al., 2020). Nurses need to countercheck to ensure that the correct medication name is displayed on the product and the casing or box. This policy aims to ensure the administration of the right medicine to the right patient. The policy needs to be fully implemented within two weeks of initiation.
The hospital also needs to implement policies that prevent the healthcare providers from possessing mobile phones and other gadgets that are a source of destruction and interruption during medication. The nurses and physicians need to leave the gadgets in their offices or the nursing station, especially when attending to the patients, to minimize the occurrence of the sentinel event (Treiber et al., 2018). Mobile phone is one of the major cause of destruction and interruption in healthcare settings (Sanderson et al., 2019). According to a study by Bonfide et al. (2018), interruption and destructions interfere with the outcome of clinical procedures. The policy’s goal is to minimize destruction during medication to improve the quality of health to patients. The policy needs to be fully implemented within 48 hours of initiation. Finally, the healthcare setting should conduct a root cause analysis to establish the cause and propose solutions to medication errors (Hibbert et al., 2018). A root cause analysis is crucial in addressing various practice issues in the healthcare setting.
Bonafide, C. P., Miller, J. M., Localio, A. R., Khan, A., Dziorny, A. C., Mai, M., … & Keren, R. (2020). Association between mobile telephone interruptions and medication administration errors in a pediatric intensive care unit. JAMA pediatrics, 174(2), 162-169. https://jamanetwork.com/journals/jamapediatrics/article-abstract/2757364
Crowe, R. P. (2021). The evolution of quality concepts and methods. Emergency Medical Services: Clinical Practice and Systems Oversight, 2, 424-431.
Hibbert, P. D., Thomas, M. J., Deakin, A., Runciman, W. B., Braithwaite, J., Lomax, S., … & Fraser, C. (2018). Are root cause analyses recommendations effective and sustainable? An observational study. International Journal for Quality in Health Care, 30(2), 124-131.
Litman, R. S. (2018). How to prevent medication errors in the operating room? Take away the human factor. British journal of anesthesia, 120(3), 438-440.
Martyn, J. A., Paliadelis, P., & Perry, C. (2019). The safe administration of medication: Nursing behaviors beyond the five rights. Nurse education in practice, 37, 109-114.
Sanderson, P., McCurdie, T., & Grundgeiger, T. (2019). Interruptions in health care: assessing their connection with error and patient harm. Human factors, 61(7), 1025-1036. https://journals.sagepub.com/doi/full/10.1177/0018720819869115
SingleCare (2022, January 20). Medication errors statistics 2022. https://www.singlecare.com/blog/news/medication-errors-statistics/#:~:text=Medication%20errors%20statistics%20by%20setting,Patient%20Safety%20Network%2C%202018).&text=Improper%20dispensing%20of%20medications%20results,BMJ%20Open%20Quality%2C%202018).
Treiber, L. A., & Jones, J. H. (2018). After the medication error: Recent nursing graduates’ reflections on education adequacy. Journal of Nursing Education, 57(5), 275-280.
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