The Medication Error Reporting Project

The Medication Error Reporting Project
Zin Myo Han
Enjoli Flynn
English 105
06/18/14
The problem and solution "The medication error reporting project (MERP) estimates that confusion
surrounding drugs with similar names accounts for up to 25 percent of medication errors."
(www.jcaho.org). The Food and Drug Administration (FDA) says that" about 10 percent of all
medication errors reported result from drug name confusion. A patient taking the wrong drug is an
impact to the safety goal."(www.fda.gov) The confusion of two medications with similar names
could occur with an unclear prescription, due to illegible writing or similar medication names that is
not verified by the doctor or by the pharmacist grabbing the wrong medication due to a similar
name. Medication errors can occur between brand names, generic names and brand–to–generic
names (i.e, Toradol and Tramadol). An eight–year–old died, it was suspected, after receiving
Methadone instead of methylphenidate which is a drug used to treat attention deficit disorders. An
eighteen year old man showed signs of potentially fatal complication after he was given Clozapine
instead of Olanzapine, two drugs used to treat schizophrenia. And a fifty–year–old woman was
hospitalized after taking Flomax, used to treat the symptoms of an enlarged prostate, instead of
Volmax, used to relieve bronchospasm. That is the event that happened in my country last couple of
years ago. Since that patient was sent to our hospital, all the doctors was maelstrom because she
took the drug
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A Brief Note On The Emergency Department Observation
Emergency Department Observation Brittany Bilger Craven Community college Observed Care
Specific to the Unit The role of the emergency department is to diagnose and treat acute and urgent
illnesses and injuries. Patients are seen in order of medical urgency. The emergency department
bases the patients urgency for treatment based on levels. Level 1 is critical and life–threatening. This
is usually related to ABC's (Airway, Breathing, and Circulation). These patients are top priority and
require a lifesaving intervention. Level 2 is also considered high priority and can also be life–
threatening. Psychiatric patients are considered level 2, and patients arriving to the ED with chest
pain. Level 3 patients require resources such as sutures, x–rays, CAT scans, MRI, etc. Level 3
patients are provided treatment services only after Level 1 and 2 have been addressed. The
emergency department at CEMC also has a trauma room and a SANE room. The trauma room is
equipped with life–saving medications (such as antidotes for drug overdose) and medical
equipment. The SANE (Sexual Assault Nurse Examiner) room consists of equipment used to assess
a patient who has been sexually assaulted. The equipment takes pictures of the patient for the SANE
nurse to later provide to law enforcement. A SANE nurse is a specialty nurse and CEMC has one on
call 24/7. During my rotation there I observed patients coming in with chest pain and abdominal
pain. The patients with chest pain had an

Implementing The Universal Protocol Procedure
In 2003, as an outcome of all the sentinel events reported to the Joint commission lead to the
creation of the "The Universal protocol for preventing wrong site, wrong procedures, and wrong
person surgery" (Mulloy & Hughes 2008). So, one of the ways that could have potentially prevented
the situation from happening at the first place was implementing the universal protocol procedure.
According to the protocol the conduction of proper pre as well as post–operating procedures are
extremely mandatory. Therefore, by enforcing a standardized routine pre–operating procedure such
as verifying the patient as well as the correct site for the procedure, by having the medical staff or
preferably the physician marking the operating site with his or her initials before the surgery will be
an effective preventive measure (Mulloy & Hughes 2008). Also, by properly conducting a time–out
session where the patient is provided with a standardized briefing prior to the patient is sedated in
the OR could also eliminate some the sentinel or adverse events in the OR. Furthermore, follow a
checklist, which not only pertains to the surgery itself, but also focuses on the other procedures
involved such as admissions, anesthesia equipment, and discharge (Mulloy & Hughes 2008). Using
Technology to Improve Patient Safety Another effective measure that could have potentially helped
to avoid the situation at the first place was implementation of technology for instance having a
Electronic Medical

The Problem Of Adverse Drug Events In Health
The problem of patient's adherence to their medication regime and proper education on their
medication appears in this literature. Adverse drug event (ADE) is defined as harm experienced by a
patient as a result of exposure to a medication, and ADEs account for nearly 700,000 emergency
department visits and 100,000 hospitalizations each year (Medication Errors 2017). According to the
World Health Organization, Medication errors cause at least one death every day and injure
approximately 1.3 million people annually in the United States alone. Globally, the cost associated
with medication errors has been estimated at US$ 42 billion annually or almost 1% of total global
health expenditure (WHO 2017). Since the Institute of Medicine (IOM) ... Show more content on
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Among adults, 65 years of age or older, 40% take 5 to 9 medications and 18% take 10 or more
(Budnitz, Lovegrove, Nadine, Richards, 2011).
The lack of adherence to treatment is a widely recognized major problem both in the national and
international scenarios. The average adherence rate of patients to treatment in developed countries is
as low as 50%, whereas in developing countries this percentage is even lower (Ahmed, & Aslani,
2014 v.36). This poor patient outcome is the major health care issue in the United States and abroad
because of the inability of the patient to understand and follow their medication instructions. For
patients with coexisting conditions who take multiple medications prescribed by multiple
physicians, there is a vital need to reconcile the prescribed regimen with what a patient is actually
taking and to understand why there is a difference between the two (Cutler, D., Everett, W., 2010).
With this in mind, studies have shown that this fragmentation of care is not only a major health
problem but may lead to adverse drug events and even contributes to patients deaths annually in our
health care system in this country. Hospitalizations for adverse drug events are likely to increase as
Americans live longer, have greater numbers of chronic conditions, and take more medications.
Among adults 65 years of age or older, 40% take 5 to 9 medications and 18% take 10 or more
(Budnitz, el at 2011).

Adoption Of E Prescribing At The Va
Adoption of e–prescribing at the VA will allow non–VA providers to electronically transmit
prescriptions to the VA outpatient pharmacy. This change will bring an opportunity to align itself
with the e–prescribing component of Meaningful Use requirement. It will also accommodate an
increasing number of prescriptions from providers outside the VA pharmacy since the Choice Act of
2014. What are some specific benefits or ROI resulting from its implementation? 1) Improvement in
clinical outcomes Adoption of EHR can derive a great amount of benefits in clinical outcomes such
as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such
as patient safety, effectiveness, and efficiency. Patient safety is defined as 'avoiding injuries to
patients from the care that is intended to help them'(Menachemi and Collum, 2011, p. 49). Often
times, lack of time can contribute to omission of asking patients important questions such as drug
allergy information and confirming important patient identifiers such as addresses/phone numbers.
Improvement of medication error is a well–noted benefit of EHR as seen in numerous researches.
According to a study, researchers found that a CPOE system was contributory in reducing serious
medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported
similar findings in patient safety improvement. When e–prescribing is used, prescriptions can be
checked for any drug interactions with

The Importance Of Non-Adherence Among Patients With...
Application to Clinical Practice Non–adherence has adverse implications in regards to a variety of
clinical conditions. Cardiovascular disease is a serious healthcare issue and accounts for
approximately 1 million deaths annually in the United States. In addition, approximately 5.7 million
people in the United States suffer from some form of cardiovascular disease. According to Iuga &
McGuire (2010), non–adherence among patients with cardiovascular disease stands at about 50%
and causes adverse progression in the intensity of cardiovascular–related complications. Non–
adherence among patients with cardiovascular disease is the leading cause of death. Medication is
the primary form of treatment for patients with cardiovascular diseases. ... Show more content on
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Such reminders continually remind the patient as well as their families and caregivers on their
medication schedules. The information is also relayed to the primary physician who records and
makes necessary amendments to meet the exact needs of the patient (Kolandaivelu et al, 2014). The
second intervention is through patient education and outreach. Patients diagnosed with
cardiovascular disease should undergo extensive education in regards to their disease and
medication. Patients should be educated on self–management strategies and how to incorporate
medication into their daily lives. In addition, the families, friends and primary caregivers of patients
with cardiovascular disease should be educated on the importance of adherence and side effects on
non–adherence. Healthcare providers should educate the patients as well as their families by
breaking down the complex medical terminology associated with the treatment and knowledge of
cardiovascular disease. Finally, healthcare professionals should directly and indirectly reach out to
patients with cardiovascular disease, particularly the elderly. The patients should be provided with
medication as well as disease and medication education (Kolandaivelu et al, 2014). The second
healthcare condition is in regards to HIV regimen. Patients diagnosed with HIV are required to have
an adherence rate of 95% to antiretroviral therapy to ensure that they have a strong immune system
and that the disease

Birth Control : The Harm Effects Of Birth Control
Harming the Hormones
According to Professor Janet E. Smith, "98% of all women ages 15–44 have used some type of birth
control." Birth control is not something most women think hard about taking. In today's society,
many people rather take the easy way out of most situations. Instead of dealing with short term pain
they rather seize it immediately without paying attention to the long–term effects. Birth Control is
used for many different reasons such as preventing pregnancy, clearing acne and stopping heavy
blood flow. Once women see what good it does for them they do not even pay attention to the bad,
which is where those long–term effects come in. Some harmful side effects of birth control are
weight gain, heavy bleeding, and Osteoporosis. Just like any other medication it can be helpful and
harmful but in this case birth control is more harmful to a woman's body than it is helpful.
Birth Control is a global contraceptive that has been in use for more than 50 years. When Birth
Control first came about in 1960 it was approved for married couples only, now over 10 million
women married or single use this method. Most women complain about the harsh side effects of
birth control but they rather put up with them before they risk having an unplanned pregnancy. Side
effects such as weight gain and mood changes play a major role in the decision of birth control use.
There is a saying that says, "If you knew better you would do better" most women do not even know
better so they

How Do Nurses Affect The Job Of A Nurse?
Problem Statement
The job of a nurse can be physically and mentally demanding. Nurses must be alert and focus on
every aspect that pertains to a patient's care. Patients are admitted into the hospital with varies
conditions, so nurses must be able to adapt to each situation. Nurses are expected to deliver quality
care without any complications and each shift should be error free. Nursing errors may include but
are not limited to medication errors, patient safety, and documentation errors. When working twelve
hour shifts, managing different patients and being exhausted the risk for medical error increases.
Being overworked causes many nurses to be dissatisfied with their job which reflects their
performance. The performance of a nurse is an essential factor in being able to ... Show more
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Even with this being the goal, medical errors occur and the number of adverse outcomes increase
yearly. A significant amount of medical errors is the result of nursing errors, causing harm to patient
and an increase in treatment expenses (Hashemi, Nasrabadi, & Asghari, 2012). It has been found
that one in three patients that are admitted into the hospital will experience a medical error (Classen,
et al, 2011). This alone proves the change needed to create a safer environment for patients,
regardless of the medical error severity. To combat this issue, the types of medical errors must be
identified. There are three categories of errors should be considered by healthcare facilities: errors
that harm the patients, errors that do not result in harm of the patient and errors that may harm but
are diminished before reaching the patient (Hashemi, Nasrabadi, & Asghari, 2012). An explanation
must be made for these three categories in order to find a solution and stop them from occurring
again. Another crucial factor in battling medical errors, is to determine whether or not they are being
report and nurse's definition of an

The National Transitions Of Care
The purpose of this paper is to bring forth awareness when it comes to patients and medication
errors and further educates health care professionals on the importance of communication especially
during transition of care. According to Williams and Ashrcoft (2013) " An estimated median of 19.1
% of total opportunities for error in hospitals." Although not all medication errors occur during
transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace
(2015) "An estimated 60% of all medication errors occur during transition of care. The National
Transitions of Care Coalition defines a transition of care as the movement of patients between
healthcare locations, providers, or different levels of care within the same location as their
conditions and care needs change, [and] frequently involves multiple persons, including the patient,
the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s),
physician(s), and other providers." When it comes to medication errors several things may occur
such as adverse drug event, unexpected deterioration, and even death in severe cases. AHRQ (2015)
states, "an adverse drug event (ADE) is defined as harm experienced by a patient as a result of
exposure to a medication, and ADEs account for nearly 700,000 emergency department visits
100,000 hospitalizations each year." There are many ways that errors may occur such as dispensary
errors, prescription errors

Medication Administration : A Multi Step Process That Is...
Medication administration is a multi–step process that is handled by multiple healthcare
professionals. It begins with the prescription that is transcribed mostly by the physician, then
dispensed by the pharmacist, and ends with the administration of the medication by the nurse.
Throughout this multi–step process, medication errors can occur at any stage of the medication
administration process. As expressed by L. Cloete in "Reducing medication errors in nursing
practice," "One third of the errors that harm patients occur during the nurse administration phase:
administering medication to patients is therefore a high–risk activity." Because the nurse is
responsible for administering medication to the patient, he/she is considered and viewed as the most
accountable in regards to the patient's safety. Medication errors are one of the most common
medical errors that can result in an adverse event that may pose a serious threat to the patient's
safety and well–being. In the article, "An inside look into the factors contributing to medication
errors in the clinical nursing practice," Savvato and Efstratios defined and characterized medication
error as "any preventable event that 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.
Such events may be related to professional practice, health care products, procedures, and systems,
including prescribing; order communication;

Risk Management Helps to Prevent Errors Essay
Ways that the risk manager could prevent this type of event happening in the future would be to
establish and maintain a functional pediatric formulary system with policies for drug evaluation,
selection and therapeutic use. To prevent timing errors in medication administration, standardize
how days are counted in all protocols by deciding upon a protocol start date. Limit the number of
concentrations and dose strengths of high alert medications to the minimum needed to provide safe
care. Assign a practitioner trained in pediatrics to any committee that is responsible for the oversight
of medication management. Develop preprinted medication order forms and clinical pathways or
protocols to reflect a standardized approach to ... Show more content on Helpwriting.net ...
On the management side of the event would include: the charge nurse, director of the unit, risk
manager, and the CEO of the organization. An event of this significance would catch the attention of
numerous management staff, due to the legal action that could be taken from the parents. The Joint
Commission, Medication Errors Reporting program, and The National Council for Medication Error
Reporting and Prevention would be the organizations involved to report the event to and aide in the
prevention of it never happening again. This type of an event could catch the eye of the media. If the
hospital were completely honest to the parents of the mistake, they could report it to the media for
awareness of the fault of the organization, sympathy or education for prevent this event happening
again. Active failures are the unsafe acts committed by people who are in direct contact with the
patient or system. The forms vary but they are easier to pinpoint such as: slips, lapse, fumbles,
mistakes, and procedural violations. Active failures have a direct and usually short lived impact on
the integrity of the defenses (Reason, 2000). Active failures are the main issues that stand out when
a risk happens. Latent conditions are the inevitable "resident pathogens" within the system. They
arise from decisions made by designers, builders, procedure writers and top level management.
Latent

The Importance Of Ethics In Nursing Ethics
Ethics is a science relating to moral actions and individual value system. It is a study of what
person's conduct and actions ought to be regarding self, another human being, and the environment.
Nonmaleficence is a duty not to harm (McEwan, 2017, p.269). In nursing, our primary
responsibility is to make sure that our patients are kept safe from harm. It is our primary duty and
responsibility that we take when we care and treat the patients. This paper will discuss three risk
management steps that could minimize patient injuries and death, the importance of reporting an
error, and the essence of tort in the nursing practice. According to Potter, Perry & Hall (2009), "
Risk management is an organization's system of ensuring appropriate nursing care by identifying
potential hazards and eliminating them before harm occurs" (Potter, Perry & Hall, 2009, p. 305).
Nurses play a vital role in risk management. The evolving nature of primary care meant that nurses
have to take roles that were previously assigned to other healthcare team members with those roles
comes with a higher level of risk. Medical errors such as medication administration, blood
transfusion, and surgeries are the most common area where medical errors happen. Drug
administration is an essential part of the nurse's role. It is a nurse's responsibility to administer right
medications to the right patients, but medication errors are a persistent problem that is related to
nursing practice. Medication errors

Medical Errors And Unsafe Care Harm
Medical errors and unsafe care harm and kill thousands of Americans each year. Approximately two
million healthcare–associated infections occur annually in the United States, accounting for an
estimated 90,000 deaths and more than $4.5 billion in hospital healthcare costs (Patient Safety,
2015). Safety is one of the six competencies the QSEN faculty and National Advisory Board
explained to be initiated in nursing pre–licensure programs in order to increase the quality and
safety of healthcare systems. Safety in healthcare decreases risk of harm to patients and providers
through both system effectiveness and individual performance. The integration of safety in
healthcare, which is important for future nurses to utilize in practice, can be ... Show more content
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With clinical expertise, a nurse can identify gaps in care that would result in critical patient
outcomes and fix the gaps in time. Nurses are accountable for speaking up for patients in situations
when safety issues arise. For example, when there is a breach in sterilization and a nurse notices the
breach, the nurse is accountable to bring awareness of the breach to the staff no matter who is
responsible or what the nurse who notices the breaches position or seniority may be. If a medical
error hurts a patient, then the involved organization and nurse is accountable and needs to take
responsibility. "Providing education about participating in crucial conversations and reviewing
culture principles could improve a team's ability to speak up and be accountable" (BattiÉ, &
Steelman, 2014). Being accountable and taking responsibility means informing the patient of the
error and damage it caused, apologizing and providing care for the injury or illness, performing a
root cause analysis of the error, and learning from the analysis by keeping the error from occurring
again. A root cause analysis needs to be done after the error occurs. All staff associated in the error
must participate in the analysis in order to keep speculation from happening that will cover up the
facts. The goal of the analysis is not to blame an individual for the error, but rather to make changes
to keep the error from happening again. Nurses are the most trusted

Ethical And Legal Implications Of Making A Mistake Essay
Making a mistake is part of human character regardless of a person's career. While it is almost
probable that one will make mistakes in their place of work, it is the act of taking responsibility for
these mistakes that really counts. When one makes an error occurs in the course of writing a drug
prescription to a patient, he or she needs to consider the ethical and legal implications of this act on
the laws, for instance in Texas. One needs to carefully consider what the law says about the resulting
consequences of disclosure and non–disclosure of the said error. Furthermore, one should consider
how the mistake will affect one's career as a nurse in the State, the health of the patient and how the
medical facility will also be affected. Many patients have suffered due to medical errors and never
get to know of such, this is due to the fear by the health professionals that they might face a lawsuit
if they admitted to these errors. In Texas, the State recognized that medical errors are a reality and
that by reporting them, they mitigate recurrence of these errors in the hospitals. The State came up
with a patient safety program through developing a medical reporting program that was enacted into
law on June, 20, 2003.The program mandates the reporting of medical errors (adverse events) by all
the hospitals, ambulatory surgical centers, and mental hospitals in the State. The Texas Board of
Nursing is mandated to regulate all nursing practices in the State. Section 301. 010:

Medical Errors
Medical errors have adverse effect on health care organization structure because it put a question
mark on health profession's reputation. The medical error definitely can cause harm to the patient or
even the death. Medical errors can happen anywhere in healthcare system: in hospitals, clinics,
surgery rooms. Medical mistakes can arise from doctors, nurses, surgeons, hospital administration,
and many others. Medical errors affect the health care organizational structure, culture, and social in
many ways. Medication errors have severe direct and indirect effects on health care organizational
structure, and culture is usually the outcome of breakdowns in a system of care. Many reasons can
involve in medical errors such as, miscommunication ... Show more content on Helpwriting.net ...
* * * * * * * * * Identify and describe a health care news situation that affects a health care
organization such as a hospital, clinic, or insurance company.
* Examine and evaluate how organizational structure and governance, culture and focus (or lack of
focus) on social responsibility affected or influenced what happened.
* Recommend what resources will be allocated to prevent this situation in the future and what
ethical issues may be tied to this decision.
Recommend how you would change the structure, governance, culture, or focus on social
responsibility to prevent this situation in the future.
Evaluate the effect of organizational structure and governance, culture, and social responsibility
focus on what happened in your chosen situation. Recommend how you would change the
organization to prevent this situation in the future. Include the following components:
Many causes can involve in medical errors such as, miscommunication of drug order, mistakes
made in medication, surgery, similar medication names, laboratory results and diagnosis to name a
few.
The "naming, blaming, and shaming" approach to dealing with errors has hindered medical error
reduction, yet it is the most commonly used approach to addressing errors in health care
(koop,1999).
The use of scanning medications is an

Dissociative Identity Disorder ( Dissociative Personality )
Dissociative identity disorder (previously known as multiple personality disorder) is thought to be a
complex mental condition that is likely brought on by numerous variables, including serious injury
amid early adolescence generally compelling, repetitive physical, sexual, or psychological
mistreatment. The greater part of us have encountered mild dissociation, which resemble wandering
off in fantasy land or losing all sense of direction at the time while taking a shot at an undertaking.
In any case, dissociative personality issue is an extreme type of separation, a mental procedure
which delivers an absence of association in a man 's musings, recollections, emotions, activities, or
feeling of character. Dissociative character issue is thought to originate from a blend of components
that may incorporate injury experienced by the individual with the confusion. The dissociative
viewpoint is thought to be a method for dealing with stress – the individual actually separates
himself from a circumstance or experience that is excessively brutal, traumatic, or difficult to absorb
with his cognizant self.
The DSM 5 elaborates on cultural background as an influence for some clinical presentations of
DID. Numerous components of dissociative identity disorder can be affected by the individual 's
social foundation. People with this issue may give unmistakable restoratively unexplained
neurological side effects, for example, non–epileptic seizures, incapacitates, or tactile misfortune,

Is Medical Errors A Medical Error? Essay
In part one of this assignment, we took a closer look at medical errors, including why errors occur,
and what is considered to be a medical error. In the busy clinical setting, nurses are often interrupted
by phone calls, patients, and even other staff members. Research shows that medical errors are now
one of the top three leading causes of death within the United States, therefore it is time to work on
addressing this problem (Daniel, 2016). Theory in nursing provide the "basis of understanding the
reality of nursing; it enables the nurse to understand why an event happens" (McEwen & Wills,
2014, p. 413). In part two, we described how the middle–range nursing theory of nursing intellectual
capital could be applied to medical errors and potentially help to prevent them from occurring in the
future; even with the demand to lower health care costs. In this final paper, we are going to take a
closer look at how we can apply the borrowed theory from W. Edwards Deming on quality
improvement to decrease medical errors. We will discuss how Deming's theory can be applied to
address this issue, along with the origins and other applications of Deming's theory.
Overview of the Issue
Throughout clinical practice environments there is always interruptions and distractions that take
place. Whether it is a phone call, a patient coming up to the desk, or even coworkers, nurses are
constantly multitasking and getting interrupted which causes medical errors to occur. A medical
error is a

Descartes 's Meditations On First Philosophy
In Meditations on First Philosophy, Descartes introduces the dualistic idea of a sharp split between
mind and body. This mind–body split is a Western secular idea and discounts many important
aspects of the human experience. Descartes argues that, "...a body, by its very nature, is always
divisible. On the other hand, the mind is utterly indivisible" (Descartes, 56). This idea that there is a
distinct difference between the mind and the body is nonsensical from both a phenomenological and
a scientific perspective. Furthermore, it is a very privileged point of view. Descartes was first and
foremost a scholar. Before dedicating his life to philosophy, he worked with analytic geometry and
analytics. In many ways, Descartes was spared experiences that might have caused him to reassess
his thoughts on the split between mind and body. Unlike the example of the man with an amputated
foot that Descartes uses in Meditations on First Philosophy, Descartes did not lose a limb. If he had,
he may have realized that the mind is just as divisible as the body, as is the case with traumatic
experiences. Based on the theoretical possibility that Descartes is wrong, it follows that mind and
body are essentially the same. This can be seen through a cognitive perspective of human
experience, and in particular, the application of modern neuroscience.
Take, for example, the neuroscientific phenomena of the Placebo Effect. The Placebo Effect occurs
when a fake treatment with no active ingredients

Abnormal Psychology : Dissociative Identity Disorder
Abnormal Psychology: Dissociative Identity Disorder
Dissociative Identity Disorder, previously referred to as Multiple Personality Disorder, is a
psychological illness that has raised a lot of controversy and led researchers to question its validity.
This disorder has been recorded as early as the 1800's, but has recently been given more attention to
by clinical researchers because of its diagnosis rates. The brain is a very complex organ and certain
traumas can lead to the occurrence of this illness. Dissociative identity disorder is an illness in
which individuals develop two or more very different personality states. In this paper, I will explain
the causes of dissociative identity disorder, outline the symptoms, and elaborate on the ... Show
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Interestingly, women are three times more likely to be diagnosed with dissociative identity than men
and only one percent of the world's population develop the disorder. In women, the number of
subpersonalities that can be involved in a single diagnosis is fifteen whereas in males it is eight. The
subpersonalities often have their own themes and there is always a host, the high functioning
personality; a child, specifically at the age in which the individual experienced the traumatic event;
a hedonistic, the personality that operates on the pleasure principle; an aggressive identity, the
personality that serves as a protector to the host; and a subpersonality of the opposite sex, this
identity is obvious through the change of tone in the individual's voice. The subpersonalities can
either maintain a relationship with one another or be completely unaware of each other's existence.
Mutually amnesic relationships, one way amnesic relationships or mutual cognizant patterns may be
present with this disorder (Comer, R. J., & Whiteford, F. 1998). Mutually amnesic relationships are
relationships when the subpersonalities have no awareness of each other; they believe they are the
only personality present. A one way amnesic relationship is when only some subpersonalities are
aware of each other, but others are not. The subpersonalities that are aware of one another will
observe the thoughts and actions set out by

Medical Technology And The Future Health Of The Human Race
Disabilities and illnesses inhabit healthy lives, and without research and experimentation, there is no
effective way to fight against them. In like manner, medical technology does not yield to other
complications, such as those presented in the working environment of hospitals and nursing homes.
Though some may argue that medical technology is too expensive, there is no monetary value to the
future health of the human race. Medical technology does not fail to increase general health,
productivity in the workplace, and more importantly, save lives. According to the CDC, in 2014,
almost three million people died last year from illness in the United States. Without medical
technology integrated into everyday life, more people will suffer ... Show more content on
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Adding to that, an ambitious dancer, Adrianne Haslet–Davis, received an advanced prosthetic leg
and was then able to continue her career aspirations without a medical complication holding her
back. By expanding the amount of medical technology in day–to–day health care, it is safe to say
that more people will have the ability to live longer, happier lives. Without the recent development
in medical prosthetic technology, people would have to sustain suppressing disabilities such as
blindness and deafness that can be completely cured today.
Medical technology leads to better overall health in today's lives. According to the
Medical Technology in Canada, with improved technology, trauma, hospital stays, and casualties are
reduced. By the same token, neurological outcomes in surgery are significantly increased by the
same factor. Neurological surgery is extremely dangerous, complications post–surgery are common
and can be life–threatening, leading to disabilities and comas, or worse, death. As medical
technology aids the healthcare industry, everyone is to benefit from it. In that, with enhanced
hospital treatments, surgical results, and lower mortality rates, the reliance upon medical technology
is critical to millions of lives. Without this development of technology, one can conclude that many
lives would be affected by increased trauma, casualties, and longer hospital stays. Medical
technology

Pharmacological Intervention Assignment : Patient X
The situation that was chosen for this pharmacological intervention assignment is the case of Patient
X, a 35 year–old male with a history of recurrent sigmoid diverticulitis who has opted for elective
laparoscopic sigmoid hemicolectomy. In conjunction with his surgery, he will be starting a regimen
of alvimopan (Entereg) to prevent the development of postoperative ileus. His situation fits into the
perioperative clinical focus of nursing practice because the dosing recommendations for alvimopan
include beginning the first dose preoperatively, 30 minutes to 5 hours prior to surgery (Erwele,
2008). This assignment will include an assessment of the patient, the establishment of a broad
behavioral outcome and specific behavioral objectives ... Show more content on Helpwriting.net ...
Because of the significant interference these recurrent episodes are having on his life, and with
understanding of the risks, benefits and alternatives of the procedure, he has consented to proceed
with laparoscopic sigmoid colectomy, including a pharmacological regimen of alvimopan. Common
adverse effects of alvimopan include nausea, vomiting and abdominal distention (Erowele, 2008).
Preoperatively, he denies nausea and vomiting, and his abdomen is soft and mildly tender in the left
lower quadrant. Per his laboratory studies, Patient X has normal hepatic and renal function. He is
not obstructed and is not taking opioids for analgesia. Though he is able to perform his activities of
daily life independently, the fact that alvimopan is only available to patients who are hospitalized
dictates that, per Orem's Theory of Self–Care, he has a self–care deficit that can be met by the
supportive–educative nursing system (Necor, 2014). Broad Outcomes
By the end of a 20–minute teaching session, Patient X will be able to describe why he is being
prescribed alvimopan, the potential side effects, and what he can do to minimize the impact of
potential adverse effects.
Specific Objectives
Objective One: By the end of a 20–minute teaching session, Patient X will be able to express the
outcome he hopes for from his

Medication Barcode Scanning Essay
Medication Barcode Scanning (MBS) has been considered as one of the significant ways of
reducing medication error. It begins from when medication is ordered by the doctor, a pharmacist
reviews the order prior to supplying the medication to the nurse who then administers the
medication to the patient (Department Veterans Affairs, 2003)). Study stated that from about
450,000 drug adverse effect that occur yearly, about 25% would be avoided with the use of certain
technologies like medication barcode scanning (Bates, Cullen & Laird et al, 1995). According to
Seibert, Maddox, Flynn & Williams (2014), technologies like "automated dispensing cabinets,
computerized prescriber order entry (CPOE), "smart" computerized I.V. infusion pumps, ... Show
POC simply means scanning patient's medication at bedside before administering medication. This
enhances safe practice by making sure that the patients take the right medication observing the five
rights of medication administration (Waxlax, 2015). It is also important to note that medication with
dosage formulation such as insulin, medications in the form of ampules, ointments and creams, to
mention but a few need to be paid attention to as this will improve the practice of POC scanning
leading to error reduction during medication administration (Waxlax, 2015). For instance
medication in the form of ampules are titrated in the medication room. As a result of not preparing
the said medication at the patient's bedside, the nurse cannot be able to scan the barcode because
he/she does not have it at that time. To accomplish the practice of POC scanning, "butterfly flag
labels" with the appropriate barcode, can be placed both to the ampule and the syringe so that when
the ampule is opened, then the nurse can take the label from the ampule and the syringe to the
patient's bedside for scanning before administering the medication (Waxlax,

Risk Management : An Organization Of Patient Safety
According to ECRI Institute (2014), risk management did not emerge as a distinct profession in
healthcare, primarily in the hospital environment, until the mid–1970s, when the number of
malpractice claims against physicians and hospitals increased dramatically, and settlements and
judgments skyrocketed. In 1977, the American Hospital Association encouraged hospitals to
implement risk management programs as a solution to malpractice problems, calling risk
management the "science for the identification, evaluation, and treatment of the risk of financial
loss" (Dankmyer and Groves; Holloway and Sax). Risk management's focus was to protect the
financial assets and reputation of organization (Kuhn and Youngberg). During the patient safety ...
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According to Mrs. Parker, Memorial Hospital of York "Is dedicated to excellence in healthcare for
our community. We believe that a comprehensive quality improvement program is a primary means
of organizational goals and promoting our mission of providing the community with an array of
high –quality health care services." Memorial hospitals promote and adopt the six aims for
improvement as identified by the Institute of Medicine; 1. Safe, 2. Effective, 3. Patient–centered, 4.
Timely, 5. Efficient, and 6. Equitable. The six aims for improvement set forth by the Institute of
Medicine are the basic foundation for Memorial Hospital structure of the Quality program.
Memorial Hospital of York, defines quality as a never–ending cycle of continuous improvement
(parker, 2015). They accomplish this goal by proactively identifying and improving systems causes
of medical errors. Some goals of the hospital quality program include; improving the quality and
safety of patient–care processes and outcomes and to organize data into useful information,
including comparison to an internal and external data source, among other few, (parker, 2015). All
employees and departments are expected to be actively involved in the program, the Board of
Trustees, Administration, Department Leaders and leaders of the organized

Implementation Of An Electronic Prescribing System
In order to obtain relevant information for implementing an electronic prescribing system, a variety
of sources were reviewed. As the HITECH Act nationwide was contributory to the recent surge of
adoption for e–Rx systems, the focus of the research was to find research data reflective of
successful implementation and practical guidance. In order to extract retrieve necessary information,
a variety of sources were reviewed; journal articles, review articles, meta–analysis, and national
guidelines on implementing e–Rx systems. Due to the heightened interest for this particular topic,
there is a lot of valuable information and guidance available regarding adopting electronic health
records (EHR) and e–prescribing systems on HealthIT.gov website and Center of Medicare &
Medicaid Services websites. In order to analyze different aspects of e–prescribing, five key areas
were reviewed in depth. The five areas consist of return on investment for implementing an e–Rx,
current landscape of e–Rx systems, barriers to e–Rx's across the board, necessary steps in ensuring
successful implementation of e–Rx systems among providers, and current situation at the VA.
Understanding the five elements can better equip and engage stakeholders as they prepare for
implementation of an e–Rx system. Without establishing a solid understanding and weighing all the
pros and cons, the pursuit of an e–Rx system may not guarantee a buy–in from its stakeholders,
resulting in a set–back or even a failed

Benefits And Treatment Of Dissociative Identity Disorder
Diazepam Paired With Psychotherapy Dissociative Identity Disorder is a disorder that is hardly
talked about, however has extreme effects on patients that suffer with it. However, this topic is
important because it can lead to finding treatments that may be more effective for patients with DID.
Past studies have shown that the main treatment for Dissociative Identity Disorder usually involves
therapy. The most popular types of therapy are psychotherapy, hypnotherapy, and family therapy.
Treatment for DID has a specific purpose which is to unite an individual with their personalities,
and form a functional identity (Pais, 2009). Additionally, a strength of past studies is that they
usually do a follow up on patients. Another strength is that the participants are usually all of
different ages. One limitation is that there is never enough participants for research, another
limitation is that there aren't many treatment options to try on patients. Furthermore, is diazepam
useful when paired with psychotherapy? Moreover, my study will be unique because there has only
been one case that tried lorazepam, which is a similar drug to diazepam, and it proved to be
successful (Mushtaq, Shoib, Arif, Shah, Mushtaq, 2014). Also, my study will have more than one
patient, to have more accurate results. Finally, diazepam and psychotherapy could be a good
treatment for DID. Method
Participants/Subjects
It

System evaluation paper
System Evaluation Paper
Donna Jackson
CIS/207
October 6, 2014
University of Phoenix
MGD is an automated pharmaceutical management product and service for hospitals and healthcare
facilities in the United States, Europe, and the Middle East (Bloomberg Business Week, 2014). Its
automated medication dispensing systems include ServeRx system, which involves automation
software, medication and supply cabinets, bedside solutions, and computerized order entry devices
for medication management (Bloomberg Business Week, 2014). The computer also offers order
entry module that promotes patient safety by eliminating transcription errors and providing real–
time information at the patient's bedside ... Show more content on Helpwriting.net ...
A tower of many small drawers stands next to a computer screen and a solution closet. In those
small drawers is a variety of commonly used drugs in a hospital which are still supplied by the
pharmacy technician daily. Once the doctor has placed the orders into the hospital information
system they go to the lab, pharmacy, and every department that is involved with the care of the
patient. This action alone will remove several hours from the admission time of the patient.
The medicine dispensary automation system helps increase pharmacy staff efficiency, support
prevention of medication errors, and provide documentation for regulatory compliance (PINT,
2011). The computerized systems combine the power of pharmacy carousel systems and bar code
packaging to automate the inventory ordering, receiving, stocking and picking processes (PINT,
2011). The right medications are stocked in the right locations, and that security is maintained for
controlled substances (PINT, 2011).
As the hospital has gained popularity and become more accepted by society in the last two decades,
with more sick people the industry has had to make changes in order to keep up with supply and
demand. The enterprise has required better organization than ever with more people taking hands
full of medicine per day. The entire world is looking for a nurse to make a mistake with
medications, so it seems. The many stipulations and rules that the nursing staff faces meeting

Post Traumatic Stress Disorder, Schizophrenia, And...
The Uninvited is the typical horror–thriller style movie. It has a good set of characters, an intriguing
plot and an absolutely crazy ending. It makes for a very entertaining movie for the lay person to
enjoy, but what if someone looks deeper into the movie? This movie is full of twists, turns, and
psychological disorders. The main character in the movie, Anna, witnessed her mother dying. From
this tragic event, she developed multiple psychological disorders. The main three that this paper will
be elaborating on are Post Traumatic Stress Disorder, Schizophrenia, and Dissociative Identity
Disorder. All three of these are very serious, but all in there own way. First, there is Post Traumatic
Stress Disorder, also known as PTSD. This is a disease that develops after a terrible event happens
in the victim's life. Some of the main symptoms of PTSD include reliving the incident, including
flashbacks, nightmares and triggers, avoiding the situation including places and other incidents
where they face similar situations, and feeling keyed up, including having a hard time concentrating
and sleeping (Besser 2015). In the movie, the main character, Anna, watches her family's boathouse
explode, killing her mother. This is a tragic event that stuck in her. This event caused her to have
PTSD. Throughout the movie, she has nightmares about the night that she watched the boathouse
explode. When she sees Rachel, her dad's new fiancé, this triggers her to think about the night it all

Medical Errors And Health Care
Every day, millions of people enter some type of health care facility seeking medical treatment.
They go to these places because they trust the physicians, nurses, and all other medical personnel
are there to provide them with adequate, quality care with hopes that they will be discharged in a
healthier state. Inadvertently, each day millions of people entering these facilities and experiencing
more complications than expected due to some type of medical error. Medical errors are becoming
more and more frequent every day and its costing patients more than ever. Medical errors have
become one of the major focuses of the health care industry since the Institute of Medicine released
its report in the year 1999, The Err Is Human. During that time there was an estimated ninety eight
thousand people dying a year in hospitals due to medical errors. Naturally this struck fear into
people and caused many to question a lot of things being done in health care facilities. According to
more recent studies, it has been noted that as many four hundred and forty four thousand people die
each year from a preventable medical error. That is only the death toll as a result of a medical error,
not the actual number of individuals that endure a medical error each year. With statistic numbers
like these, health care facilities are sacrificing large numbers of patients that equal out to the number
people within fairly large cities and states. With this number of people dying alone as a result of

Health Care Case Study
Is there a change needed and why? Having an increase in medication errors is evidence that change
is needed. Patient safety takes priority in the care of a patient. Safety is part of Maslow's Hierarchy
of Needs. If safety of a patient isn't met first, the patient can have poor outcomes during their
recovery. Patients experiencing adverse reactions from medication errors not only affects their
safety, but can become a financial burden on them. If a patient has an adverse reaction that affects
their health/illness, they may need to stay hospitalized longer, increasing their hospitalization cost.
Increase in medication errors is never a good situation, but in order to decrease the errors, Sarah
must implement change. Change will help improve ... Show more content on Helpwriting.net ...
For example, I would collect the data from reported adverse medication reactions, put the data into
the chart and compare the data to other type of medication error results in the chart. Putting data into
the chart would allow me to see which forms of medication error results is occurring the most. The
chart strategy will help indicated what type of change would be needed in order to minimize the
results of medication errors.
What questions would you ask? List at least four questions. What type of outcomes are patients
having as a result to medication errors?
How are the complications of influenza on first time patients, affecting medication errors?
How many times are medications being prescribed inappropriately? (for pharmacist)
What medications are being prescribed that are causing the most adverse effects?
Are there other implications to the increase in med errors? Such as workload, staffing, patient
acuity, etc.
At what point would you involve other individuals, and why? Involving other individuals from the
beginning would be important. By involving others into the issue from the start, it will create a team
of people who would be able to provide input to why the issue is occurring. From the time the issue
is known, having many people involved provides more resources to investigate reasons on what is
causing medication errors. Involving others as soon as possible can help find resolutions early
before the problem continues to grow. Having others

Atul Gawande Rhetorical Devices
"Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are
due to medical error..." (John Hopkins Medicine). This soaring number has caused medical errors to
become the third leading cause of death in the United States. For many people, medicine seems
foreign and unknown. People who have lost loved ones due to medical error desperately look for a
reason, and many times that blame falls upon doctors. Media has put a negative connotation on
doctors as well, causing their reputation to plummet whenever a hospital procedure turns badly. A
renown surgeon and author, Atul Gawande, uses his knowledge and experience to give people a new
perspective on medicine. In the article "When Doctors Make Mistakes," Gawande uses rhetorical
appeals: ethos, pathos, and logos to prove the need for a change in the medical systems and
procedures. He analyzes how the public looks at doctors, giving a new perspective to enlighten the
reader that even the best doctors can make mistakes. Gawande builds a connection with his audience
through credibility. The reader is able to have a better understanding of his work from his
experience in the medical field. Gawande accomplishes this by breaking down the process during a
medical procedure, "The first step in caring for a trauma patient is always the same...The first thing
you do is make sure that the patient can breathe without difficulty" (3). This explanation allows the
reader to realize the importance of specific

Organizational Systems Task 1
Organizational Systems Task 1
Western Governors University
Task 1
A. Nursing–sensitive indicators
By understanding nursing sensitive indicators, the nurses in this case could improve the structure,
process, and outcomes of their nursing care. The structure of nursing care is indicated by the supply
of nursing staff and the skill level of the nursing staff. By the nurses having increased knowledge of
the issues hip fracture patients are prone to having, such as decrease mobility, increase need for
surgical intervention, and increase risk of falls, could help improve the quality of patient care. A
patient with decrease mobility is at higher risk for pressure sores. The nurses in this case may have
prevented the one by proper ... Show more content on Helpwriting.net ...
Now, the quality improvement department will need to determine what processes can be modified to
improve outcomes. For example, if they see an increase in pressure sores and prevalence of
restraints. They could use computerized charting and order entry, along with the evidence–based
guidelines, to identify specific groups of patients who are vulnerable to developing pressure ulcers
or closely monitoring use of restraints. With early identification, automatic orders for preventive
interventions can be implemented quickly. With the assistance of the automated consults and orders,
the appropriate equipment, the interdisciplinary task force, continuing education, and monitoring,
the hospital system would be able to reduce unnecessary use of restraints and hospital–acquired
pressure ulcer prevalence rate (Cherry & Jacob, 2010).
Then, they would need to implement core measures and protocols. Continuously track performance
and outcomes. Lastly, they can disseminate results to throughout the hospital to increase quality
improvement (Cherry & Jacob, 2010).
By educating staff on nursing sensitive indicators and the issues that need to be addressed, could
advance the quality of patient care throughout the hospital. In this case, educating hospital staff on
ways to prevent restraint use and pressure sore prevention, the staff could have possible prevented
the use of restraints and the pressure sore. Also, by educating staff on how to use restraints would be

Overworking Nurses Results On Negative Patient Outcomes
Overworking Nurses Results In Negative Patient Outcomes A major issue in the medical career field
is the demand for nurses and this, of course, means that these nurses will be working strenuous
hours to meet the high demands. While this may satisfy some issues it also creates others. Longer
hours results in exhausted nurses and this leads to negative patient outcomes. Nurses have many
tasks to complete while they are on the job. While these tasks may be simple they can also be
harmful if done wrong. For example, nurses have to distribute medication to patients. If the nurse is
overworked and tired he/she may distribute the wrong medication or mishap and give them the
wrong dosage. Something so small can make a world of difference when it comes to the patient
especially, if the patient is suffering from fatal conditions. Another job that nurses partake is
transcription, meaning they have to "transcribe" what the doctor or physician says. This is extremely
important because if the nurse is not paying full attention they could miss a crucial part of what is
said. This, obviously, could lead to misdiagnosis or the wrong medication being prescribed. One of
the smaller tasks completed by nurses in charting. This could result in the same way as the
transcribing errors; the patient could be misdiagnosed or not treated to their proper illness.
"...Nurses working more than 12.5 consecutive hours were three times more likely to make an error
than nurses working shorter hours ....."

The Importance Of Artificial Stutrition And Hydration
I will argue that withdrawing artificial nutrition and hydration is not morally different from
withdrawing other types of life–sustaining treatment. I will argue the opinion using the ethical
principle of beneficence, researching medical treatments of artificial nutrition and providing
example of life–sustaining treatments that are equally in similar to artificial nutrition and hydration.
In the vignette of Ms. Conrad, I argue reasons for removing a Nasogastric Intubation (NG) to reduce
other medical complications that can occur, and the discomfort the tube could cause to the patient.
Life–sustaining treatment refers to all treatments which have the potential to postpone a patient's
death. Examples of such treatments include those of mechanical ventilation, dialysis,
cardiopulmonary resuscitation, antibiotics, and artificial nutrition and hydration. I believe that
withdrawing artificial nutrition is not morally different from other types of life–sustaining treatment.
Artificial nutrition and hydration is a medical treatment that allows a person to receive nutrients
when they are unable to take them by themselves. The treatment is provided by medical
professionals through an intravenous administration or by methods of inserting a tube in the
patient's stomach. The reasons why this particular treatment is not morally different is because the
procedure is at inconvenience to the patient; not at the patient's comfort. Artificial nutrition and
hydration does not offer the

Benchmarking Essay
Benchmarking:
A continuous process of measuring products, services and/or practices against the competition in
order to find and implement the best practices. Benchmarking process measures the organization's
internal processes by identifying, understanding and adapting to outstanding practices from other
organizations which are similar and considered having best quality performance.
Based on the data collected from Amerinet, a healthcare solutions organization and one of the
biggest healthcare group purchasing organizations in US; organizations that perform benchmarking
process have created a competitive environment by promoting improvement and growth, decreased
financial burden by 3% along with enhanced caseload by 10% and most ... Show more content on
Helpwriting.net ...
There are four broadly classified performance indications and priorities which are measured,
monitored and analyzed that are:
a. Hospital Performance Improvement Priorities (Sepsis Bundle Compliance, Hospital–Acquired
Infections, Pressure Ulcer Prevention, Patient Identification, Pain Management, etc.)
b. Medical staff–hospital wide improvement activities (Medication management oversight, Medical
record review, Quality management system, etc.)
c. Medical staff performance–specific indicators (Prescribing of medications, surgical case review,
Readmissions, Appropriateness of care, etc.)
d. Indicators per regulatory and accreditation requirements (Threats to patient safety, Medication
therapy/medication use, Operative and invasive procedures, Unanticipated deaths, Infection
prevention and control system, Customer satisfaction, etc.)
Measuring, monitoring and analysis:
Houston Methodist Hospital organizational monitoring and performance measures will be aligned
with regulatory standards and best practices, through the benchmarking from external databases
including physicians, nursing, and researchers. These initiatives are based on Houston Methodist
Second Century Vision and commitment to leading medicine.
The following processes is utilized to

Patient Safety In Health Care
Patient safety has been described as the prevention of errors and adverse effects to patients
associated with health care (WHO, 2016). Medication errors is a prevalent patient safety issue in
today's health care environment. It is estimated that approximately 10,000 preventable errors and
2000 preventable deaths occur in the Republic of Ireland alone. That means 1 in 10 people
experience a medication error once entering a hospital (Oglesby, 2012). Although some of these
errors may be minor many can be detrimental as some medication have more adverse symptoms
than others.
Clozapine is an atypical antipsychotic drug used in the treatment of schizophrenia. In particular this
drug is rather difficult to maintain due to its possible side effects

Research Paper On Cascade Iatrogenesis
"Cascade iatrogenesis is a series of adverse events triggered by an initial medical or nursing
intervention initiating a cascade of decline" (The Hartford Institute for Geriatric Nursing, 2005). A
combination of treatments may be needed in order to properly treat urinary incontinence. A
commonly used medication used to treat over active bladder and urge incontinence is
anticholinergics. Some examples of anticholinergics is oxybutynin (Ditropan XL), tolterodine
(Detrol), and darifenacin (Enablex) (Mayo Clinic, 2014). With each medication that is taken some
possible side effects include heart rhythm disturbances, cognitive problems such as confusion, and
dizziness due to postural hypotension. Other types of medications that are used include

Dissociative Identity Disorder In The Movie Shutter Island
It is vital to study psychological disorders since individuals all over are constantly diagnosed with
some form every day. In addition, by studying them, researchers will learn more about how to care
for these patients. One common disorder involves dissociative identity disorder, which is when a
person experiences multiple personalities (BOOK). In addition, this disorder involves some form of
break in the consciousness usually caused by trauma (book). By examining Leonardo DiCaprio's
characters in the movie Shutter Island, directed by Martin Scorsese, a viewer can see post–traumatic
stress brought on his Dissociative Identity Disorder. Teddy Daniels, also known as Andrew Laeddis
suffers from posttraumatic stress disorder as he produces symptoms in all three categories for
PTSD: flashbacks, avoidance, and hypervigilance. To begin this analysis, it is important to offer a
synopsis of the movie. The main character, Teddy Daniels, plays a 30–year old U.S. Marshal who
visits Ashecliffe Hospital for the criminally insane, with his partner Chuck, to investigate the
disappearance of a patient named Rachel Solondo. Rachel was admitted to the hospital after
drowning her three children. In addition, Teddy chose this assignment as a way to find Andrew
Laeddis, the man who set fire to his apartment, unfortunately killing Teddy's wife. Andrew Laeddis
is also the most dangerous patient at Ashecliffe. Throughout the movie a viewer sees Teddy
interacting with many people leaving behind

Elderly Population At Risk For Hospital Readmission
With a variety of trends that account for the increasing cases of the elderly population at risk for
hospital readmission, the authors discuss an in depth evaluation on why this occurs. Hospital
readmission, a growing health concern, tallied in a whopping $17 B in Medicare cost for unplanned
hospitalizations. Readmission, refers to a return to the hospital after discharge from a recent stay
where rates are reported mostly at 30, 60, and 90–day intervals after discharge. Even though the
elderly, aged 60 years or older, unfailingly represent the highest rate of hospital readmissions
compared to other age groups, according to the authors, readmission rates have been associated with
patient demographics, chronic conditions and utilization factors. Additionally, although the
aforementioned factors contribute to readmission, adverse events such as injuries that result from
hospitalization or at home like medication errors. According to (Robinson, Howie–Esquivel, &
Vlahov)
According to the authors, the elements that lead to most hospital readmission in the Elderly
population consist of sociodemographic and clinical characteristics, frequency of drug use,
individual patient level factors, visits to outpatient care facilities, and system–level factors.
sociodemographic factors encompass some of the hierarchical needs chart such age, sex,
socioeconomic status, education, social support, insurance type, financial status and access to or
availability of services. After research was

Medication Error In Health Care
Medication Error This reflection will reflect on an incident that happened during my clinical
placement. According to Gulland, A. (2013, Jul) the most frequent reported error in health care
settings are medication errors. The first stage of Gibbs (1998) model requires a description of
events. During my placement, I was working with a registered nurse in one of the hospital wards. I
was asked by the registered nurse to administer insulin to the patient. The nurse had already drawn
up the insulin and asked me to give it. I asked the nurse if she is sure about it and I was told that the
patient had been having it every day and has already been checked by another registered nurse.
After I gave the 24units of insulin, I was told by the registered nurse that I had just administered the
wrong dose of insulin as the correct dose was 2.4units and not 24units. Moving on to the second
stage of Gibbs (1998) model of reflection, whereby I will discuss my thoughts and feelings ... Show
After evaluating the incident, I found that the negative aspect of the incident was that after
administering the wrong dose of insulin the patient was at a major risk and that the duty of care was
not performed well. The positive aspects of this incident were that I learnt the importance of
checking the medication chart thoroughly and paying more attention to the numbers and units in the
chart. It is also safe to administer medication using the five rights of medication administration,
such as the right patient, the right medication, the right dose, the right time and the right route
(Medication Handling in NSW Public Health facilities, 2013). (Cheragi, Manoocheri & Eshani,
2013) have stated that medication errors tend to occur from nurses due to, tiredness, carelessness,
high workload, stress and poor communication and as well as having a poor knowledge and

The Medication Error Reporting Project

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