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Respond
As the unit director for the emergency department and part of an
ad hoc interdisciplinary committee formed to address rise in
medication errors it is important to include all stakeholders to
combat this issue system-wide. Ultimately, stakeholders are
known as our consumers or patients, however, we must take into
consideration the stakeholders of the organization; CNO, nurse
manager, pharmacist technicians, nurses, pharmacists, IT and
any member of the team that has access to medication rooms.
Stakeholders are not chosen by the organization, but rather
stakeholders choose to have a stake in the organization’s
decision making (Marquis & Houston, 2017). It is essential to
include all members of the organization because each individual
has their own vision and view toward their approach to
medication administration, medication verification, and the
technology used to do so.
I’ve worked in both adult health and currently in the
pediatric arena; one major difference to reducing medication
errors between specialties is highly regarding diabetes and
insulin and anticoagulants. To compare the two fields, in the
pediatric field our medication administration is calculated
weight based and in specific the sliding scale protocol is based
on caloric intake per meal. Each syringe of medication is drawn
and sent via tube from pharmacy, nurses are never to draw up
units from vials. This extra precaution and safety measure
(although medication checks are still necessary and double RN
checked) is put in place to reduce complications relating to
insulin administration. Medication errors often times occur
when layers of defense are not implemented correctly, when
teamwork is strong on a unit and resources are available, most
often another team member may catch the error before it occurs,
the Swiss Cheese Model illustrates exactly that (Aebersold &
Kalisch, 2016).
As different roles gather to overcome the medication
error prevention ad hoc, we must look into organizational
culture and organizational climate. Organization culture is
known as the total of an organization’s values, language,
traditions customs and certain aspects of the organization that is
not open for change (Marquis & Houston, 2017). With that
being said, the team will utilize effective, respectful
communication and transparency throughout the process.
Approaching medication errors with the intention to learn from
mistakes and find the “swiss cheese” effect is essential in all
departments involved. In short, the organizational culture can
be specific to one organization, including unique ways of
thinking and behavior. On the other hand, organizational
climate is how the organization is perceived. One employee may
perceive the organization in a positive light whereas another
may not. Leadership and management can influence their
employee’s perception of the unit or organization as a whole,
influencing perceptions through effective communication,
leadership style, culture of safety and transparency. Forming a
workplace culture where in the event of medical errors occur,
we must empower our nurses, respiratory therapists, pharmacy
techs and others to share the occurrences. Sharing events that
crossed the Swiss Cheese Model which draws attention to the
organizational efforts in reducing disparities, not necessarily
the individual involved.

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Respond As the unit director for the emergency department an.docx

  • 1. Respond As the unit director for the emergency department and part of an ad hoc interdisciplinary committee formed to address rise in medication errors it is important to include all stakeholders to combat this issue system-wide. Ultimately, stakeholders are known as our consumers or patients, however, we must take into consideration the stakeholders of the organization; CNO, nurse manager, pharmacist technicians, nurses, pharmacists, IT and any member of the team that has access to medication rooms. Stakeholders are not chosen by the organization, but rather stakeholders choose to have a stake in the organization’s decision making (Marquis & Houston, 2017). It is essential to include all members of the organization because each individual has their own vision and view toward their approach to medication administration, medication verification, and the technology used to do so. I’ve worked in both adult health and currently in the pediatric arena; one major difference to reducing medication errors between specialties is highly regarding diabetes and insulin and anticoagulants. To compare the two fields, in the pediatric field our medication administration is calculated weight based and in specific the sliding scale protocol is based on caloric intake per meal. Each syringe of medication is drawn and sent via tube from pharmacy, nurses are never to draw up units from vials. This extra precaution and safety measure (although medication checks are still necessary and double RN checked) is put in place to reduce complications relating to insulin administration. Medication errors often times occur when layers of defense are not implemented correctly, when teamwork is strong on a unit and resources are available, most often another team member may catch the error before it occurs,
  • 2. the Swiss Cheese Model illustrates exactly that (Aebersold & Kalisch, 2016). As different roles gather to overcome the medication error prevention ad hoc, we must look into organizational culture and organizational climate. Organization culture is known as the total of an organization’s values, language, traditions customs and certain aspects of the organization that is not open for change (Marquis & Houston, 2017). With that being said, the team will utilize effective, respectful communication and transparency throughout the process. Approaching medication errors with the intention to learn from mistakes and find the “swiss cheese” effect is essential in all departments involved. In short, the organizational culture can be specific to one organization, including unique ways of thinking and behavior. On the other hand, organizational climate is how the organization is perceived. One employee may perceive the organization in a positive light whereas another may not. Leadership and management can influence their employee’s perception of the unit or organization as a whole, influencing perceptions through effective communication, leadership style, culture of safety and transparency. Forming a workplace culture where in the event of medical errors occur, we must empower our nurses, respiratory therapists, pharmacy techs and others to share the occurrences. Sharing events that crossed the Swiss Cheese Model which draws attention to the organizational efforts in reducing disparities, not necessarily the individual involved.