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Nurses Are Critical to Preventing Medication Errors

Nurses are familiar with the "five rights" of medication: right patient, right drug, right time, right dose, right route. But a failure in any of the five rights can result in patient harm, even fatal outcomes. What can nurses do to ensure patient safety?

Plain and simple, studies show that nursing education is a major factor in patient outcomes, with higher levels of medication errors found in nurses prepared at the associate or diploma level rather than a Bachelor of Science in Nursing (BSN).

The good news is that online nursing programs are making it more convenient for RNs to advance their education and level of patient care. For example, Northern Kentucky University (NKU) offers an online RN to BSN program that prepares RNs with the skills today's professional nurses need.

What Are the Consequences of Medication Errors?

More than 380 million drugs were prescribed or administered in hospital emergency department visits in 2016, according to the Centers for Disease Control and Prevention (CDC). Humans make mistakes, but medication errors can result in patient deaths.

In the year 2000, the Institute of Medicine (IOM, now the National Academy of Medicine) reported that as many as 98,000 people were dying each year as a result of medication errors. Preventable medical errors were causing more deaths than motor-vehicle accidents, breast cancer and AIDS. A recent Johns Hopkins study also found that medication error is a leading cause of death.

According to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), a medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer."

As the following examples show, things can go terribly wrong with medication administration.

  • Betsy Lehman, a health reporter for the Boston Globe, died from an overdose of the chemotherapy drug cyclophosphamide.
  • A drug mix-up resulted in a nurse administering intravenous vecuronium instead of the prescribed Versed, which resulted in the patient's death. The nurse was charged with homicide for extreme medical negligence.
  • A resident of a nursing home was prescribed the blood thinner warfarin. A nurse placed the order in the wrong record. The resident who should have received that medication went days without it and died of a stroke.

Preventable medication errors not only cost patients their lives, but they result in significant costs for hospitals.

What Are Some Tips for Preventing Medication Mistakes?

Looking at the impact of medication errors alone, it is easy to understand why more hospitals are preferring BSN nurses. The safest hospitals have a higher percentage of nurses prepared at the bachelor's and master's levels, based on an American Association of Colleges of Nursing (AACN) review of the research.

According to a 2019 AACN survey, nearly 43% of hospitals and other healthcare settings now require new hires to have a BSN. Over 82% state a strong preference for BSN program graduates.

In addition to the "five rights" check, there are many other actions RNs can take to minimize medication errors. A sampling of strategies follows:

  • Minority Nurse recommends reading back the order to the prescribing physician to ensure it has been transcribed accurately.
  • Pharmacy Times notes the importance of placing a zero before a decimal. This can prevent dangerous dosing errors, such as misinterpreting predniSONE 5 mg as predniSONE 50 mg.
  • A manual, independent double-check of high-alert medications detects about 95% of medication errors, according to the Institute for Safe Medication Practices (ISMP). The ISMP defines this process as two clinicians separately checking then comparing each component of prescribing, dispensing and verifying a high-alert medication before administering it.
    Technology is also helping RNs reduce medication errors. For example, the NEHI reports that

using barcode-assisted Electronic Medication Administration Records (eMAR) to verify patient identity and drug dosage resulted in a reduction of over 50% of medication errors. The hospital in this study also achieved a savings of $2.2 million annually.

Medication errors do not always result in death. In fact, some patients may show no noticeable signs of distress. Still, no nurse wants to be on the delivery side of a medication error.

RNs who take the step to earn a BSN can develop the skills, knowledge and confidence they need to minimize the chances of a breakdown in the "five rights." In the process of improving patient safety, RNs who earn their BSN can also protect their reputations and enjoy stronger long-term career growth.

Learn more about NKU's online RN to BSN program.


American Association of Colleges of Nursing (AACN): The Impact of Education on Nursing Practice

AACN: Employment of New Nurse Graduates and Employer Preferences for Baccalaureate-Prepared Nurses

American Nurses Association: Creating a More Highly Qualified Nursing Workforce

Centers for Disease Control and Prevention: Therapeutic Drug Use

CUREATR: 6 Medication Error Stories That Made Headlines

Institute for Safe Medication Practices: What Are High-Alert Medications?

Johns Hopkins Medicine: Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S.

Medical Economics: Who Caused This Tragic Medication Mistake?

Minority Nurse: 10 Strategies for Preventing Medication Errors

National Center for Biotechnology Information: To Err Is Human: Building a Safer Health System

National Coordinating Council for Medication Error Reporting and Prevention

PULMCCM: Former Vanderbilt Nurse Arrested, Charged With Homicide for Medication Error

Pharmacy Times: Preventing 10-Fold Dosage Errors

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