Abstract

Session presented on Friday, July 25, 2014:

Purpose: Medical errors are common problems in types of medical negligence. Medicine behavior is the most activating part of nursing work every day. When accidental events happen, they affect patients' safety, worsen patients' condition, prolong the length of days in hospital and even result in death. The purpose of the study was to describe medical error problems and prevent new staff from abnormal medication administration.

Method: The study used actual medication auditing process, abnormal analysis and interview for new staff. The data collection period was from March, 2013 to October, 2013. Our investigation has shown that new nurse's incorrect medication administration revealed as follows: (1) lack of standard training courses (2) lack of medication auditing process for internal reference (3) lack of knowledge and skills in medication administration (4) similar medicine were placed close to each other.

Resolution: The Plan-Do-Check-Action (PDCA ) cycle was applied and multiple intervention strategies implemented, including Plan -(1)Hold continuing medication administration education (2) case studies of abnormal medication administration events (3) make DVDs of proper medication administration (4) redesign the location of similar medicine; Do - create a medication auditing process for internal reference only; Check - implement new target supervise system; Action- revise operating standards of medication administration flowchart.

Results: New nurses following the PDCA process have made less mistakes from the 24 abnormal medication administration events down to 11 ones. Auditing process rate has reached 100 percent, which represents the new staff could issue medication correctly.

Conclusions: By implementation of this project, nurse should be able to amend the accuracy of general medication and elevate the safety of using medication. As a result, patients will receive a better quality of nursing and share this sort of problem with other new staff.

Author Details

Li Hua Lee, BS; Hsiu-Hui Lei, MA; Wei-Ping Cheng, BS

Sigma Membership

Unknown

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Medication Error, New Nurse, PDCA

Conference Name

25th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Hong Kong

Conference Year

2014

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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A project of applying PDCA Cycle to improve new nurse medication error in surgical ward

Hong Kong

Session presented on Friday, July 25, 2014:

Purpose: Medical errors are common problems in types of medical negligence. Medicine behavior is the most activating part of nursing work every day. When accidental events happen, they affect patients' safety, worsen patients' condition, prolong the length of days in hospital and even result in death. The purpose of the study was to describe medical error problems and prevent new staff from abnormal medication administration.

Method: The study used actual medication auditing process, abnormal analysis and interview for new staff. The data collection period was from March, 2013 to October, 2013. Our investigation has shown that new nurse's incorrect medication administration revealed as follows: (1) lack of standard training courses (2) lack of medication auditing process for internal reference (3) lack of knowledge and skills in medication administration (4) similar medicine were placed close to each other.

Resolution: The Plan-Do-Check-Action (PDCA ) cycle was applied and multiple intervention strategies implemented, including Plan -(1)Hold continuing medication administration education (2) case studies of abnormal medication administration events (3) make DVDs of proper medication administration (4) redesign the location of similar medicine; Do - create a medication auditing process for internal reference only; Check - implement new target supervise system; Action- revise operating standards of medication administration flowchart.

Results: New nurses following the PDCA process have made less mistakes from the 24 abnormal medication administration events down to 11 ones. Auditing process rate has reached 100 percent, which represents the new staff could issue medication correctly.

Conclusions: By implementation of this project, nurse should be able to amend the accuracy of general medication and elevate the safety of using medication. As a result, patients will receive a better quality of nursing and share this sort of problem with other new staff.