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Kyle Anthony has a nursing background in medical intensive care and is currently a graduate student in acute care nursing. Catherine Bauer is an advanced clinical nurse in the medical intensive care unit. This article has been designated for CE credit.
A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives: Define medication error and describe the implications of these events for critical care nurses Identify common causes of medication errors Discuss the concept of the sterile cockpit and its application and implementation in the health care setting During medication preparation, a No Interruption Zone could decrease interruptions and enhance safety.
In the technologically advanced environment of the ICU, nurses play a central role in the maintenance of patient safety. Although safety encompasses many processes and personnel, nurses have the primary role in safe administration of medications, which is recognized as a nurse-sensitive outcome.
Review of the Literature Medication Errors: Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.
Performance level failures that accounted for medical errors in a medical and coronary ICU were due to inattention or failure to carry out intended actions in patient care. In a French study, Tissot and colleagues 16 reported that interrupted workflow during medication administration was a contributing factor to the 6.
Strategies to Reduce Medication Errors Evidence exists to support the use of specific strategies or processes to reduce the incidence of medication errors.
The NIZ has been recommended as a strategy by the Institute for Safe Medication Practices, a nonprofit North American organization dedicated to the prevention of medication errors. During a 3-year period, these innovations were communicated to staff, and improvements in medication preparation were noted.
In subsequent feedback, nurses suggested changing the color to yellow and allowing nurses to choose between a vest or a sash.
Applying the principles for a sterile cockpit approach, as suggested by the Institute for Safe Medication Practices, during critical steps in the process of medication administration may provide new insights to address this issue. The conceptual background for this study comes from high-reliability theory, which recognizes that the work in some organizations, such as hospitals, is complex and risky and depends on coordination, communication, differentiation, and accountability.
Errors can occur anywhere along a sequential continuum of processes, so systems must be in place to identify weak links that can lead to dangerous results.
Having a way of thinking that supports continuous adjustments can improve systems before they break down and result in catastrophic events. High-reliability theory suggests that organizations focus on identifying where and how mistakes can be made and then implement responses, such as the NIZ, that improve system functioning.
Limiting interruptions during medication preparation in the ICU appears to be an effective strategy to improve safety and reduce the risk of errors. Because we found no evidence supporting whether an interruption-free zone in the ICU is effective in promoting medication safety, we conducted this pilot study.
The research question was, Does the implementation of an NIZ decrease the number of interruptions during medication preparation?
Study Design and Setting This quasi-experimental pilot study used observational methods to compare the number of interruptions in medication preparation before and 4 weeks after the creation of the NIZ. The study took place in 2 ICUs: Each ICU has 5 decentralized medication carts and 1 central medication preparation area that is located in the center of the unit.
Operational Definitions For the purpose of the study, the following definitions were used: An interruption could be a verbal or nonverbal cue from another individual prompting the nurse to give a verbal or nonverbal response.UPDATE: December 4, IT TOOK ABOUT A YEAR, but the findings are out regarding the crash of AirAsia flight , the Airbus A that went down during a flight from Surabaya to Singapore last December, killing everybody on board.
In the technologically advanced environment of the ICU, nurses play a central role in the maintenance of patient safety.
Although safety encompasses many processes and personnel, nurses have the primary role in safe administration of medications, which is recognized as a nurse-sensitive outcome.
NBAA Safety Committee Top Safety Focus Areas. Much like NTSB's most wanted list, the NBAA Safety Committee has created a Top Safety Focus Areas list.
SUBTITLE VII—AVIATION PROGRAMS PART A—AIR COMMERCE AND SAFETY subpart i—general. IPP is the world wide leader in providing Scheduled Airline Failure Insurance to the global travel industry.
We also provide ABTA, ATOL, ABTA, BCH / AITO, AIRLINES and P.S.A bond requirement and application forms. Part IV. DEPARTMENT OF LABOR. Occupational Safety and Health Administration. 29 CFR Parts and [Docket No. R] RIN AB Occupational Injury and Illness Recording and Reporting Requirements.