“When the Five Rights Go Wrong” Article Critique

In the health care settings of the United States, medication errors are one of the most frequent errors that occur. The Institute of Medicine reports that more than 1.5 million people are harmed every year. According to this report, on average, one patient will suffer one administration error each day. The records also show that more than a billion dollars are spent due to medication errors. This article is the critic of the study by Jackie H. Jones and Linda Treiber, named When the five Rights Go Wrong Medication Errors From the Nursing Perspective, published in 2010 (Jones &Treiber, 2010). This study used both qualitative and quantitative methods. Sowe can assume that the method used by Jones and Treiber is a mixed-method (Burns & Grove, 2007). The focal point of the study, as depicted by Jones and Treiber is clear. They say, “This study describes nurses’ perceptions about how and why medication errors occur and their personal experiences with medication errors” (Jones &Treiber, 2010, 1).

The study identifies the research problem and develops around the issue. Then the research develops in logical consistency following the steps of the research process in a logical manner. Literature Review provided the needed help. However, all of the literature included is of recent origin and revolves within the time frame of 10 years and it presents a thorough outline of the problem and the possible solution. The literature is mainly primary sources but there are a few secondary sources too. Most of the 16 references used are scholarly journal articles. Nevertheless, books and websites were also used.

When researching on the topic, however; it was found that despite an intense organizational focus on this issue, the problem is still a lingering problem in recent times. Medical errors are proving to be one of the most uncontrollable aspects in recent medical history. This has something to deal with the working condition of the nurses in recent times. In general, clinical establishments, the function of the nurse is a tiring job and is in a general complex set up in where nurses have to deal with patients in a high stake manner. They have to look after numerous patients and have to remember different types of medications for each patient. It also implies that multiple patients ensure that they have to deal with multiple diseases and use multiple routes of treatment. Medical administration is a complex task altogether. The variables like schedules and other distractions also add up on the already complex procedure. Generally, in these types of cases, all understand that medication administration is always an extremely risky enterprise to be taken into account.

For ensuring total medical safety the nurses should take into account all the existing processes. The main purpose of the study, in this case, is only to discover why all the medical errors occur. Another aspect was to discover from the personal experiences of the nurses why the medication errors occur, which adds up to the importance of the paper.

In a recent survey, 79% of the nurses who participated have agreed that most medical errors occur when a nurse neglects the five rights of medication administration. Another 58% have mentioned that the errors are a part of nursing incompetence. The top five reasons are like:

  1. Distractions and interruptions during medication administration
  2. The inadequate ratio of patient and staff.
  3. Medical records are written in a language, which is almost impossible to understand.
  4. Incorrect calculation of the dosage of the medications.
  5. Similar names of drugs and subsequent packaging sometimes cause huge confusion (Jones &Treiber, 2010).

Many of the patients believe that the nursing errors are negligence and incompetence, although the nurses say that alteration of their environment can help them improve their work. Another research shows that 89% of the population believes that nursing errors are the result of the negligence of the nurses about the five errors. Other people say that error reporting is one of the most important aspects to judge the capabilities of a nurse. The five most important causes of medication errors are as follows:

  1. The difficult-to-read handwriting of the physician
  2. Distraction
  3. The fatigue factor of the nurses
  4. Drugs with similar names sometimes cause real confusion
  5. The miscalculation of dosage by the nurses.

The study undertaken has a distinctive design assigned to it. The participants were asked to rate 11 potential factors on a four-point scale (one is ‘strongly agree’ and four is ‘strongly disagree’). The participants were asked that if they ever made a medication error.

In another process, there were 2500 nurses with presupposed tasks. Most of them satisfied all the criteria, whereas 28 of them failed to match the final standards. The 11considered factors were:

  1. A large number of medicals scheduled in the peak times
  2. New graduate status
  3. Insufficient training (56%)
  4. The incompetence of the nurses (66%)
  5. High patient-nurse ratio (71%)
  6. Patient acuity level (54%)
  7. Insufficient staffing (68%)
  8. Not following the five rights (77%)
  9. Lookalike and sound-alike drugs (60%)
  10. Unclear verbal orders (68%)
  11. Unclear handwriting of doctors (86%)

About 94% of the participants said that the majority of the medications errors must be reported. A few also believe that the nurse managers should keep track of the medication errors of nurses.

Many do believe that introduction of technology is necessary to reduce all the nursing errors. Among all the nurses 74% also believe this strongly. About 28% of the participants also believe that it will be also a time-consuming process. In the following parts, there is a discussion about the potential causes of the distraction of the nurses (Jones &Treiber, 2010).

  • Physical Exhaustion: Physical exhaustion is the most important factor in the process of medication errors as the nurses report in the survey.
  • Interruptions and distractions: When a nurse has to do multiple tasks in hurry, it increases the chances of medical error more than ever. Other distractions like casual discussions between the doctors and the patient party can break the concentration of the nurse.
  • Inexperience and Lack of Training: Sometimes inexperience takes a huge pressure on the nurses. Lack of training also contributes to this aspect.
  • Pace and load of the patient: Sometimes the ratio of the patient and the nurse become a big issue in the case. Sometimes cost-cutting efforts of the medical institution contribute to this case that the facility has a lower number of nurses than generally required.
  • Feelings about medication errors: the nurses are aware of their failures and how it harms both the professional image and also the image of their concern.
  • A concern of Patient Harm: One of the most important aspects of medication errors is the harm to the patients. The basic concern of a nurse is always the concern for the patient. They always try to look at the side of the patient and all the mistakes are generally unintentional.
  • Violation of Patient Trust: The nurses believe that if something wrong is done from their side the patient will be the most suffered party and a nurse always try to look at the side of the patient.
  • Culpability, shame, and self-blame: The nurses judge them harshly for any of the errors conducted by them. Sometimes they try to show any external factor contributed to the error and try to lessen their faults.
  • Loss of the Image: the failures ultimately hamper the professional image of the nurses.

This is a well-written report. The report is also grammatically correct and there is no use of jargon. In the context of organizing the paper, it can be stated that the formulation of the paper is very good. The study shows that the researchers are well qualified and hold appropriate degrees and positions in the particular field of the study, as they both are Ph.D. degree holders, and thus the issue has been well negotiated throughout the paper. One indication of the study is well organized is the title of the study itself. The title, ‘When the five Rights Go Wrong Medication Errors From the Nursing Perspective, clearly indicates the approach and the basics of the study. The title is clear, accurate, and unambiguous. Similarly, the abstract offers a clear overview of the study including the research problem, sample. Alongside, the method, findings, and recommendations are clear and concise. In conclusion, the study is one of the very important in the aspect of medication errors and it will surely contribute to the aspect of developing the infrastructure of the health care system.

References

Burns, N., & Grove, S.K. (2007). Understanding nursing research. New York: Elsevier Health Sciences.

Jones, J., & Treiber, L. (2010). Medication Errors From the Nursing Perspective: When the 5 Rights Go Wrong. J Nurs Care Qual, 25(3), 240–247.

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