How to Reduce Heparin Drips Administration Errors
Phase Two
Lianet Aroche
Florida National University
Nursing Research
Nora Hernandez-Pupo
06/10/2022
Prevalence of heparin drip errors
A heparin drip error occurs when the incorrect dose of heparin is administered to a patient, which can have disastrous results, resulting in severe bleeding or even death. Blood thinners account for about 7% of all prescription errors in hospitalized patients (Johnson et al., 2018). Medication mistakes are common and are connected with higher patient morbidity and mortality (Panagioti et al., 2019). Every year, 7000–9000 individuals die due to medical errors (MEs) in the United States alone. 19% of MEs in the ICU are life-threatening, and 42% are significant enough or clinically significant to necessitate different life-sustaining therapy (Al-ani et al., 2020). A study showed that 1 of every 12 reported errors (8.3%) were anticoagulant errors (Dreijer et al., 2019). Anticoagulants were commonly involved in prescription error reports.
The percentage of nurses who report drug errors is 57.4% (Jember et al., 2018). Most parenteral drug faults are discovered during administration, with a rate of 32.1 percent versus 8.65 percent during preparation (Sutherland et al., 2020). Between December 2012 and May 2015, 42 962 pharmaceutical mistakes occurred. (87%) of these errors were caused by hospitals, whereas (13%) were caused by primary care. Anticoagulant prescription errors were detected in 8.3 percent of the reports, with hospitals reporting 96 percent. Low molecular weight heparins [LMWHs] were the most frequently reported drug classes (56.2%). Heparins accounted for 6.8% of the total (Sutherland et al., 2020). Despite the proportion of heparin drug infusion errors, several steps can be implemented to reduce the risks and incidences.
Factors associated with heparin drip administration errors
Heparin administration errors can have a variety of causes. One cause could be the complicated dose and delivery protocol for heparin infusions. Heparin is a strong anticoagulant, and administering heparin drips requires careful titration to get the optimal degree of therapeutic effect. Human error was the most common cause of anticoagulant drug mistakes (53.4%). Competence deficit (23.5%), failing to observe standard protocols (12.5%), and failure to double-check dosage were the most commonly occurring factors (12.2%) (Dreijer et al., 2019).
Furthermore, errors in the management of medicinal heparin infusion were attributed to the absence of communication and a recall slip during the nursing handoff communication. The procedure of obtaining blood was also influenced (Johnson et al., 2018). The most prevalent error was incorrect medicine, followed by an inaccurate dose, an inappropriate administration method, and an incorrect rate (Al-ani et al., 2020). Heparin drugs are more likely than others to cause serious harm due to the complicated doses, poor monitoring, and unequal adherence to treatment.
Factors include incorrect setting or value into the infusion pump interface, incorrect order, transcription, or preparation of medication, failure to correctly connect or clamp IV tubing, and patient intentionally or unintentionally adjusted pump programming increases the likelihood of drip error. Cooperation among professional members is another distinguishing feature contributing to infusion pump administration errors (Taylor et al., 2019). Also, recklessness due to weariness is another cause of heparin administration errors in various studies (Hee et al., 2019). Health care workers are affected by extreme working conditions, resulting in drug therapy errors.
Prevention of heparin drip administration errors
In detecting and preventing prescription mistakes, pharmacy technicians and pharmacists play an essential role (Maaskant et al., 2018). Heparin drips were better monitored by using frequent nursing shift updates. One of the specialized techniques identified in the current study for preventing medication errors was competent and experienced nurses, implying that trained and experienced nurses are better equipped (Jessurun et al., 2018). Determining the type of error and encouraging nurses to disclose errors is crucial (Hong, Hong, et al., 2019). It will assist in the evaluation of mistakes. As a result, providing an economic motivation for detected medical errors may assist healthcare facilities in reducing the number of heparin-related mistakes.
Among the most important preventive methods for preventing heparin drip mistakes are for nurses to act professionally. Studying pharmaceutical instructions, analyzing mistakes, nurses’ understanding of medication administration errors, jurisdictional difficulties, refresher courses on medication processes, and accuracy are all important aspects of clinical competence (Salar et al., 2020). Collaborative practice is necessary to ensure safe medication use and distribution. High-alert medications, particularly those with strict medical safety limitations, should be double-signed by doctors and nurses (Rodziewicz et al., 2022). All healthcare practitioners should collaborate to prescribe, administer, and monitor medications to reduce medication errors.
Nurses are more likely to make medication errors due to the increased pressures placed on them. Incidences must be detected, documented, and transformed into great experiences from which learning can be gained and utilized to enhance patient treatment procedures and methods. Nurses have been on the front layers of protection in identifying and disclosing drug errors thus far; these faults are substantially inadequately reported (Jember et al., 2018). It is important to ensure adequate staffing and proper shift allocation to minimize overwhelming situations in care delivery, resulting in medication errors.
Methodology
Introduction
This chapter explains the study’s design, geography, population, sampling techniques, and data collection methods, as well as how the data will be reviewed and presented after collection. It also contains details on the study’s ethical concerns.
Study Design
A descriptive, cross-sectional study design including quantitative data will be used in this investigation. Cross-sectional research is favored because it is rapid, saves time, is inexpensive to undertake, and is simpler to use.
Inclusion Criteria and Exclusion Criteria
Inclusion Criteria
The study will include respondents with suitable physical and mental health conditions, as determined by the respondents’ verbal testimonies and willingness to participate.
Exclusion Criteria
Participants who refuse to agree or display a lack of engagement in completing the responses by the studied sections or who submit copies of the questionnaire will be removed from the project.
Sampling Methods
A stratified sampling technique will be utilized to capture the sampled data equitably.
Data Collection Method
The respondent’s demographic details, as well as data on the distribution of heparin drip drug errors, factors associated with heparin drip errors, and preventative measures of heparin drip errors, will be gathered through a questionnaire. The questionnaire will be utilized after its accuracy and reliability have been confirmed. A panel of specialists will assess the questionnaire’s internal consistency. The participant will obtain consent after explaining the study’s details. Participants will be given instructions on how to complete the surveys, and after they are completed, the questionnaires will be returned to the researcher for evaluation and storage.
Data Analysis
Summary analysis with version 28 of the Statistical Package for Social Sciences will be used to evaluate quantitative data (SPSS). These findings will be discussed using tables, bar graphs, and pie charts. Frequency charts will be presented for binary categories, while mean scores will be provided for continuous data. The relationship between heparin drip delivery and parameters connected to heparin drug mistakes will be examined using chi-square statistics. The impact of various parameters on the proportion of heparin drip medication mistakes will be assessed using binary logistic regression analysis.
Ethical Considerations
The study’s procedure will be authorized by the hospital’s and school’s research ethics committees. Before being interviewed, consent will be sought from study participants after describing the research aim and objectives and ensuring the anonymity of the collected data. The information acquired from study participants will be treated with confidentiality to the greatest extent possible. The completed questions will be kept safe and secure in passcode spreadsheets.
Conceptual framework.
References
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