Quality and Safety Issues Raised by the Family Member (Research Paper Sample)

Quality Management in Health
Name:
Institution:
Introduction
According to Dodwad (2013), for the provision of quality health management, there should be better governance of the clinical resources and better management of human resource practices. Therefore, this is important because it enhances accountability of the health practitioners, resource efficiency. Furthermore, quality in health management helps in minimizing medical errors that occur in any medical health facility, and also it maximizes the use of adequate care by ensuring that all the patient needs are addressed (Stroubouki, 2013). Hence, it is important to note that the patient is the core individual in quality healthcare management because the health quality management system in the facility should be able to care effectively on the needs of the patient. For this to happen effectively, the hospital has to put standards that every department in the facility must attain. This article gives a clear understanding of the issues that the staff faces concerning providing quality healthcare management to the patients. It is an essential step in helping Carol (CEO of significant health service) to determine the factors that hindering the effective provision of quality health management and making progress on how these factors can get addressed. Moreover, this article explains the quality and safety issues that got raised by a family member at a public patient safety forum. The issues raised are that there are numerous medication errors that the hospital staff do that leads to provision of quality health. Also, the article identifies a medication management issue and uses the Plan-Do-Check-Act-Cycle to plan for the investigating the matter and identifies the potential solution.
Quality and Safety Issues Raised by the Family Member
At the public patient safety forum, the family member said that her Dad had experienced numerous medication errors with the hospital facility which were mostly human errors. It was a serious issue because her dad had many health problems with the main one being lung disease. Another issue raised by the family member concerning the quality and safety issue was that the hospital staff was incompetent in providing proper medication that would get rid of the chest infections that the dad often experienced. The main reason for this is that the team seemed only to stuff up the dad with medication that was prone to medication errors. Moreover, the other medication errors were experienced by the family member at the emergency department when the doctors did not write down the medication that the dad required adequately from the list. Furthermore, the doctors sometimes failed to write the medication down at all or sometimes some medicine that the dad necessary used to miss some from the list. The family member gave an example which was when her mum was with the dad in the ward he got admitted, and she told the family member that the doctors had missed some of his medication. Also, the staff assured the mum that they would get a doctor as soon as they could to look at his chart though they failed to do so. It was a severe offence in quality and safety in healthcare provision by a proper medical facility because the family member had to go up to the hospital and check the dad's chart.
Furthermore, the family member said that the dad’s epilepsy and other medications were not even on the chart and the family member had to demand that the staff puts them on immediately. It is a clear breach in providing quality and safe healthcare on patients because the doctor later came and went through his medication list and added the four missing lots were missing. It is a shame that the family member's mum had to be present in the dad's ward late at night so that the hospital staff does not make mistakes in giving medication to the dad. It is because some of the nurses could not read the doctor's notes, or even sometimes they mistook the milligrams which were an uncompromising health quality and safety issue on the patient. Also, the nurses sometimes failed to read the dad's chart, and they neither looked at the chart twice or thrice on the sheet of medication which made the chances of medication errors during administration to occur. Moreover, sometimes the nurses failed to handover another nurse at the dad's bedside and the nurse went home without giving him his medication. It is a serious offend in quality and safe health provision by a nurse because the mum had to call the nurse who was at home because she was not in the hospital to care for the dad. Also, sometimes the nurses failed to read the medication bottles correctly which caused them to give him an under-dose of his medication because they gave him one tablet instead of two. According to the family member, once when the mum did not make it to the hospital in time for the dad's lunchtime tablets, she found his epilepsy medication on the floor under the bed. Moreover, another time a nurse misplaced the dad's chart which she took and the next morning the nurse on duty could not find it. It caused the dad to miss his medication that morning until the mum came in and demanded that they give him his medicine and it took them a while before they found it and gave the dad his medicine.
The family member further states that the family had tried just about every time a medication stuff up occurs they report it so that the hospital may fix the problems. For instance, the family member had meetings with the Director of Medical Services, the Director of Nursing; the Pharmacy and the Patient Liaison Officer and sometimes had them at the same time. They assured the family member that they would make sure that the bed handover gets done and that they would tell the nurses to be vigilant. Furthermore, they assured the family member that they would say the doctors to be careful and look at the dad's medication. However, even after all the meetings and a dozen complaints all the efforts made by the family member to get the issues addressed fell on deaf ears. The reason given by the hospital management was that the nurses were making mistakes because they were nervous because the patient was his father who is a well-known community advocate. Another issue that has affected the quality and safe health provision is that patients who took their medications at certain times of the day did not get their medication until the nurse on duty was able. For instance, the family member said that the mum had to wait until 10 p.m. so that the dad could get his teatime tablets. Furthermore, it was not right that only one nurse was the one with trolley giving medication to the patient and also the pharmacy did not get medicines checked daily on the wards. Moreover, the family member reported that sometimes patients came into the emergency department and the doctors did not know what medications they are on. Furthermore, the quality and safety issues are vivid when most of the time the mum used to look after the dad's needs which included feeding him, showering, emptying his urine bottle which is nurses' duties.
Causes, Frequency of Occurrence and Contributing Factors on Quality and Safety Issue
1 Errors Per Stage of the Drug Delivery Process
According to Shahrokhi (2013), most errors that occur in hospital facilities happen in the early stages of the medication delivery process. From a study carried out in a particular hospital, there was 42% of the prescribing errors while there was 37% of dispensing errors though there were no administration errors. Also, some errors occurred due to the hospital organization which made it possible for the nurses to make the mistakes thus when the nurses are knowledgeable about the medicine doses and check medicines before administering it would help in reducing errors (Allard, 2002). Therefore, the family member presents various errors that were mostly human errors such as giving the dad an under-dose of his medication (WHO, 2016). According to the family member, the pharmacy failed at all times to put in check medications that were required daily by the wards. Moreover, the nurses sometimes did not read the doctors’ notes which caused them to mistake the milligrams of certain medications the dad was supposed to get given.
2 Errors counting During Medication Administration
According to Allard (2002), suggests that drug administration errors may arise from prescription, transcribing or the dispensing stage (21% of errors at multiple stages) hence, counting and categorizing errors may occur. The only way to limit such errors is by ensuring that the quality management system in the hospital facility is efficient to deal with such errors (Keers, 2013). From what the family member said, there were numerous counting errors which were caused by the doctors in the emergency department not writing down medication properly form the list. Moreover, the doctors sometimes missed writing some medicines on the list while sometimes they never prescribed at all. Other times the family member said that the nurses did not read the bottles correctly while other times they would give his dad an under-dose of one tablet instead of two. Such errors can get prevented by ensuring that the nurse read the details of the medication carefully before administering it and also the doctors should give all the details of the medicine that is required by a patient.
3 Workload And Shift Work Done By the Nurses
Most of the errors sometimes occur due to fatigue that the nurse incurs during the day which results in human errors in drug administration. Research done shows that when the hospital staff is busy, there is a higher frequency of medication errors that are prone to happen (Allard, 2002). Most of the hospital staff are often working at night because most prescriptions are written in the afternoon and also the shift work effect of the nurses often caused er...