Running head: POOR COMMUNICATION AND MEDICATION ERRORS

Effective communication

NRS1121

Effective communication with conscious patients on mechanical ventilation

Student name: Boukhouite Imane

Student number: A00045220

Supervisor : Mr. Anass Moussa, Mrs. Lizelle potgieter

Fatima College of Health Sciences

Word count: 1413

Semester 1, 2017-2018

March 16, 2018

POOR COMMUNICATION AND MEDICATION ERRORS 2

Communication has a prime role in health care setting. It is an action of sharing

information in both forms verbal and non-verbal at several scales. Poor communication is one
of the main problems resulting medication errors among health caregivers and patients.
Solving communication problems ensures effectiveness and improvement in medication,
prevents medical practice from becoming terrible and interrupting progress or propagating
other health failures. Effective communication skills have various positive outcomes on health
and patient fulfillment. (Isyaku, Myat, Tuan, Rabiu, & Zayyanu, 2018). Some researchers
treat certain types of negative effects, or unplanned events, including death or severe injuries
which are related to poor communication. It is always on the top ranked of such reasons,
which are resulting from medication errors for the complete year. These errors are the
responsibility of healthcare institutions, enhancing effective communication techniques
reduce and lower the malpractice of medication faults. (Harvey & Rachel, 2016)

Nurses have direct contact to prevent errors at administration level and are completely
inducing prescriptions, explaining dosages during writing period of prescription, claiming
pharmacist about wrong dispensed drugs, picking up errors and using the right steps in
preparing medication before administrating them. (Cloete, 2015) The purpose of the present
paper is to identify how ineffective communication leads to medication errors and to offer
some recommendations in order to tackle this phenomenon.

Medication errors are a wide charge in U.S health care system. About 80% of serious
medication errors include the absence of efficient communication between medical staff,
which creates negative consequences such as unnecessary and extended stays in hospitals.
Poor communication between a pharmacist and nurse causes a life-threatening medication
error during transferring medication information. The Joint Commission Center for
converting Healthcare has been shedding light on the significance of ameliorating transitions
of care by focusing on hand-off communications. Inadequate communication during
transmission of care is responsible for almost one-half of medication errors and one-fifth of
adverse drug events. Poor communication not only results into medication errors during
transition of care but also postpones and retards care. (Johnson, Guirguis, & Grace, 2015 )

Inter-professional communication orderly embraces the interaction of numerous

medical professionals in health care sector. Health professionals should have the sense of
cooperation in work place to alleviate undesirable impact on care. Communicating is the clef

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POOR COMMUNICATION AND MEDICATION ERRORS 3

to effective collaboration among health staff. Problems in communication ,particularly the

transmit of medication orders, have been identified as one of the most crucial factors in
serious adverse events in Australian hospitals and about 70% of unexpected of unsafe
medication use are caused by communication failure. Effective communication within
interprofessional teams is the baseline of managing medication cycle from appropriate
treatment to the transfer of verified information. (Day & Sassoli, 2017)

Miscommunication among health care practitioners is a fundamental cause of

medication errors. A study showed that 90% of errors happen because of the nurse-physician
level of communication, not only errors but also stated that between 44 000 and 98 000
patient died yearly in American health facility. The cancellation of communication barriers is
a practical strategy to reduce medication error. (Walker, 2016). A number of 100 out of 163
of participated nurses found another factor which has a responsibility of causing medication
errors. For instance, no explanation no confirmation between the nurse and the nurse manager
about medication errors topics as foremost in comparison with other agents (Savvato &
Efstratios, 2014) . A study at the Saudi hospital setting identified one important issue
connected to health care services goodness and the quality of patient security in delivery care.
The nurses’ perception for agents participate to medication administration errors linked to
communication with medical team matters and doctors are the major causes for medication
administration mistakes. (Aboshaiqah, 2014)

A conducted research of Emmanuel Walker highlights that one-third of physicians'

writing hand prescriptions were unreadable and orders were incomprehensive, obscure or too
vague also cause medication errors. Orders given in spoken form, rather than in written one
are considered as a difficult problem, due to diversity of languages, accents, misinterpretation
of names and others. Verbal medication instructions should not be supported and applied
solely when written or computerized medication orders are not workable. Medical
abbreviations are main producer of medication errors as well. These abbreviations, symbols
and dose designations have been proven as a principal pitfall to effective communication and
have performed in severe harm to patients. To exemplify, instead of writing “QD” (daily) this
is often wrongly read as QID (four times daily). The Drugs and Therapeutics Committee at
the University of Cape Coast Hospital instructs all clinicians to write medicines using their
generic names free from of any abbreviations and this is observed through every three month
prescriber care indicator studies. (Walker, 2016)

Boukhouite Imane ID :A00045220 NRS1121

POOR COMMUNICATION AND MEDICATION ERRORS 4

Diverse clinical implementations have been planned to decrease medication incidents

and enhance patient safety. The SBAR verbal communication framework (Situation-
Background- Assessment- Recommendation) is one of the techniques that has been
incorporated into health communication aimed at preventing medicines errors. The SBAR
communication sample provides a framework to incapable professionals with few
communication skills to accurately switch information about the patient’s current status. The
SBAR strategy has been performed and adjusted in different areas such as Canada, America
and United Kingdom hospitals. The SBAR device provided changes to communication
process, relief of nurses and team work doctors, and patient. Healthcare advising the SBAR
communication as a functional solution for most communication related to medication errors.
(Day & Sassoli, 2017)

In addition, within the range of tools which have been suggested for decreasing the
rate of medication errors, the use of a Computerized Physician Order Entry (CPOE) system is
advocated by certain European and American hospitals. POE software permits physicians to
record medical prescription by computer. It also contains functionalities as drug dosage
support, alerts about harmful interactions and clinical decision support, which can further
minimize errors. This system generally reduces errors associated with hand-written
prescriptions by lowering unreadable hand writing, incomplete prescriptions or wrong dose.
Statistics of 23 researches demonstrate that 13–99% diminishing in the risk of medication
errors after the integration of CPOE. The relief of medication errors motivated by CPOE
system, which has a positive effect and should be more largely spread in hospitals. (Antignac,
et al., 2015)

In conclusion, the results indicate that, in general, nurses had agreement that
communication with physicians and workload are the main factors that associate with
medication administration errors, while other factors had minimal effects. Moreover, charge
nurses seem to have the highest level of perception among all nurses with convenient mean
item response in most domains. Besides communication between patients and medical
personnel should be direct, understood because caregivers must assume the duty to
communicate according to the patient’s health literacy. (Redley, Botti, Wood, & Bucknall,
2017) In future wide and credible researches require to be taken with regard attentively by
incorporating suitable strategies to avoid medication errors by promoting and using multi-
surveillance procedures to help raise medication safety.

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POOR COMMUNICATION AND MEDICATION ERRORS 5

References
Aboshaiqah, E. A. (2014). Nurses’ Perception of Medication Administration Errors. American

Journal of Nursing Research .

Antignac, M., Cherrie, B., Doursounian, L., Feron, J.-M., Hernandez, F., Majoul, E., et al.

(2015). the Impact of a Computerized Physician Order Entry System on the Rate of

Medication Errors in an Orthopaedic Surgery Unit.

Cloete, L. (2015). (Reducing medication errors in nursing practice. Continuing professional

CPD development .

Day, G., & Sassoli, M. (2017). Understanding Pharmacist Communication and Medication

Errors: A Systematic Literature Review. Asia Pacific Journal of Health Management .

Harvey, P., & Rachel, D. (2016). ( The Cost Consequences of Unsuccessful Patient

Communication ; .

Isyaku, H., Myat, M. T., Tuan, H., Rabiu, M. M., & Zayyanu, S. (2018). Avoiding medication

errors through effective communication in a healthcare environment. Movement,

Health & Exercise .

Johnson, A., Guirguis, E., & Grace, Y. (2015 ). Preventing medication errors in transitions of

care: A patient case approach. CPE TRANSITIONS OF CARE .

Redley, B., Botti, M., Wood, B., & Bucknall, T. (2017). Interprofessional communication

supporting clinical handover in emergency departments: An observation study.

Australasian Emergency Nursing Journal .

Savvato, K., & Efstratios, A. (2014). An inside look into the factors contributing to

medication errors in the clinical nursing practice. HEALTH SCIENCE JOURNAL .

Walker, E. (2016). Medication Errors. Imperial Journal of Interdisciplinary Research (IJIR) .

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Boukhouite Imane ID :A00045220 NRS1121