Medication Errors in Pediatrics among Nurses: Capstone Project Change Proposal
Background
The capstone change proposal has been focused on the issues of medication errors in pediatrics among nurses, the relationship between the excellence of health services to capital availability, nurse staffing and welfare, and diabetic foot ulcers as a complication of diabetes and its management. The availability of capital has been identified to relate with nurse staffing, having an impact on the patient-nurse ratio recommended to be about 4:1. With the appropriate patient-nurse ratio, the quality of service delivery and patients’ outcomes are expected to improve. Apart from errors related to nurses’ intervention, the proposal also seek to establish other possible causes of medication errors. Project change proposal change under literature review assignment, as well, seek to establish a better understanding of diabetic foot ulcers, risk factors of occurrence, prevention, management, and treatment of the condition.
Clinical problem statement
Pediatrics medication errors, the influence of capital challenges on services delivery, and diabetic foot ulcers covered in this capstone project proposal change are huge health problems that require proper attention. It has been established that 5% to 27% of all pediatrics medications ordered, resulting in errors. Several errors have shown a possible association with low nurse staffing that has led to burnout, lowered morale, and poor service delivery among nurses. It is also worth noticing that poor nurse staffing arises from the financial challenges of health facilities. Capital challenges not only affect staffing but also affect the training of staff and the provision of new skills and technical know-how to promote evidence-based practice. Consequently, diabetic foot ulcer is a serious and common complication among diabetic patients, affecting about 15%, requires the need for early preventive interventions, management, and treatment.
Purpose of the change proposal concerning providing patient care in the changing health care system.
The purpose of the change proposal is to identify and establish the modalities that can be put in place to limit or eradicate pediatric medication errors, formulate measures to combat capital challenges in such a way that excellent service delivery and patient outcomes are maintained, help in the development of policies that should help create a balance between competing needs/ stressors, and to illustrate the roles nurses and patients themselves can play in the identification of diabetic ulcer risks, prevention strategies, management, and treatment.
PICOT Question
Problem/patient/population
The treatment outcomes of neonates/infants treated in health facilities with adequate nursing staff who are well trained are compared with those from otherwise poorly staffed and trained. A review of patients’ data/information from articles of past studies was conducted and analysis made.
Intervention
Nurses need to be properly trained on the five rights of medication administration that include; administering to the right patient, the right drug, the right dose at the right time through the right route. It is also important to explore other possible causes of medication errors such as nurses’ burnout and the availability of the right equipment and technique. Adequate financial investment should also be made to ensure enough nursing staff is recruited to enhance better patient care. Patient education on self-care should be initiated especially for patients with diabetic foot ulcers to minimize complications and possible amputation. The development of reliable nursing guidelines and welfare is also key to the promotion of better care and limitation of medication errors. Above all, promoting the culture of error reporting and educating nurses on the importance of the same is very crucial.
Comparison Intervention
Patient outcomes from well-trained nurses in comparison with those with compromised training are done to assess interventions. Consequently, several methods of diabetic foot ulcer management are done and the relevance of proper capital investment in the care process is examined with regards to poor capital investment. A comparison of error rates may also be done to verify outcomes in situations where the culture of error reporting is highly appreciated.
Outcome
Pediatric medication errors are substantially reduced by the provision of proper training to nurses on medication administration. Adequate capital investment in a care facility ensures recruitment of sufficient nursing staff, which imply that there will be a good patient-nurse ratio, proper training, availability of reliable equipment and procedures, and better patients’ outcome. Proposal change interventions furthermore promote better management of diabetic ulcer, prevention, identification of risk factors, and better treatment outcomes.
Time factor
This intervention is applied to the nursing staff working in the pediatric department of the
The hospital for 6 months and the review of data/information from articles written based on previous research would be dependent on the amount of material to be reviewed.
Relevant studies were retrieved by carrying data searches in databases such as PubMed, Scopus, Embase, Web of Science, and the Cumulative Index to Nursing Applied Literature, not forgetting previous systemic reviews. Full-text and abstracts articles were reviewed and the inclusion criteria were based on the identification of original data that is peer-reviewed and relates pediatric medication errors, diabetic foot ulcer management, and influence of capital on the quality of health care.
Evaluation of the literature.
The literature used for the change proposal development has been obtained from peer-reviewed sources/databases. The literature is purely based on issues to deal with pediatric medication errors, nurse staffing, burnout, and their relation to medication errors and finally, diabetic foot ulcers’ risk factors, prevention, management, and treatment. Medication errors are any events that can be prevented that lead to inappropriate use of medication or that causes harm to patients. The review on medication errors was carried out by a review of 4 articles that highlights the predisposing factors to medication errors, methods of detection of medication mistakes, error types, and incidence ratios of these errors. The literature was majorly based on randomized control trials, longitudinal studies, and retrospective studies. Similarly, the literature on diabetic foot ulcers, management, prevention, and treatment was done.
Applicable change or nursing theory utilized.
The theory of planned behavior may be applicable in clarifying the issues related to negative behavioral patterns among nurses that lead to medication errors as well as patient behavior that not only limits them from getting diabetes but also make them properly prevent diabetic foot ulcers and their management. This theoretical standpoint moderates the relationship of behavior and intention from a recognized behavioral control. The theory of health belief can also play a key role in motivating nurses to care behavior, thereby limiting medication errors and promoting patients’ self-care in diabetic foot ulcer management.
Proposed implementation plan with outcome measures
A proposition of medication errors/mistakes investigation and securing medication management training for nurses is an ideal way of combating medication errors. The prescribers should be intimate with regards to pediatric medication, evaluating medication sensitivities, contraindications, and communications, and how to put them in a medication plan. Double-checking of medication dose calculation and other medication information can also prove vital in the limitation of medication errors. Provision of better job environment and conditions for nurses also influence care behavior and outcomes and ensuring a rigorous process of error reporting. To properly manage diabetic foot ulcers, patient education is advised, along with the use of effective management plans.
Discussion of how evidence-based practice was used in creating the intervention plan.
Evidence-based practice helps create intervention plans that are clear and detailed leaving no room for doubt or confusion. It has therefore aided in the development of double-checking of dose calculation by other staff members as a reliable way of minimizing errors. This is with the understanding that anyone is prone to making errors. Proper understanding of the science behind the occurrence of diabetic foot ulcers, as well, helps in creating better management, prevention, and treatment modalities of diabetic foot ulcers.
Plan for evaluating the proposed nursing intervention.
The plans would include; monitoring the outcomes of pediatric patients based on the established interventions in comparison with the pre-intervention’s outcomes. Additionally, the development of control trials against the established interventions would help in the evaluation of outcomes.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
One of the main barriers to the elimination of medication errors in the reporting of medication errors due to fear of losing opportunities, therefore, the exhaustion medication errors as improvement potential has become difficult. Financial challenges that diminish learning/continuous training opportunities for nurses also hinder the potential of nurses acquiring better skills of care and medication administration, and finally, lack of effective management strategies also harm identification of medication errors and deteriorating staff welfare, and establishing best possible solutions. In the case of diabetic foot ulcer care, patient beliefs may strongly stand against self-education and care.
The barriers can be eliminated by creating better management programs that ensure a better working environment for nurses/caregivers. Educating nurses on the importance of reporting errors while providing moral support in cases of error may also be valuable in ensuring. Promoting the evidence-based practice and the value of compassionate care transcends all aspects of caregiving thus ensuring low medication errors and better management of patients with diabetic foot ulcers.
