lean Six Sigma; Medication administration; Medication Errors
||the author(s) 2015. this article is published with open access at www.chitkara.edu.in/publications.
This study focuses on reduction of medication errors by application of lean Six Sigma approach in Medication administration by nurses in a corporate chain hospital of India. It helped the hospital to understand the impact of dedicated Medication Nurse on the Medication administration error rate. the purpose of the research is to redesign the policy on medication administration i.e. introducing the concept of Medication nurse for the management of medication administration errors and depletion of interruptions faced in medication delivery in order to improve the efficiency, effectiveness and safety of care delivered to patients. as per the study done on medication administration, the medication error rate found was very high in a ward (mostly contributing were 31% of missed dose, 21% of wrong dose and 17% at wrong time) due to many interruptions and challenges faced by nurses during drug administration which in turn affecting the safety of care delivered to the patients and total medication delivery time taken by a general nurse was 9 minutes. By using the lean Six sigma methodology, it was observed rate of medication errors was decreased, the complexity of the work flow became simple and systematic, the work load on all nurses was decreased, and the average time for drug administering was decreased by 55% i.e. to 4 minutes in three months. thus, it helped in reducing mess up and complexity in the ward with better utilization of other nurses to perform other activities which are needed to be done at the same time and delivering best quality of patient care with high efficiency.
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- are You taking Medication as Prescribed? (2009, June). Food and Drug administration. Retrieved May 18, 2013, from: http://www.fda.gov/ForConsumers/ ConsumerUpdates/ucm164616.html
- Bendell t.(2006), a review and comparison of Six Sigma and the lean organizations. tQM Magazine, 18(3): 255–262.http://dx.doi.org/10.1108/09544780610659989
- Brady a.M., Malone a.M., Fleming S. (2009). a literature review of the individual and systems factors that contribute to medication errors in nursing practice. Nursing Management. 17(6): 679–697. http://dx.doi.org/10.1111/j.1365-2834.2009.00995.x
- Case-lo C., Krucik g. (2013), administration of medicine, Healthline
- Ching J.M., C. long, B.l. Williams, C.C. Blackmore (2013). Using lean to improve medication administration safety : in search of “perfect dose”. Joint Commission Journal on Quality and Patient Safety. 39: 195–204.
- Harvey S., Murphy F., lake R., Jenkins l., Cavanna a., tait M. (2010). Diagnosing the problem: using a tool to identify pre-registration nursing students” mathematical ability. Nurse Education in Practice. 10 (3): 119–125.http://dx.doi.org/10.1016/j. nepr.2009.04.007
- Kwak Y.H., anbari F.t .(2006). Benefits, obstacles, and future of six sigma approach. technovation. http://dx.doi.org/10.1016/j.technovation.2004.10.003
- liker J., (2004) the toyota Way-14 Management Principles from the World’s greatest Manufacturer. Mcgraw –Hill Education:New York.
- McMullan M., Jones R., lea S. (2010). Patient safety: numerical skills and drug calculation abilities of nursing students and registered nurses. Journal of advanced Nursing. 66(4): 891–899. http://dx.doi.org/10.1111/j.1365-2648.2010.05258.x
- Medication Error Reports. (2009). Food and Drug administration. Retrieved May 19, 2013, from:http://www.fda.gov/Drugs/DrugSafety/MedicationErrors/ucm 080629.html
- National Reporting and learning Service (2009). Safety in Doses: Improving the Use of Medicines in the NHS. National Patient Safety agency, london.
- Newton S.E., Harris M., Pittiglio l., Moore g. (2009), Nursing student math aptitude and success on a medication calculation & assessment. Nurse Educator. 34(2): 80–83. http://dx.doi.org/10.1097/NNE.0b013e3181990814
- Ramjan l.M. (2011), Contextualism adds realism: nursing students” perceptions of and performance in numeracy skills tests. Nurse Education today. 31(8): e16-e21. http://dx.doi.org/10.1016/j.nedt.2010.11.006
- Scachitti S., Mozammel a., Mapa l.B. (2011). application of lean six sigma in healthcare. american Society for Engineering Education, aC 2011–604.
- Schelbred a.B., Nord R. (2007). Nurses” experiences of drug administration errors. Journal of advanced Nursing. 60(3): 317–324. http://dx.doi.org/10.1111/j.1365- 2648.2007.04437.x
- Sharon a.S., allard E.D.(October 2009), the applicability of lean and Six Sigma techniques to clinical and translational research. Europe Pubmed Central, Journal of Investigative Medicine, 57(7): 748–755.
- Smith g., Poteat g.a., Harrison l.M., Randolph g.D.,(2012) applying lean principles and Kaizen rapid improvement events in public health practice. Journal Public Health Management Practice., 18(1): 52–54. http://dx.doi.org/10.1097/PHH.0b013e31823f57c0
- t reiber l.a., Jones J.H. (2010). Devastating human: an analysis of registered nurses” medication error accounts. Qualitative Health Research. 20(10): 1327–1342. http:// dx.doi.org/10.1177/1049732310372228
- Ulhassan W., Sandahl C., Westerlund H., Henriksson P., Bennermo M., Von t.S.U., thor J.,(2013) antecedents and characteristics of lean thinking implementation in a Swedish hospital: a case study. Quality Management in Health Care. 22(1):48–61. http://dx.doi.org/10.1097/QMH.0b013e31827dec5a
- Vincent C. (2012). the Essentials of Patient Safety. tinyurl.com/ Vincent-essentials (last accessed: June).
- Vincent C., Barber N., Franklin B.D., Burnett S. (2009). the Contribution of Pharmacy making Britain: a Safer Place to take Medicines. Royal Pharmaceutical Society of great Britain, london
- Womack J., Jones D.(2003), lean thinking. New York, NY: Simon & Schuster.