MEDICATION ERRORS AT BIG CITY GENERAL HOSPITAL

 

 

 

Consider the following scenario:

Big City General Hospital is a reputable healthcare facility known for providing high-quality patient care. However, in recent months there has been a concerning increase in medication errors reported by nurses and pharmacists. The hospital administration is alarmed by this trend and wants to identify the root causes behind the rise in medication errors to implement effective solutions and improve patient safety.

Hospital administration has asked you to form a task force to identify potential factors contributing to the rise in medication errors. The task force comprises members with diverse roles within the hospital. The task force findings are as follows:

Problem Statement: Big City General Hospital has an increase of reported medication errors.

Five major factors have been identified:

· Nurses and pharmacists are experiencing heavy workloads due to a surge in patient admissions.

· Each department seems to have a unique procedure for medication administration and documentation.

· Poor communication between staff about medication orders and changes might lead to misunderstandings.

· Recent increased working hours and high-stress levels could impair decision making and concentration.

· Newly hired temporary nursing staff members might not have received proper training on medication administration protocols.

For this Discussion, you will prepare a 5-Why analysis to determine the root cause(s) along with a written description of the effect-cause-effect relationship of each factor (element) and your recommendations for improvement. Create a logic tree diagram that clearly displays the 5-Why in the form of an effect-cause-effect. The diagram can be drawn by hand or with software. (Note: Tables are not appropriate; a diagram is required.)

To prepare for this Discussion:

· Review this week's Learning Resources, especially those on the 5-Why tool.

· Consider the task force findings, the effect-cause-effect relationship of each factor, and your recommendations for improvement.

Post an analysis of the task force findings that demonstrate the root cause(s) through the use of the 5-Why tool. In your analysis, include the following:

· A robust effect-cause-effect logic tree diagram to identify the root cause(s) of the increasing number of reported medication errors at Big City General Hospital

· An explanation of the effect-cause-effect flow leading to the root cause(s)

· At least two recommendations for reducing the number of medication errors at the hospital 
 

Sample Solution

 

 

Big City General Hospital is facing a critical challenge: a concerning rise in medication errors. A task force identified five major factors contributing to this trend. To address these effectively, a 5-Why analysis is crucial for each factor to pinpoint the underlying root causes, followed by a description of their effect-cause-effect relationships and actionable recommendations.

5-Why Analysis and Effect-Cause-Effect Relationships

Problem Statement: Big City General Hospital has an increase of reported medication errors.

Factor 1: Nurses and pharmacists are experiencing heavy workloads due to a surge in patient admissions.

Effect-Cause-Effect Description: The surge in patient admissions (Cause) has directly led to heavy workloads for nurses and pharmacists (Effect). This heavy workload, in turn, creates an environment where staff are rushed, have less time for crucial double-checks and verification steps, and experience cognitive overload. These conditions then impair their concentration and decision-making (Effect), which directly increases the likelihood of medication errors (Effect).

 

 

 

IS IT YOUR FIRST TIME HERE? WELCOME

USE COUPON "11OFF" AND GET 11% OFF YOUR ORDERS