NR-360 Week 4 Discussion: Workarounds and Their Implications for Patient Safety (GRADED A)

NR-360 Week 4 Discussion: Workarounds and Their Implications for Patient Safety 1. What is a workaround? Identify a workaround (specific to technology used in a hospital setting) that you have used or perhaps seen someone else use, and analyze why you feel this risk-taking behavior was chosen over behavior that conforms to a safety culture. What are the risks? Are there benefits? Why or why not? 2. Discuss the current patient safety characteristics used by your current workplace or clinical site. Identify at least three aspects of your workplace or clinical environment that need to be changed with regard to patient safety (including confidentiality), and then suggest strategies for change. Discuss the current patient safety characteristics used by your current workplace or clinical site In many jobs and institutions, they have safeguards with technology that allows the maximum safety of patients. These safeguards are integrated with technology to provide safety. For example, of these safeguards could be passcodes that nurses use in certain situations to protect their identity and keep records of their activity. For instance, the safety characteristic at work for nurses is when they must punch in a code to go into a supply room. Also, nurses must use code in order to use the MAR and Pyxis to provide medication to patients. In addition to that nurse is also having to scan the medication and read certain prompts on the computer before they can administer the medication. Another safeguard with technology that nurses must do is follow the 6 rights of medication administration. It is the nurse’s responsibility to double check the name the date and other details on the computer before giving medication. It is important for nurses to keep these past codes private because other nurses and he even clients can use these codes and abuse them. It is for the client’s safety that nurse protects their passcodes in the hospital and read all prompts on the computer before administering medication to prevent medication errors. I can understand that technology is becoming more complex in the medical field. Many nurses may become frustrated when they must enter passcodes or safeguards to give medication, clocking into work or entering a supply room. However, according to our textbook in chapter 11, many nurses create workarounds and, “if at all possible, will design workarounds that allow them to circumvent troublesome technology. However, workarounds are only a Band-Aid; they are not a long-term solution” (McGonigle & Mastrian, 2018). Therefore nurses will make sure cuts to make their job easier. Identify at least three aspects of your workplace or clinical environment that need to be changed with regard to patient safety (including confidentiality), and then suggest strategies for change. 1.) During my clinical experience, I notice that many nurses when providing medication to their clients do not read all the prompts on the computer. Also, they do not follow the 6 rights of medication administration. For example, when you provide medication to a client in their room certain prompts appear to show you certain side effects and considerations. Although I know nurses must be familiar with many drugs, they should still be aware and take their time to read the considerations for drugs that they are not familiar with. Also, the nurses don’t follow these 6 rights of medication because once they grab the correct medication from the medication room sometimes, they don’t double check the patient’s information and ID before providing the medication to the patients. Furthermore, under the U.S Department for health care Research and Quality an article was written by Tucker she states, “staff repeatedly work around safety-related warnings to obtain and administer excessively large doses of medications rather than contacting the pharmacist or the physician” (Tucker, 2009). This is another problem with medication administration because nurses are not reading the warning prompts on the computer and simply administer the medication as quickly as possible. In order to fix this, you will have to understand why Nurses are trying to save time during medication administration. One possible cause for why nurses are not following all the prompts on the computer before administering medication is because maybe the computers are slow and old. The nurses weren’t reading all the prompts on the computer before providing medication not because they were lazy. But because they were saving time. When are nurses busy and have to provide medication to multiple patients sometimes the computer can be slow and it can impede workflow. A simple fix to this would be providing newer and faster computers. 2.) I have thought of another possible workaround in the hospital. Although I have never seen a nurse do this. I have thought that it is possible for nurses to do this to save time. What I’ve noticed that nurses must enter many access codes to enter certain rooms. For example, nurses frequently must start an IV and every time they need to start an IV they need to enter an access code to go into the supply room. Although I know it would be extremely reckless, I thought about putting in a door stopper in the supply room so I wouldn’t have to enter a passcode every time. The reason why I thought about this is that they are different access codes for different supply rooms and I was getting frustrated that I was forgetting the different access codes. In order to resolve this issue, I thought it would be very beneficial if the supply rooms had fingerprint sensors on them. Much like how our modern cell phones today can use your fingerprint to access our cell phones faster than punching in the code, we can use the same fingerprint technology for nurses to go into supply rooms faster. This will help prevent workarounds because nurses would be able to access rooms faster while maintaining security. 3.) In my last example, I have noticed that it is difficult to scan certain bar codes on patients and on certain medications and supplies. I understand that the bar code technology is necessary because it helps to keep track of medication administration and other records. But sometimes it is very difficult to scan the bar code. According to your textbook in chapter 11, it states, “nurses devised workarounds, such as removing the armband from the patient and attaching it to the bed, because the bar-code reader failed to interpret bar codes when the bracelet curved tightly around a small arm” (McGonigle & Mastrian, 2018). In this example, nurses can have difficulty scanning a barcode on a child. A nurse may devise a workaround by scanning removing their identification bracelet to scan it easier. Although this may save time, clients can be misidentified if nurses remove armbands too frequently. To fix this and nurses can request that bar code readers be replaced. Sometimes it’s not the nurse’s fault for why technology is not working. Instead of using shortcuts such as removing the identification armband, it would be better for the patient safety to request newer and more advanced bar code readers. Although this may sound like an expensive solution, It is still better than waiting for a lawsuit because you miss identified a patient after a nurse decided to remove their identification armband to scan it. Works Cited McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge. (4th edition). Burlington, MA: Jones and Bartlett. Tucker, Anita L. “Workarounds and Resiliency on the Front Lines of Health Care.” PSNet, (2009) retrieved from