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One out of three medication administrations that occur involve causing serious harm to the patient. In order to help the patient as quickly and effectively as possible and to grow from the errors that where made we should normalize reporting all medication errors (Gluyas, 2018). We should no longer reprimand Nurses who make a medication error but teach them and let them use this as a learning opportunity (Gluyas, 2018).

An observational study was performed a crossed three countries which included 145 BSN students in their last semester of nursing school. The faculty observed 11 medication errors. The most common errors included the students not checking the patient's wristband, discovered the wrong name on the arm band, giving medication without indication, and giving medication with potential of an allergic reaction (Kuo et al., 2021). Although these errors were performed by senior nursing students, this indicates that there needs to be more education regarding the medication administration process. This will help our new grad nurses prevent medication errors from occurring.

Overall, the literature reveals that 5 to 10 percent of all medications administered include some form of error (Millichamp & Johnston, 2020). This is a shockingly large percentage of mistakes that are being made by Nurses. In order to fix this issue, we need to provide more education (Grimes & Guinan, 2022). In addition, we should encourage Nurses to report all errors (Abuelsound, 2018).

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1. Patient safety: at Sentara college we have learned to always put the patient's safety FIRST. Throughout my clinical experiences I have realized that safety is the pinnacle of every patients hospital stay. Learning this concept has prepared me to be a good nurse is so many ways. When I transition into professional practice I can help keep my patient safe in so many ways. These might include but are not limited to: identifying my patient's name and DOB, asking about allergies, using the 6 rights of medication administration, and using safety precautions such as 3 bed rails up, lowering the bed, and putting the call bell within reach.

2. 6 Rights of Medication Administration: In our Pharmacology course we first learned the six rights. We now use these every time we give medications. These rights include: the right patient, the correct medication, the right route, the right time, dose, and documentation. This concept has prepared me to be efficient and cautious when passing medications to my patients. It helps students get in the habit of verifying every step so that a mistakes are prevented. I can use this concept throughout my entire nursing career to keep my patients safe from harm.

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The barcode scanner is a type of informatics technology that allows the nurse to scan the patients ID band and indirectly identify their information.

It is still important that the nurse ask the patient to verify their name and DOB before administering any medications and of course go trough the six rights.

Overall the barcode scanner has helped reduce the amount of medication administration errors

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The Nurse's Role
Since the COVID-19 pandemic there has been increased stress on the RN role. As a result, mistakes are easily made due to fast working pace and heavy patient loads. This results in RN's easily making medication errors. At times, the barcode scanner is not used which can result in errors and exacerbate the issue. In addition, not all nurses use the six rights of medication when passing medications which also results in careless mistakes.

Importance of Nurse Involvement
The RN is the centerpiece in reducing the number of medication errors. The Nurse can help by paying attention to detail and taking all possible measures to prevent an error from occuring. Some of these measures include using the barcode scanner, the 6 rights, reporting medication errors and participating in necessary education. Their involvement will help improve patient safety.

Barriers of Nurse Involvement
One of the main barriers to Nurse's involvement in this issue is lack of time. RNs often don't have the energy or time to bring awareness to an issue like this. They often have high nurse to patient ratios. Another barrier is the fear of legal action. Nurses often don't look into or report medication errors because they are afraid of the consequences they could face.

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What is the Problem?
The Issue here is errors in medication administration. This is an ongoing issue that can occur within any healthcare facility but mainly in hospitals.

Between 5 and 10 percent of medications administered to patients in hospitals include some form of medication administration error (Millichamp & Johnston, 2020).

The main concern here is patient safety. Some of the common errors that are made include giving the patient the wrong medication, the wrong dosage, giving medication at the wrong time, giving drugs that are not compatible (Abuelsoud,2018) and confusing drug names that look alike and sound alike (ISMP, 2019).

Who is affected?

The patient is the main individual who suffers the consequences of these mistakes. As a result, it puts them at risk for adverse reactions such as confusion, distress and even death.

This issue also affects the RN and Doctor. Making errors puts them at risk for loosing their license and they have to take immediate action when an error like this occurs.

How?
Errors commonly occur when there are higher nurse to patient ratios and when nurses do not use the 6 rights when administering medications.

Certain medications require a second nurse check before administration. Some of these medications include but are not limited to insulin, certain pain medications, PCA pumps, IV drips, and blood administration. Nurses often skip this step and falsify that they have had that second check.

When the RN is rushed they are more likely to make a medication error.

When?
This issue can occur at any time. Although as mentioned before, errors are most commonly made when the nurse has a heavy patient load.

Where?
Anywhere that medications are given to a patient by a healthcare professional a medication error can be made. Some example include: the hospital, outpatient facilities, the operating room, long-term care facilities or even clinics.

Why?
Medication errors occur as result of the way the nurse thinks and then acts, or otherwise known as human cognition. Some examples of this include someone's organizational process and how they react to their work environment (Gluyas, 2018).

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1. Reporting medication errors, ME. Reporting medication errors is a very important step in correction and prevention of future errors (Abuelsoud, 2018) In order to prevent future mistakes from happening we have to learn from the ones that have already been made. Some nurses might be fearful to report medication errors. Therefore, we should teach nurses that reporting ME's is crucial for the patient's safety and will help us formulate our corrective action.

2. Education. We need to be educating future healthcare professionals of the importance of safe medication administration. Medication safety should be embedded into their standard curriculum (Grimes & Guinan, 2022). Interprofessional education is also necessary in the prevention of medication errors and will promote patient safety (Irajpour, Farzi, Saghaei & Ravaghi, 2019). We can utilize new technology such as simulation which allows the Nurse to practice passing medications without causing harm. It has also been proven that new RN's using simulation has improved medication administration knowledge and closed a major knowledge gap (Myroniak & Elder, 2021).

3. STAR (stop, think, act & review) This is a method used by Sentara to prevent safety errors. Before the administration of medications, the nurse should STOP what they are doing, slow down and focus on the patient at hand. THINK about what they are giving, who are they giving it too, is it the correct dose and route, is it the right time to give this to the patient? Then they can ACT or give the medication if everything is correct. Lastly, the nurse should REVIEW all steps and be sure the medication was administered correctly.