The article Medication Timeliness – Timely Medication Administration Guidelines for Nurses: Fewer
Wrong-Time Errors? highlights the problems and inherent safety risks associated with the unrealistic
30 minute rule for the majority of non-critical medications. One quote from the article truly brings the
issue to the forefront of the clinical practice arena.
Healthcare has changed since “right time” was first defined many years ago. Hospitalized patients are
sicker, more medications are prescribed to each patient, and the formulary has expanded
dramatically. The medication administration process (from physician order to patient administration)
has grown in complexity with the addition of computerized physician order entry, medication
barcoding, automated dispensing cabinets, electronic medical records, and time-consuming patient
identification procedures. The 30-minute rule was outdated and impractical even before it
became “law.”
Answer the questions that follow in paragraph format using the readings for context and citations.
Part one
1. Think about the information from the power point, article and the readings about errors and
answer the question: Can you see the patient safety risks related to continuing to try and follow
the 30 minute rule?
Use and cite at least one concept or content from the article
Part two: Using this short scenario, answer the questions in 2-3 paragraphs
At an acute care hospital, a change in the process of medication administration is occurring because
the unit is piloting use of a bar coding system for medication administration.
One month after the barcoding system was initiated, the nursing unit receives information from the
Performance Improvement Department identifying that a significant decrease in the timeliness of
administration of antibiotics has been noted. The nurse manager has written several reprimands for
the staff involved. Using concepts from the chapters and required articles, answer the following
questions.
1. Is this nurse manager taking an appropriate approach to this problem? Address the concept of
Blame or a Culture of Safety.
2. During this same time, the nurse educator and the students notice that additional patient ID bands
have been placed on the side rails of the beds. The instructor explains that this is a form of a
work around, allowing the staff to scan the patients ID band more easily for the bar coding
system. What are the inherent risks associated with work arounds and this one in particular?
