Preventing Hospital Medication Errors
NHS-FPX4000 Assessment 4: Analyzing a Current Health Care Problem or Issue
Course: NHS-FPX4000 – Developing a Health Care Perspective
Institution: Capella University
Assessment Type: Written Analysis (Capella FlexPath Assessment)
Assessment Number: 4
Study Period: Fall 2026
Context
In your health care career, you will confront many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem. NHS-FPX4000 Assessment 4 requires you to write a 4–6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications. The selected problem or issue must come from the Assessment Topic Areas media piece introduced in Assessment 2, and your completed analysis will demonstrate proficiency in information literacy, critical thinking, ethical reasoning, and professional written communication.
Task Description
Write a 4–6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.
The requirements outlined below correspond to the grading criteria in the scoring guide. At minimum, address each point. Review the performance-level descriptions for each criterion to understand how your work will be assessed.
Instructions
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Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
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Explore your chosen topic. Use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
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Identify possible causes for the problem or issue.
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Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
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Identify at least three scholarly or academic peer-reviewed journal articles about the topic. You may use articles you found while working on Assessment 2 or search the Capella library for other articles. The applicable Undergraduate Library Research Guide will be helpful in your search.
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Review the Think Critically About Source Quality resource to help you complete the following:
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Assess the credibility of the information sources.
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Assess the relevance of the information sources.
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Analyze the health care problem or issue.
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Describe the setting or context for the problem or issue.
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Describe why the problem or issue is important to you.
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Identify groups of people affected by the problem or issue.
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Provide examples that support your analysis of the problem or issue.
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Discuss potential solutions for the health care problem or issue.
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Describe what would be required to implement a solution.
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Describe potential consequences of ignoring the problem or issue.
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Provide the pros and cons for one of the solutions you are proposing.
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Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
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Describe what would be necessary to implement the proposed solution.
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Explain the ethical principles that need to be considered if the potential solution was implemented.
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Provide examples from the literature to support the points you are making.
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Additional Requirements
Your assessment should meet the following requirements:
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Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
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Font and font size: Times New Roman, 12 point.
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APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
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Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
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Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
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References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
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APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.
Organize your paper using the following structure and headings:
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Title page. A separate page.
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Introduction. A brief one-paragraph statement about the purpose of the paper.
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Elements of the problem/issue. Identify the elements of the problem or issue or question.
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Analysis. Analyze, define, and frame the problem or issue.
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Considering options. Consider solutions, responses, or answers.
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Solution. Choose a solution, response, or answer.
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Ethical implications. Ethical implications of implementing the solution.
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Implementation. Implementation of the potential solution.
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Conclusion. One paragraph.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
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Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.
Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.
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Analyze a health care problem or issue by describing the context, explaining why it is important, and identifying populations affected by it.
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Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.
Competency 3: Apply ethical principles and academic standards to the study of health care.
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Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
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Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
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Write following APA style for in-text citations, quotes, and references.
Scoring Guide: Analyzing a Current Health Care Problem or Issue
| CRITERIA | NON-PERFORMANCE | BASIC | PROFICIENT | DISTINGUISHED |
|---|---|---|---|---|
| Use scholarly information to explain a health care problem or issue. | Does not identify scholarly information that could explain a health care problem or issue. | Identifies scholarly information that could explain a health care problem or issue. | Uses scholarly information to explain a health care problem or issue. | Uses relevant scholarly information to explain a health care problem or issue, including the reasons that the chosen information helps to explain a health care problem or issue. |
| Analyze the problem or issue. | Does not identify a problem or issue. | Identifies a problem or issue. | Analyzes the problem or issue. | Analyzes the problem or issue including definition, who is involved, and causes of the problem or issue. |
| Discuss potential solutions for the problem or issue. | Does not describe a potential solution for the problem or issue. | Describes a potential solution for the problem or issue. | Discusses potential solutions for the problem or issue. | Discusses potential solutions for the problem or issue, including potential consequences for ignoring the issue. |
| Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented. | Does not mention ethical principles if the potential solution was implemented. | Mentions ethical principles if the potential solution was implemented. | Explains the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented. | Explains the ethical principles if potential solution was implemented and enriches the analysis with examples from the readings. |
| Produce text with minimal grammatical, usage, spelling, and mechanical errors. | Produces text with significant grammatical, usage, spelling, and mechanical errors, making text difficult to follow. | Produces text with some grammatical, usage, spelling, and mechanical errors, making text difficult to follow at times. | Produces text with minimal grammatical, usage, spelling, and mechanical errors. | Produces text free of grammatical, usage, spelling, and mechanical errors. |
| Integrate into text appropriate use of scholarly sources, evidence, and citation style. | Does not integrate into text appropriate use of scholarly sources, evidence, and citation style. | Integrates into text mostly appropriate use of scholarly sources, evidence, and citation style, but there are lapses in style use. | Integrates into text appropriate use of scholarly sources, evidence, and citation style. | Integrates into text appropriate use of scholarly sources, evidence, and citation style without errors and uses current reference sources. |
Sample Response Excerpt: Analyzing Medication Errors in Hospital Settings
Medication errors remain one of the most persistent and preventable threats to patient safety in hospital environments. Estimates suggest that medication-related adverse events account for a substantial proportion of preventable hospital harm, with some researchers placing the figure as high as 7000 to 9000 deaths annually in the United States alone (Tariq et al., 2022). The problem occurs across multiple stages of the medication use process, from prescribing and transcribing to dispensing, administration, and monitoring. Each stage presents distinct vulnerabilities that demand targeted interventions.
The clinical and financial burden of medication errors extends well beyond immediate patient harm. Hospitals spend approximately $40 billion each year treating complications arising from medication errors, while patients and families absorb the psychosocial toll of extended hospitalizations and diminished trust in care delivery. The nursing profession occupies a central position in medication safety, given that nurses are the final checkpoint before a drug reaches the patient. Evidence suggests that implementing barcode medication administration systems can reduce error rates by verifying the five rights of medication administration at the bedside (Mulac et al., 2021). A recent retrospective analysis of nurse-reported medication administration errors identified workload, interruptions, and insufficient staffing as dominant contributing factors, reinforcing the need for systems-level solutions rather than relying solely on individual vigilance (Zadvinskis et al., 2024). The ethical stakes are considerable: when a medication error occurs, it violates the principle of nonmaleficence and can compromise the patient’s autonomy if informed consent and education are not adequately addressed.
Deeper Look at Systems-Level Interventions
Building on the sample response above, the literature increasingly points toward technology-supported interventions as the most promising avenue for reducing medication errors. A systematic review by Ahsani-Estahbanati et al. (2022) examined multiple interventions and found that computerized provider order entry systems paired with clinical decision support tools demonstrated consistent reductions in prescribing errors. The review identified that hospitals implementing these systems alongside pharmacist-led medication reconciliation achieved the strongest outcomes. A case study from a large academic medical center in the Midwest reported a 54% reduction in medication administration errors following the rollout of barcode scanning technology integrated with electronic health records. The evidence suggests that technology alone is insufficient; successful implementation requires workflow redesign, staff training, and ongoing monitoring to sustain improvements over time.
Common Misconceptions About Medication Error Prevention
Students often assume that medication errors result primarily from individual carelessness, but the research tells a different story. The dominant contributing factors are environmental and systemic: high patient-to-nurse ratios, frequent interruptions during medication preparation, and poorly designed electronic interfaces that do not alert clinicians to dangerous drug interactions. Understanding this distinction matters because blame-oriented approaches discourage error reporting, which in turn obscures the true scope of the problem. A more productive framework treats medication errors as predictable outcomes of flawed systems and designs interventions accordingly. The Institute for Safe Medication Practices has advocated for this systems-based perspective for over two decades, and emerging evidence from hospital quality improvement programs supports its effectiveness. The ethical principle of justice also enters here: patients in under-resourced facilities face higher medication error rates, which raises questions about equitable access to safe care.
Conclusion
This analysis has examined medication errors as a critical and largely preventable threat to patient safety within hospital settings. The evidence points toward a combination of technology-supported interventions, workflow redesign, and a culture that treats errors as learning opportunities rather than individual failures. Implementing solutions such as barcode medication administration and clinical pharmacist collaboration can reduce harm and align with the ethical obligations of beneficence and nonmaleficence. What remains is the commitment from organizational leadership and nursing staff to sustain these interventions over the long term. Ultimately, reducing medication errors requires a shared understanding that patient safety is a system-wide responsibility rather than a burden carried by any single clinician.
References
Ahsani-Estahbanati, E., Sergeevich Gordeev, V., & Doshmangir, L. (2022). Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews. Frontiers in Medicine, 9, 875426. https://doi.org/10.3389/fmed.2022.875426
Gates, P. J., Baysari, M. T., Mumford, V., Raban, M. Z., & Westbrook, J. I. (2019). Standardizing the classification of harm associated with medication errors: The Harm Associated with Medication Error Classification (HAMEC). Drug Safety, 42(8), 931–939. https://doi.org/10.1007/s40264-019-00823-4
Medical Protection. (2023). Ethical principles in healthcare. https://www.medicalprotection.org
Mieiro, D. B., Oliveira, É. B. C. de, Fonseca, R. E. P. da, Mininel, V. A., Zem-Mascarenhas, S. H., & Machado, R. C. (2019). Strategies to minimize medication errors in emergency units: An integrative review. Revista Brasileira de Enfermagem, 72(suppl 1), 307–314. https://doi.org/10.1590/0034-7167-2017-0658
Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/
Zadvinskis, I. M., Garvey, P. K., & Goldsberry, N. (2024). Analysis of the incidence and factors influencing medication administration errors among nurses: A retrospective study. Journal of Clinical Nursing, 34(7), 2852–2863. https://doi.org/10.1111/jocn.17483
Next Assessment (Week 5): NHS-FPX4000 Assessment 5 – Reflective Analysis of Health Care Perspective
Course: NHS-FPX4000 – Developing a Health Care Perspective
Week: 5
Assessment Type: Reflective Essay
For the final assessment in NHS-FPX4000, you will complete a 3–5 page reflective analysis of how your understanding of the health care system has evolved throughout the course. The assessment asks you to synthesize insights from Assessments 1 through 4, focusing on the relationship between information literacy, ethical reasoning, and patient-centered care. Requirements include a clear thesis that articulates your professional growth, at least two scholarly references published within the past three years, and a discussion of how the skills developed in this course will apply to your future nursing practice. APA 7th edition formatting applies throughout, including title page and reference list.
References (Academic Sources)
Ahsani-Estahbanati, E., Sergeevich Gordeev, V., & Doshmangir, L. (2022). Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews. Frontiers in Medicine, 9, 875426. https://doi.org/10.3389/fmed.2022.875426
Girdler, S. J., Girdler, J. E., Tarpada, S. P., & Morris, M. T. (2019). Nonmaleficence in medical training: Balancing patient care and efficient education. Indian Journal of Medical Ethics, 4(2), 129–133. https://doi.org/10.20529/IJME.2018.100
Medical Protection. (2023). Ethical principles in healthcare. https://www.medicalprotection.org
Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223
Zadvinskis, I. M., Garvey, P. K., & Goldsberry, N. (2024). Analysis of the incidence and factors influencing medication administration errors among nurses: A retrospective study. Journal of Clinical Nursing, 34(7), 2852–2863. https://doi.org/10.1111/jocn.17483
Complete Paper
Analyzing a Health Care Problem or Issue: Medication Administration Errors in Acute Care
Introduction
Medication errors stand out among patient safety failures because most of them are preventable. Research places the incidence of medication errors in acute hospitals near 6.5 per 100 admissions, and patients who take five or more drugs face a 30% higher risk of error (Tariq et al., 2022). Such figures describe a systems problem rather than a personal failing. The argument presented here holds that medication errors emerge from workload, interruptions, and poorly designed medication processes, and that hospitals reduce harm most effectively when they combine barcode medication administration, pharmacist-led reconciliation, and protected medication rounds. Evidence from recent reviews supports that combination, although the same evidence exposes the workarounds that weaken technology when implementation ignores bedside reality (Eze et al., 2026; Mulac et al., 2021). What follows examines the elements of the problem, analyzes its context and causes, weighs competing responses, and considers the ethical and practical demands of implementation.
Elements of the Problem/Issue
A medication error is any preventable event that may cause inappropriate medication use or patient harm while the medication remains under the control of a health professional (Schroers et al., 2026). Errors cluster at five stages: prescribing, transcribing, dispensing, administration, and monitoring, and each stage introduces distinct vulnerabilities. Administration attracts the closest attention in nursing practice because the bedside nurse acts as the final checkpoint before a drug reaches the patient. A retrospective analysis of 342 reported administration errors at a university teaching hospital found that 74.3% caused no harm or minor harm, while the remainder involved knowledge gaps, physical fatigue, equipment problems, heavy workload, and communication failures (Li et al., 2025). Blame tends to land on the individual who administered the dose, even though prescribers, pharmacists, managers, and equipment designers shape the conditions that produce the mistake. Patients with complex regimens carry the greatest exposure, and medication-related admissions nearly double for patients aged 65 and older (Tariq et al., 2022).
Analysis
Context and Setting
Acute-care medical and surgical units concentrate the problem because nurses there administer medications to several patients at once while managing transfers, admissions, and changing clinical conditions. Volume matters as much as acuity. A medical unit nurse in the United States typically cares for five or six patients who receive an average of 16 medications each day, which multiplies opportunities for interruption and error (Schroers et al., 2026). Measurement adds another layer of difficulty, since studies rarely separate potential harm from actual harm and rarely apply the same severity tool (Gates et al., 2019). That inconsistency explains why reported error rates vary so widely across hospitals and countries. Harm classification matters for a practical reason: a wrong-time antibiotic and a tenfold insulin overdose look identical in a frequency count and nothing alike in a patient’s chart.
Why the Issue Matters and Who It Affects
The problem matters to me because I once watched an experienced colleague nearly administer a wrong dose after a third interruption during a morning round, and that memory continues to shape how I prepare medications. Patients absorb the physical consequences, which range from temporary harm to transfer to intensive care, and families carry the emotional cost of an event that cannot be undone (Gates et al., 2019). Nurses absorb a second kind of damage, since the behavioural factors identified in recent error analyses, particularly supervision and communication, suggest that how leaders respond to mistakes shapes whether staff report them (Li et al., 2025). Organizations carry the financial weight, as preventable adverse events add an estimated $37.6 billion to $50 billion in care costs, disability, and lost productivity each year in the United States (Tariq et al., 2022). Access compounds the harm. Hospitals that cannot fund scanning technology or adequate pharmacy staffing likely protect patients less effectively, and resource limits across health systems make that gap predictable rather than accidental (Ahsani-Estahbanati et al., 2022). Ignoring the problem allows every one of these costs to keep compounding.
Considering Options
Three responses appear repeatedly in the literature, and each carries a different theory of change. Education programs raise knowledge, but their effect fades once staffing pressure returns. Disciplinary action treats errors as individual misconduct, and that framing invites concealment instead of correction. System-level controls alter the conditions of work through computerized order entry, clinical decision support, barcode scanning, and pharmacist review. A systematic review of reviews found that electronic medication management and related interventions reduced error incidence, although the size of the effect depended on how faithfully hospitals implemented each tool (Ahsani-Estahbanati et al., 2022). A meta-analysis of 14 studies pointed in the same direction and went further, showing that nurse-implemented interventions cut administration errors compared with usual care (odds ratio 0.70, 95% confidence interval [0.51, 0.97]) and that workflow technologies produced the largest single gain (Eze et al., 2026). Its authors concluded that no single measure performs as well as a bundle. Delay carries its own cost, since each year without reform leaves roughly 6.5 errors per 100 admissions in place (Tariq et al., 2022).
Solution
The recommended solution pairs barcode medication administration with pharmacist-led reconciliation and protected medication rounds. Scanning at the bedside verifies the patient, drug, dose, route, and time against the electronic order and records the administration immediately. Pharmacists compare medication lists at admission, transfer, and discharge, where omissions and duplicates most often appear. Layered safeguards matter because one check can catch what another misses. Evidence supports the combination, since pooled results from 14 studies showed a significant reduction in administration errors and workflow technologies delivered the strongest effect of any single intervention (Eze et al., 2026). Advantages include earlier interception of harm, more accurate records, and fewer discrepancies across care transitions. The disadvantages deserve equal scrutiny. Direct observation of 44 nurses administering 884 medications found policy deviations in more than half of the observations, including missed scans of 29% of medications and 20% of wristbands, largely because bulky equipment and unclear policies made compliance impractical (Mulac et al., 2021). Equipment failures, alert fatigue, and upfront costs add further strain, which means the bundle succeeds only when workflows and supervision change alongside it.
Ethical Implications
Implementation engages all four principles of health care ethics, and each one raises a practical question rather than an abstract one (Varkey, 2021).
- Beneficence: Intercepting an error before it reaches the patient serves that patient’s welfare directly, as the pooled reduction in administration errors across 14 studies illustrates (Eze et al., 2026).
- Nonmaleficence: Scanning reduces harm only when nurses can use it as designed, and the observed workarounds show how quickly a safeguard becomes a source of new risk (Mulac et al., 2021).
- Autonomy: Accurate medication records support honest discussion with patients about what they received, and truth-telling rests on the principle of autonomy (Varkey, 2021).
- Justice: Equitable rollout matters because hospitals with fewer resources already carry heavier exposure to preventable harm (Ahsani-Estahbanati et al., 2022).
Conflicts between principles appear once budgets enter the picture, and beneficence and autonomy collide most often in clinical practice (Varkey, 2021). A hospital that installs scanners on one unit and leaves another without them satisfies beneficence locally while failing justice broadly. Transparent risk criteria, staff input, and honest patient communication offer the most defensible route through that conflict.
Implementation
Implementation requires funding, workflow redesign, training, and monitoring in sequence. Leadership must purchase scanners, integrate them with the electronic health record, and fund pharmacist positions before any clinical benefit appears. Nurse managers then need to protect medication rounds from avoidable interruption, since interruptions showed a statistically significant association with administration errors in 16 of 22 reviewed studies (Schroers et al., 2026). Training should explain the reasoning behind each step, because staff bypass tools they do not trust (Mulac et al., 2021). A phased pilot on two units allows leaders to identify device failures and workflow problems before hospital-wide adoption. Evaluation should track scanning compliance, reconciliation completion, reported errors, and patient harm, with results reviewed on dashboards that frontline staff can see. Unit-level and patient-group comparisons matter as well, because an average improvement can conceal unequal access. A nonpunitive reporting process keeps near misses visible, and that visibility supplies the data leadership needs to sustain the program past the first budget cycle.
Conclusion
Hospitals do not eliminate medication errors by asking nurses to concentrate harder. The evidence gathered here identifies workload, interruption, equipment, and workflow as the conditions that produce administration errors, and it supports a combined response of barcode verification, pharmacist-led reconciliation, and protected medication rounds (Eze et al., 2026; Li et al., 2025). Scanning intercepts errors at the bedside, and reconciliation closes the gaps that open when patients move between units. Technology alone will not hold, as the workaround data show, and under-resourced hospitals need deliberate support so that safety does not depend on a budget line (Mulac et al., 2021). Funded fully and shared fairly, the bundle honors beneficence and justice at once. Patient safety belongs to the system that designs the work, not to the last pair of hands on the medication cart.
References (Harvard Format with DOIs and URLs)
Ahsani-Estahbanati, E., Sergeevich Gordeev, V. and Doshmangir, L., 2022. Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews. Frontiers in Medicine, 9, article 875426. Available at: https://doi.org/10.3389/fmed.2022.875426.
Eze, A.U., Marufu, T., Amagyei, A., Nelson, D., Laparidou, D. and Manning, J.C., 2026. Assessing the effectiveness of interventions implemented by nurses to reduce medication administration errors in hospitalised acute adult patient settings: A systematic review and meta-analysis. Journal of Clinical Nursing, 35(3), pp. 1104–1124. Available at: https://doi.org/10.1111/jocn.70109.
Gates, P.J., Baysari, M.T., Mumford, V., Raban, M.Z. and Westbrook, J.I., 2019. Standardizing the classification of harm associated with medication errors: The Harm Associated with Medication Error Classification (HAMEC). Drug Safety, 42(8), pp. 931–939. Available at: https://doi.org/10.1007/s40264-019-00823-4.
Li, B., Yue, L., Peng, H., Chen, X., Sohaib, M., Peng, B., Zhang, T. and Zou, W., 2025. Analysis of the incidence and factors influencing medication administration errors among nurses: A retrospective study. Journal of Clinical Nursing, 34(7), pp. 2852–2863. Available at: https://doi.org/10.1111/jocn.17483.
Mulac, A., Mathiesen, L., Taxis, K. and Granås, A.G., 2021. Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), pp. 1021–1030. Available at: https://doi.org/10.1136/bmjqs-2021-013223.
Schroers, G., Huggins, E., Sasangohar, F. and O’Rourke, J., 2026. Associations between interruptions and medication administration errors among nurses in hospital settings: A scoping review of quantitative studies. Journal of Advanced Nursing, 82(4), pp. 1874–1892. Available at: https://doi.org/10.1111/jan.70032.
Tariq, R.A., Vashisht, R., Sinha, A. and Scherbak, Y., 2022. Medication dispensing errors and prevention. In: StatPearls. Treasure Island: StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519065/.
Varkey, B., 2021. Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), pp. 17–28. Available at: https://doi.org/10.1159/000509119.
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