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Choosing Safety 

Workarounds circumvent or temporarily fix a perceived workflow hindrance. Identify a workaround you have seen used in your work setting or nursing training.  Analyze why you believe the risk-taking behavior was chosen over behavior that conforms to a safety culture.  Discuss changes that could be made to lessen the “felt need” for the workaround.

Content is coming mostly from your own experience, however please provide one scholarly reference to show 

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Choosing Safety

 

Workaround: Barcode Scanning Override

The introduction of technology also presents the challenge of workarounds that create potential risks to patient safety. Workarounds are practices that deviate from the normal protocol and are potentially viewed as harmless, but they can result in harm such as adverse events due to medication errors. In my nurse training, I worked in a clinical setting where a common workaround was failing to scan the patients' barcode on the wrist band to save time. Instead, some nurses scan patients' barcoded IDs on printed sheets. Others also rely on the information on the Electronic Health Record. The practice compromises the practice of ascertaining the five Rs of medication.

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To address this workaround, the system needs to run weekly reports to show instances that nurses failed to scan the patient’s wristband. This should be followed by sensitization training on the protocols and procedures of barcode medication administration. Training is important in understanding the risks posed by such workaround and change nurses’ attitudes towards the practice (Seaman, 2015). Similarly, it is essential that the nurse or unit leader walks around the wards while activities are going on and observe, as well as listen to comments about the system. This will help identify the challenges that nurses are facing and work with IT to fix them. Additionally, implementing strict policies and protocols and monitoring compliance will also contribute to lessening the habit of overriding the function of scanning a patient’s wristband before administering medication. After all, if the practice persists, those found guilty will be given stern warnings and disciplinary action taken as appropriate.

 

Reference

Seaman, J. B. (2015). Workarounds in the Workplace—A Second Look. Orthop Nurs., 34(4), 235–242. doi: 10.1097/NOR.0000000000000161.

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