COGNITIVE STRATEGIES FOR SAFE MEDICATION ADMINISTRATION

Driven by increasing incidences of medication errors made by nurses and the accompanying adverse patient outcomes and complex etiologies of the errors, there has been a plethora of research generated. Medication errors and their sequelae are well documented. However, there remains a paucity of studies that examine nurses’ clinical judgment and reasoning abilities especially those that facilitate safe medication administration. In this doctor of nursing practice project, cognitive strategies for nurses and nurse leaders are proposed to mitigate this problem. Based upon an integrative literature review, 98 cognitive strategies for safe medication administration were identified. Benner’s Framework of Nursing Competence and the Johns Hopkins Nursing Evidence-based (JHNEBP) Practice Rating Scales guided the integrated literature review and synthesis of findings. The Tang Model of Cognitive Strategies for Safe Medication Administration was formulated using Lasater's Clinical Judgment Rubric as a guide. The model is to be used during medication administration. Ideally, the nurse would visualize the Model and then activate the cognitive strategies from the model. This should remind the nurse to employ: 1) patient-centered and pattern-recollected Mindfulness; 2) Clinical Reasoning while prioritizing; 3) protective, protocol-driven, and proactive Decisionmaking; 4) perceptive reassessment with Validation in patient care. The Model has not been tested.