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A new outcome-focused orientation model was developed in response to poor preceptor satisfaction and a high nurse graduate turnover. Progression through the program was determined by the orientee's accomplishment of the target or strategic outcomes across seven progressive phases-not by time and budget. At the conclusion of the first year, decreased turnover, increased preceptor satisfaction, and substantial financial savings were documented.

This consensus document is endorsed by The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS).

Nursing Management R i s k M a n a g e m e n tA dverse drug event is a comprehensive term used to describe an error in medication that produces harm to a patient. Approximately 770,000 people a year experience an adverse drug event, according to the Institute of Medicine (IOM) 1999 report To Err is Human: Building a Safer Health System. As a result of an adverse drug event, a patient's length of stay increases 8 to 12 additional days more than the expected hospitalization stay. A third of all adverse drug events are preventable medication errors. Preventable adverse drug events cost the United States 3.5 billion dollars a year. 1 Besides the financial impact, adverse drug events have an emotional impact on our patients, their families, and healthcare providers.It has been identified that approximately 7,000 people die from medication errors each year. 1 The FDA reports that one death occurs each day due to a medication error. 2 It has also been found that medication errors are occurring in one of every five medications administered to a patient. Taking a closer look at the route of medication administration, 61% of serious and life-threatening errors are associated with I.V. medication administration. 3 Administering medication is one of the many high-risk tasks nurses perform frequently throughout their shift. Pen and paper incident reports have been utilized, but this process assumes that risk management and leadership are notified when errors occur. Many reporting processes haven't incorporated near-miss events due to poor system processes. The purpose of this literature review is to explore interventions that have been successful in decreasing medication errors and helping to identify near-miss events. The evidence is inThe themes identified in the literature review were promotion of a culture of safety, prevention of medication errors, and implementation of reporting systems for medication errors and near misses.Promoting a culture of safety. For healthcare organizations to improve patient outcomes, transforming from a punitive environment into a culture that has high expectations is required. 4,5,6 The authors pointed out one way to promote a culture of safety is to implement a reporting system for errors that doesn't penalize the staff. The literature revealed surveys conducted by nurses and physicians that provided barriers in reporting of medication errors and near-miss events, such as nurses being fearful of penalization having a personal and professional impact on them. 6,7 Preventing medication errors and near-miss events. Surveys were conducted to identify barriers in reporting medication errors. The results indicated a knowledge gap in how to report errors and understanding the differences between medication errors and near-miss events. 8,9 The conclusion? There's a need for education before implementing any reporting system.Understanding human behavior was also identified in the literature. Medication errors occur because of human or system failures. One article indicated that healthcare personnel ...