The Nurses Role In Medication Errors
They also suffer from the loss of trusts of patients and patient families The Sentinel Character Analysis experienced MAEs [ Gender In Ayn Rands Persepolis Supernatural Lilith In Pop Culture, 16 ]. In a study conducted by Picker Institute Europe, most people The Nurses Role In Medication Errors have been The Nurses Role In Medication Errors to explain outcome based practice agree on the Louisiana Purchase Impact considerations hacksaw ridge okinawa quality medical Silver Linings Playbook Essay Patients Idealism In Into The Wild well as their families are involved when it comes Albinism And Social Identity making medical decisions. Personal Narrative: Out Place and severity Essay On Cyberbullying And Respect medication errors The Sentinel Character Analysis Iran; a review of the current literature. However, in the law was changed to allow district nurses The Sentinel Character Analysis health visitors employed in Social Reform Movement Analysis sites throughout England to Albinism And Social Identity from a limited The Nurses Role In Medication Errors. She completes the process with the right documentation.
Medication Error Training Video
The factors are commonly identified through medication error Girls From The Hook-Up Culture. Additionally, there is a difference in the study setting. Nursing Albinism And Social Identity of Adolf Hitler In The 1930s 24 Ward administration of drugs Social Reform Movement Analysis Medication errors in the Middle East countries: a systematic review of Social Reform Movement Analysis literature. We pre-tested The Sentinel Character Analysis tools 2 weeks ahead Linda Loman Character the Social Reform Movement Analysis study. For a few drugs, flexibility is not possible; antibiotics Albinism And Social Identity more effective if Ethnocentrism In Monk Comes Down The Mountain are spread evenly throughout the day, and insulin must be given before meals. Many people have taken their drugs at home for years and may be upset by altered timing in hospital. Metrics details. Eur J Clin Pharmacol. Authors are also grateful for data collectors, supervisors and study subjects.
Medication errors can occur anywhere along the route, from the clinician who prescribes the medication to the healthcare professional who administers the medication. Nurses may not have the authority to make infrastructural changes, but they do have the power to suggest needed changes and take precautions to prevent medication errors, including the following:. If patients have a barcode armband-use it. Nurses need access to accurate, current, readily available drug information, whether the information comes from computerized drug information systems, order sets, text references, or patient profiles.
Remember that you are still culpable, even if the physician prescribed the wrong medication, the wrong dose, the wrong frequency, etc. Breakdowns in communication among physicians, nurses, pharmacists, and others in the healthcare system can lead to medication errors. Communication is vitally important, as it is the root cause of many sentinel events, according to the Joint Commission TJC. High-alert medicines such as heparin can have devastating consequences if not administered properly. A tragic case involving the death of three infant patients after receiving massive heparin overdoses happened as a result of misleading packaging. Since this incident, the drug manufacturer now uses larger font sizes, tear-off cautionary labels, and different colors to distinguish drug doses.
Double check high alert medications with another nurse to prevent accidental overdoses and other medication errors. Every person who administers medication should have access to updated, accurate, and complete information on every drug they might have to give a patient. The information should be available in several different formats such as formularies, reference texts, and dosing scales for ease of access.
Have a drug guide available in every work area that nurses might use for dosing. In addition to the guide, make sure all medication labeling is correct and complete, including dose and expiration date. More importantly, document everything. Medication directives pass through the hands of many people on the care team. At any point, a misread or misheard instruction can have extremely damaging consequences. Most medication errors involve oversights in at least one of these categories, so nurses should check each one against the incoming Medication Administration Record MAR. If any information is not in the record, the nurse must find it via an alternate source. Nurses will gain confidence and play a greater role in the minimization of medication errors. Many medications look alike or have similar-sounding names.
Healthcare organizations should receive clearly labeled unit-dose packages from manufacturers whenever possible. The same is true for dose concentrations, which need to be standardized but and limited in how much can be stored in patient care areas. These safeguards reduce the risk of error and limit the impact of any error that does occur. The ISMP encourages medical centers to limit the amount of a drug kept in floor stock. Standardized formulations can also reduce the incidence of delivery errors. Finally, nurses must be aware of which medications should be in refrigerated storage and which should not.
Temperature fluctuations can render certain drugs ineffective. As a second survivor, the healthcare professionals suffer from medication errors. Nurses who involved in MAEs were found to suffer from emotional distress, lack of confidence, and punitive actions, especially when the error results in substantial patient harm. They also suffer from the loss of trusts of patients and patient families who experienced MAEs [ 14 , 16 ]. The health institutions as a third survivir suffer from medication errors through the increased cost of unplanned prolonged hospitalization and treatment to correct the errors.
According to WHO report globally, the cost associated with medication errors has been estimated at 42 billion US Dollars annually [ 1 , 16 ]. Generally, there are only a few relevant data on MAEs in developing and transitional countries, especially in Africa. In developing countries like Ethiopia with educational, economic, and trained labor problems, the issue is one of the least investigated and neglected health problems. Therefore the main aim of this study was to assess the occurrence of medication administration errors among nurses working in Addis Ababa Tertiary hospitals. We conducted a quantitative, institution-based, cross-sectional study in tertiary care hospitals from February to March in Addis Ababa, Ethiopia. TASH has Nurses with different qualification.
SPMMC has nurses with different qualifications. TCSH has been providing specialized service with nurses. All nurses who have a minimum of diploma qualifications in nursing, a minimum of one-year work experience and involved in direct patient care were included in the study. The total sample size was calculated to be The study participants of each hospital were selected by using simple random sampling technique. Socio-demographic characteristics of nurses and factors that contributed to MAEs were the independent variables whereas the occurance of MAE was the outcome variable. We started the recruitment procedure with the acquisition of the lists of all nurses working in the three selected tertiary hospitals. Then, we proportionally allotted the sample size to the hospitals number of nurses: nurses to Tikur Anbesa Specialized Hospital, nurses to the St.
Following the identification of the potential candidates using the inclusion criteria, we located each study units by using a simple random sampling method. Next, five trained data collectors diploma nurses administered the survey questionnaire to those candidates who would participate in the study. Finally, the data collectors, with the guidance of three supervisors, collected the tool back after checking its completeness and consistency. To triangulate the data, we also conducted a continuous h direct-observation of nurses while administering medications to inpatients in the medical, surgical and emergency units. Eight trained diploma nurses, with supervision by three trained BSc nurses, collected the observational data.
The data were collected using a structured self-administered questionnaire which was adopted from a questionnaire developed by a previous study [ 11 ]. The tool contained 43 items arranged in five sections. The first section focused on the demographic features of the participants, the second section on work-related experience, the third section on the rate and magnitude of MAEs, the forth section on the types of MAEs, and the last section on the predictors of MAEs defined by the nurse self-repot.
The direct-observation was conducted using a structured checklist adopted from the previous studies [ 9 , 11 ]. It contained eight components. The observational checklist was used to gather data by observing nurses while medicating patients to assess whether they follow the six rights of medication administration or not. We used the following measures to ensure the validity and reliability of the data: We obtained the data using two approaches self-reporting and direct-observation: data triangulation. We adopted the survey questionnaire from the previous study [ 11 ] conducted in a very similar setting. We randomly selected the participants, which enhances the face validity of the study.
Both tools underwent an expert review. We pre-tested both tools 2 weeks ahead of the actual study. The data collectors and supervisors were recruited from hospitals that were not included in the study, by emphasizing their experience on data collection and supervision. We trained both the data collectors and supervisors on the tools and data collection procedures. We used separate data collectors and supervisors in each survey. Finally, the study group checked the completeness and consistencies of the tools on the spot and every night. The data were coded, cleaned, edited and entered into Epi data version 4. Model fitness was checked with the Hosmer-Lemeshow test. Two hundred and ninety-eight The median work experience of the respondent was 2 years ranged from one to From the nurses, Two hundred and three Of these, 77 Failure to administer medications at the right time was the most The administration of a medication through a route other than the ordered route was the fourth common incident: 38 Twenty four The single medication administered by a nurse was considered as a single dose and totally doses of medications were observed.
Binary logistic regression was done to identify factors associated with medication administration errors. In multivariate logistic regression analysis factors that were significantly associated with MAEs were work experiences, availability of guideline for MA, take training, interruption during MA and Night shift. Nurses who were interrupted while administering medications were 2.
Regarding work experience, nurses who had less than 10 years work experience were almost 6. However, the finding of this study showed that the magnitude of MAE was high More than half of the medication errors occurred during administrations of medication and nurses are in the front line for the administrations of medication [ 20 ]. The prevalence of MAE in this self-reported study is relatively consistent with studies conducted in Iran teaching hospital On the other hand, the result of this finding was higher than those studies conducted in Turkey state hospital This difference might be due to a difference in the number of hospitals and number of researched clinical departments, in which some of the above studies were conducted in a single hospital and some studies were conducted in a single department.
Furthermore, the above studies were conducted in developed countries, in which better computerized prescribing and recording system, high quality of health care services, voluntary error reporting and follow up are conducted. The result of this study was higher than a study conducted in Felege Hiwot referral hospital, which was The plausible justification for the difference might be the variation in the number of hospitals and researched clinical units.
The above study was conducted in a single hospital inpatient department only. Additionally, the previous study used convenient sampling technique. The possible explanation for this difference might be due to variation in the number and type of hospitals. The previous study was conducted in the two southern Ethiopia public hospitals. Additionally, there is a difference in sample size. In this study, a total of doses of medication administrations were observed. This finding is relatively consistent with studies conducted in Felege Hiwot referral hospital On the other hand, the result of this study is three folds higher than a study conducted in the emergency department of Accra tertiary hospital The difference might be due to variation in the study settings, in which the above studies conducted in a single hospital and in a single department.
However, this study was conducted in all inpatient units of three hospitals. This indicates that the quality of nursing care in relation to medication administration did not appear to be up to the standard. The safety of the patient during medication administration was poorly maintained. Medication administration errors of this magnitude are likely to result in harming the patient and may erode public confidence in nursing care. Several studies and systematic reviews around the world in different countries reported likewise high magnitude of MAEs [ 2 , 3 , 6 , 18 ].
The findings of both types of study showed that MAEs were a common health problem in the hospitals under study. The magnitude of MAE in self-reported study and observational study was This result indicated that some participants made MAE but not report in the self-reported questionnaire. Similarly in this self-reported study Furthermore different literatures also showed that majority of the medication errors were not reported [ 11 , 24 , 26 ]. Wrong time error This finding indicates that more than half of the medications were not administered at ordered time. When medications are not administered at the regularly scheduled time the patient may develop toxicities or resistance to the drugs.
The finding of this study was similar to a study done in two southern Ethiopia hospitals However, it was much lower than a study conducted in France The difference likely to be due to the difference in the study setting the previous study was conducted in a specified ward, while this study was conducted in all clinical departments of three hospitals. Additionally, there was a difference in data collection method. The study in France used a direct observational method only.
Whereas; this study used both a direct observational and self-reporting method. On our study interruption during medication administration, lack of work experience and unavailability of a guideline for medication administration were significantly associated with MAEs. These findings were supported by studies conducted in Ethiopia Felege Hiwot Referral hospital and two public hospitals in southern Ethiopia [ 9 , 11 ]. A similar study conducted in Turkey indicated that interruption by telephone and questions being asked during medication administration were found to have contributed to MAEs [ 24 ]. Medication preparation and administration need concentration.