An urban medical system's exploratory study of medication errors

Frequency of Medication Administration Timing Error in Hospitals: A Systematic Review

BACKGROUND

Medication administration timing error (MATE) leads to poor medication efficacy, harm, and death. Frequency of MATE is understudied.

PURPOSE

To determine MATE frequency, and characteristics and quality of reporting studies.

METHODS

A systematic review of articles between 1999 and 2021 was conducted using the Cumulative Index of Nursing and Allied Health Literature, ProQuest, and PubMed databases. Articles were scored for quality using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist.

RESULTS

Initially, 494 articles were screened; 23 were included in this review. MATE was defined as administration beyond 60 minutes before or after the scheduled time in 13 (57%) of the included studies. Measurement procedures included data abstraction, self-report, and observation. Frequency of MATE was 1% to 72.6%. Moderate study quality was found in 78% of articles.

CONCLUSION

Research on MATE is characterized by inconsistent definitions, measurements procedures, and calculation techniques. High-quality studies are lacking. Many research improvement opportunities exist.

Factors causing medication errors in an electronic reporting system

Aim

To analyse medication error data from a hospital's electronic reporting system and identify the factors affecting error types and harmfulness.

Design

A retrospective study.

Methods

The 805 near misses and adverse events reported to the hospital's electronic reporting system between January 2014 and December 2018 were analysed using descriptive statistics, chi‐square tests and logistic regression analyses.

Results

A total of 632 near misses and 173 adverse events were reported. Near misses and adverse events were the most common error type during the dispensing stage and medication administration, respectively. The odds of medication errors reported by nurses with 1–9 years of clinical experience were relatively low. After adjusting for confounders, the odds of medication errors directly observed by nurses were 65% lower than the odds of medication errors not directly detected. In clinical practice, nurses must be educated about errors in reporting depending on their degree of clinical experience.

How do nurse managers describe clinical nurses' work arrangements? A qualitative study

Aim

The researcher sought to understand how nurse managers describe nurses in alternative work arrangements.

Design

The researcher conducted this study using grounded theory.

Method

Semi-structured interviews. A theoretical sample of 26 baccalaureate-prepared nurse managers located across the United States participated in the study.

Results

A typology of five work arrangements provides descriptors that contribute toward greater conceptual clarity on nurses' work arrangements. The data reveal that the typology is fluid because nurses can easily switch across work arrangements. Because the rise in alternative work arrangements means that nurses can leave permanent positions-or explore different work arrangements-when circumstances permit or necessitate, nurses who do not receive continued mentoring will likely bring their deficiencies in skill and/or knowledge to facilities where they find future employment. Hence, inadequate mentoring at the unit level has practical consequences for the quality of patient care at the institutional level.