Use of Simulation-Based Learning to Teach High-Alert Medication Safety: A Feasibility Study

Medication safety climate from the perspectives of healthcare providers: A cross-sectional study

BACKGROUND

Medication safety as an indicator of care quality is the measures taken by healthcare team members to prevent or adjust adverse drug events at the time of medication administration. This study was conducted to investigate the medication safety climate from healthcare providers' perspectives.

MATERIALS AND METHODS

This cross-sectional descriptive study was conducted in a selected educational hospital affiliated with the Isfahan University of Medical Sciences, Isfahan, Iran, in 2021. Participants were healthcare providers who are involved in the medication process. The sampling was done using the quota method. The study instruments were a demographic questionnaire and the Medication Safety Climate (MSC).

RESULTS

The total mean of positive responses to MSC items was 64.11%, denoting a moderate-level MSC. Collected data were managed using the SPSS software (v. 16.0) and were summarized using the measures of descriptive statistics, namely mean, standard deviation, frequency, and percentage. The lowest and the highest dimensional mean scores were related to the management support for medication safety dimension (mean: 48.42%) and the Teamwork dimension (mean: 80.43%), respectively.

CONCLUSION

Managers' inattention and insufficient understanding of safety provide the basis for medication errors and threaten patient safety. Healthcare team members are highly motivated to provide quality and safe care by observing the managers' positive performance regarding patient safety. To improve the medication safety climate, healthcare team members are required to work in a safe workplace and have sufficient job satisfaction. Health center managers need to employ a proactive approach to prevent errors.

Nursing Students' Knowledge, Personality Traits, and Self-Efficacy Related to Medication Administration Error

BACKGROUND

Nursing education influences medication administration practices, which involve clinical decision making and risk perceptions.

METHOD

This mixed-methods concurrent nested study explored the relationship among knowledge, personality traits, and self-efficacy related to medication administration error in fourth-year, prelicen-sure nursing students (n = 60) who were recruited from three campuses of a large university.

RESULTS

Results indicated low mean knowledge (70.75) and neuroticism (2.44) scores, and high mean self-efficacy and confidence (5.78) and conscientiousness (4.51) scores. Conscientiousness was correlated with both knowledge (r = .271, p = .036) and neuroticism (r = -.313, p = .015). Thematic analysis yielded four themes: nature of risk perceptions, more opportunities to learn, experiences with medication administration error, and intrinsic characteristics influence errors. Convergence was evident in both knowledge and personality data; self-efficacy/confidence and risk perceptions data diverged.

CONCLUSION

Knowledge, personality traits, and self-efficacy appear to influence nursing students' risk perceptions of medication administration error, indicating an area for future research. [J Nurs Educ. 2022;61(7):367-374.].

Use of simulation to improve nursing students' medication administration competence: a mixed-method study

Background

Medication administration errors are among the most important adverse events in healthcare systems. To minimise the risk of this occurring, nursing training programmes should emphasise the overriding priority of patient safety. In this respect, simulation can be a valuable resource in teaching procedures, for patient safety in general and safe medication administration in particular. In this study, we evaluate the use of a simulation-based activity for students to acquire skills in safe medication administration, and consider the students’ perceptions of this activity.

Methods

Second-year nursing students enrolled in the subject of pharmacology at a Spanish university during the academic year 2018–2019 were invited to participate in this mixed-method study. Their acquisition of professional competencies via a simulation exercise was evaluated according to the ‘six rights’. Before the simulation, each student completed a researcher-developed online questionnaire. The simulation was evaluated by the students’ tutor, using a checklist. A descriptive analysis was made of the data obtained from the questionnaire and during the simulation. At the end of the semester, the students' opinions were recorded in the questionnaire, in response to an open question. A content analysis was made of the responses to the open question.

Results

The simulation exercise was performed by 179 students, of whom 73 had previously completed the questionnaire. Analysis showed that, in comparison with the pre-simulation questionnaire results, compliance with the six rights improved in all dimensions except data documentation: right patient (from 64.4% to 83.3%); right medication (from 60.3% to 95.8%); right dose (from 60.3% to 100%); right route (from 54.8% to 95.8%); right time (from 24.7% to 70.8%); the right documentation result fell from 54.8% to 45.8%. The students expressed their satisfaction with the simulation method, affirming that it brought them closer to the reality of health care.

Conclusions

Simulation is a useful tool for the acquisition of skills in medication administration. The students were satisfied with the simulation capacity to bridge the gap between theory and practice. Moreover, simulation represents an added teaching resource in the nursing degree curriculum and is expected to enhance patient safety.