1
|
Salman M, Mustafa ZU, Shehzadi N, Mallhi TH, Asif N, Khan YH, Khan TM, Hussain K. Evaluation of knowledge and practices about administration and regulations of high alert medications among hospital pharmacists in Pakistan: findings and implications. Curr Med Res Opin 2022; 38:1967-1975. [PMID: 36111419 DOI: 10.1080/03007995.2022.2124063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A death of a nine months old child in Pakistan following the rapid administration of potassium chloride raised serious concerns on the awareness of appropriate use of high alert medications (HAMs) among healthcare professionals (HCPs). This study aimed to ascertain HAMs-related knowledge among hospital pharmacists in Pakistan. METHODOLOGY A cross-sectional study using exponential non-discriminative snowball sampling was conducted among hospital pharmacists in healthcare settings in Punjab, Pakistan. A validated study tool was used to determine knowledge on administration, regulation, and practices related to the HAMs. Barriers to conducting HAMs training in the hospitals were assessed from an open-ended question. All quantitative data were analyzed using SPSS 22.0 while the content analysis was performed on the qualitative data. RESULTS A total of 202 hospital pharmacists were included in the study. The mean knowledge score for HAMs administration and regulation were 5.86 ± 1.89 (95% CI 5.60-6.12) and 7.25 ± 1.70 (95% CI 7.02-7.49), respectively. Approximately half of the respondents (49.5%) achieved scores ≥ 70%, demonstrating sufficient knowledge of HAMs. In the multivariable-adjusted model, increasing age and work experience were found to be the positive predictors of good HAMs knowledge. The mean practice score was 36.42 ± 1.97 (95% CI 34.05-38.77), with 62.4% of pharmacists following good HAMs-related practices. We identified several barriers to conducting HAMs training through qualitative analysis. These barriers included lack of knowledge, poor attitude and behavior of medical and paramedical staff, false beliefs, lack of active support by hospital administration, lack of cooperation between HCPs, lack of opportunities, heavy workload, insufficient human resources, financial constraints, and lack of motivation. CONCLUSIONS A significant proportion of the hospital pharmacists had unsatisfactory knowledge and practices of HAMs. These findings underscore that training on HAMs should be conducted periodically as a part of hospital-based pharmacy education to maximize drug safety.
Collapse
Affiliation(s)
- Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
- Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Zia Ul Mustafa
- Department of Pharmacy Services, District Headquarter Hospital, Pakpattan, Pakistan
| | - Naureen Shehzadi
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Kingdom of Saudi Arabia
| | - Noman Asif
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Kingdom of Saudi Arabia
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Science, University of Veterinary and Animal Science, City Campus, Outfall Road Civil line Lahore, Lahore, Pakistan
| | - Khalid Hussain
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| |
Collapse
|
2
|
Qedan RI, Daibes MA, Al-Jabi SW, Koni AA, Zyoud SH. Nurses' knowledge and understanding of obstacles encountered them when administering resuscitation medications: a cross-sectional study from Palestine. BMC Nurs 2022; 21:116. [PMID: 35578234 PMCID: PMC9109424 DOI: 10.1186/s12912-022-00895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 05/09/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Medication errors (ME) are one of the most important reasons for patient morbidity and mortality, but insufficient drug knowledge among nurses is considered a major factor in drug administration errors. Furthermore, the complex and stressful systems surrounding resuscitation events increase nursing errors. AIMS This study aimed to assess the knowledge about resuscitation medications and understand the obstacles faced by nurses when giving resuscitation medications. Additionally, errors in the reporting of resuscitation medication administration and the reasons that prevented nurses from reporting errors were investigated. METHODS A cross-sectional study was conducted in the West Bank, Palestine. Convenient sampling was used to collect data, which was collected via a face-to-face interview questionnaire taken from a previous study. The questionnaire consisted of five parts: demographic data, knowledge of resuscitation medications (20 true/false questions), self-evaluation and causes behind not reporting ME, with suggestions to decrease ME. RESULTS A total of 200 nurses participated in the study. Nurses were found to have insufficient knowledge about resuscitation medications (58.6%). A high knowledge score was associated with male nurses, those working in the general ward, the cardiac care unit (CCU), the intensive care unit (ICU) and the general ward. The main obstacles nurses faced when administering resuscitation medication were the chaotic environment in cardiopulmonary resuscitation (62%), the unavailability of pharmacists for a whole day (61%), and different medications that look alike in the packaging (61%). Most nurses (70.5%) hoped to gain additional training. In our study, we found no compatibility in the definition of ME between nurses and hospitals (43.5%). CONCLUSIONS Nurses had insufficient knowledge of resuscitation medications. One of the obstacles nurses faced was that pharmacists should appropriately arrange medications, and nurses wanted continuous learning and additional training about resuscitation medications to decrease ME.
Collapse
Affiliation(s)
- Rawan I Qedan
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Marah A Daibes
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
| |
Collapse
|
3
|
Psychometric Properties of the Brazilian Version of the Nurses' Knowledge of High-Alert Medications Scale: A Pilot Study. Res Theory Nurs Pract 2020; 33:23-38. [PMID: 30796146 DOI: 10.1891/1541-6577.33.1.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE High-alert medication is considered to be a medication that presents a high risk of causing significant patient harm when used erroneously and its consequences can be fatal. The Nurses' Knowledge of High-Alert Medication scale (NKHAM) is a tool available to evaluate the knowledge of nurses in practice about this issue. AIM This pilot study aimed to measure the reliability and known-groups validity of the Brazilian version of the NKHAM. METHODS This pilot psychometric study was carried out at the Faculty of Nursing and University Hospital of the University of Campinas, São Paulo, Brazil. Forty nursing students and 44 registered nurses working in complex clinical or surgical settings completed a sociodemographic questionnaire and the Brazilian version of the NKHAM. The Kuder-Richardson 20 (KR-20) coefficient and Mann-Whitney test were used to establish reliability and known-groups validity. A significance level of ≤ 0.05 was adopted for all the analyses. RESULTS Analyses demonstrated preliminary acceptable reliability scores of 0.55 and 0.60 in domains A and B of NKHAM, respectively. A significant difference was found between the nursing students' and the registered nurses' knowledge of high-alert medications, demonstrating the scale's ability to discriminate between the two groups. IMPLICATIONS FOR PRACTICE Although this is pilot study, results suggest that the Brazilian version of the NKHAM might be a reliable and valid tool to measure nurses' knowledge of high-alert medications.
Collapse
|
4
|
Zyoud SH, Khaled SM, Kawasmi BM, Habeba AM, Hamadneh AT, Anabosi HH, Fadel AB, Sweileh WM, Awang R, Al-Jabi SW. Knowledge about the administration and regulation of high alert medications among nurses in Palestine: a cross-sectional study. BMC Nurs 2019; 18:11. [PMID: 30936779 PMCID: PMC6425670 DOI: 10.1186/s12912-019-0336-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Medication errors (MEs) are unintended failures in the drug treatment process that can occur during prescription, dispensing, storing, preparation or administration of medications. High alert medications (HAMs) are defined as those medications that bear the highest risk of causing significant patient harm when used incorrectly, either due to their serious adverse events or to a narrow therapeutic window. Nurses are responsible for administration of HAMs; incorrect administration can have a significant clinical outcome. This study aimed to assess the level of knowledge of HAMs among nurses in government hospitals in West Bank, Palestine. METHODS A cross-sectional study was conducted in 2015, in West Bank, Palestine. Data were collected via a face to face interview questionnaire, which was taken from a previous study. Data were collected by convenient sampling. The questionnaire consisted of four parts: demographic characteristics of the nurses, drug administration knowledge (10 true-false questions), drug regulation knowledge (10 true-false questions), and self-evaluation. RESULTS A total of 280 nurses participated in the study; these nurses were working in the emergency room (ER), intensive care unit (ICU), paediatric or medical ward. The response rate was 93%. Nurses were found to have insufficient knowledge about HAMs; 67.1% of participants had a score of less than 70%, with a mean total score of 59.9 ± 15.1. Factors associated with sufficient knowledge among nurses were HAMs training and ICU training, both with p-values of 0.002. Nurses with a master degree, those working in the ICU ward, head nurses, and male nurses were the most knowledgeable groups, with a p-values < 0.001. 81.8% of respondents hoped to obtain additional training. The leading obstacles reported were inconsistent opinions between doctors and nurses (37.9%), and no established standard operating procedure for HAMs (37.1%). CONCLUSIONS Lack of knowledge was one of the obstacles that nurses encountered during administration of HAMs which might result in MEs. Nurses reported that they would like to have additional training to update their pharmacology knowledge. Nurses could benefit from additional continuing education and training programs.
Collapse
Affiliation(s)
- Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samar M. Khaled
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Baraa M. Kawasmi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahed M. Habeba
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ayat T. Hamadneh
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Hanan H. Anabosi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Asma’a Bani Fadel
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Rahmat Awang
- 0000 0001 2294 3534grid.11875.3aWHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), 11800 Penang, Malaysia
| | - Samah W. Al-Jabi
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| |
Collapse
|
5
|
Flannery AH, Parli SE. Medication Errors in Cardiopulmonary Arrest and Code-Related Situations. Am J Crit Care 2016; 25:12-20. [PMID: 26724288 DOI: 10.4037/ajcc2016190] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PubMed/MEDLINE (1966-November 2014) was searched to identify relevant published studies on the overall frequency, types, and examples of medication errors during medical emergencies involving cardiopulmonary resuscitation and related situations, and the breakdown by type of error. The overall frequency of medication errors during medical emergencies, specifically situations related to resuscitation, is highly variable. Medication errors during such emergencies, particularly cardiopulmonary resuscitation and surrounding events, are not well characterized in the literature but may be more frequent than previously thought. Depending on whether research methods included database mining, simulation, or prospective observation of clinical practice, reported occurrence of medication errors during cardiopulmonary resuscitation and surrounding events has ranged from less than 1% to 50%. Because of the chaos of the resuscitation environment, errors in prescribing, dosing, preparing, labeling, and administering drugs are prone to occur. System-based strategies, such as infusion pump policies and code cart management, as well as personal strategies exist to minimize medication errors during emergency situations.
Collapse
Affiliation(s)
- Alexander H. Flannery
- Alexander H. Flannery is a critical care pharmacist, medical intensive care unit/pulmonary, University of Kentucky HealthCare, and an adjunct assistant professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky. Sara E. Parli is a critical care pharmacist, trauma/acute care surgery, University of Kentucky HealthCare, and an adjunct assistant professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy
| | - Sara E. Parli
- Alexander H. Flannery is a critical care pharmacist, medical intensive care unit/pulmonary, University of Kentucky HealthCare, and an adjunct assistant professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky. Sara E. Parli is a critical care pharmacist, trauma/acute care surgery, University of Kentucky HealthCare, and an adjunct assistant professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy
| |
Collapse
|
6
|
Lan YH, Wang KWK, Yu S, Chen IJ, Wu HF, Tang FI. Medication errors in pediatric nursing: assessment of nurses' knowledge and analysis of the consequences of errors. NURSE EDUCATION TODAY 2014; 34:821-828. [PMID: 23938094 DOI: 10.1016/j.nedt.2013.07.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/03/2013] [Accepted: 07/22/2013] [Indexed: 06/02/2023]
Abstract
AIM The purposes of this study were (i) to evaluate pediatric nurses' knowledge of pharmacology, and (ii) to analyze known pediatric administration errors. BACKGROUND Medication errors occur frequently and ubiquitously, but medication errors involving pediatric patients attract special attention for their high incidence and injury rates. METHODS A cross-sectional study was conducted. A questionnaire with 20 true-false questions regarding pharmacology was used to evaluate nurses' knowledge, and the known pediatric administration errors were reported by nurses. FINDINGS The overall correct answer rate on the knowledge of pharmacology was 72.9% (n=262). Insufficient knowledge (61.5%) was the leading obstacle nurses encountered when administering medications. Of 141 pediatric medication errors, more than 60% (61.0%) of which were wrong doses, 9.2% of the children involved suffered serious consequences. CONCLUSIONS Evidence-based results demonstrate that pediatric nurses have insufficient knowledge of pharmacology. Such strategies as providing continuing education and double-checking dosages are suggested.
Collapse
Affiliation(s)
- Ya-Hui Lan
- Tri-service General Hospital, Taipei, Taiwan
| | - Kai-Wei K Wang
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Shu Yu
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - I-Ju Chen
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | | | - Fu-In Tang
- School of Nursing, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|