Medication error encouragement training: A quasi-experimental study

The effect of the clinical supervision model on nursing internship students' nursing process-based performance: an experimental study

BACKGROUND

The nursing process is a systematic method for identifying the patient's problems and planning to resolve them. It is also a crucial pillar of high-quality nursing care. Nursing internship students may lack the necessary skills to implement the nursing process due to the increased independence, the absence of constant professorial supervision, and limited experience. The clinical supervision model is a method of clinical education that bridges the gap between theory and practice.

OBJECTIVE

This study was conducted to investigate the impact of the clinical supervision model on the performance of nursing internship students in each of the five stages of the nursing process, as well as overall.

METHOD

This experimental study was conducted in 2022. The 70 eligible internship students were conveniently selected and randomly assigned to either an intervention or a control group. In the present study, the clinical supervision model was implemented for the intervention group, while the control group received routine supervision. This was carried out over six sessions in three months. The data collection was conducted using a researcher-developed checklist of nursing process-based performance in both groups. Moreover, the Manchester questionnaire was used to evaluate the model in the intervention group. The variables considered as confounding factors included age, gender, marital status, number of monthly shifts, and grades of the nursing process credit completed in the third semester. SPSS version 16 software, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), and analytical statistics (independent t-test, chi square, repeated measures Anova and LSD) were used to analyze the data.

RESULTS

Intergroup analysis revealed that there was no significant difference between the scores of nursing process steps and the total score before the intervention in the control and intervention groups, as well as in baseline characteristics (P > 0.05). According to the intragroup analysis, the intervention group showed a significant increase in both the total scores and scores of nursing process steps over time (P < 0.001), whereas the control group exhibited contradictory results (P > 0.05). Finally, the "P-Value Intervention" demonstrated the effectiveness of this training model in improving the performance of the intervention group based on the nursing process compared to the control group. The mean score of the Manchester questionnaire in the intervention group was 136.74, indicating the high impact of implementing the clinical supervision model in the intervention group.

CONCLUSION

The results indicated that the implementation of the clinical supervision model led to improved utilization of the nursing process by nursing internship students at all stages. Therefore, it is recommended that nurse educators utilize the clinical supervision model by providing feedback on errors in action during supervision sessions to enhance the quality of nursing care provided by nursing internship students and improve patient safety in clinical environment.

Effects of the small private online course combined with simulation-based training in a patient safety education program among nursing students: A quasi-experimental study

Objective

This study aimed to explore the effects of the small private online course (SPOC) combined with simulation-based training in a patient safety education program among nursing students in China.

Methods

A quasi-experimental design was conducted. A total of 219 nursing students from four parallel classes were selected from the nursing department of a health vocational college in Zhengzhou, China, from November 2020 to June 2021 and allocated to the intervention group (n = 113) and control group (n = 106). Based on SPOC, nursing students in the intervention group implemented simulation teaching in small groups, with three class hours each time, a total of two times, divided into three stages: pre-class preparation, teaching implementation, and after-class reflection. The control group received theoretical patient safety education through SPOC, implemented on the DingDing platform for two class hours each time, four times. All participants were invited to complete a demographic questionnaire and the Chinese version of Patient Safety Competency Self-Evaluation (PSCSE) before and after the intervention.

Results

A total of 103 and 102 students from the intervention and control groups completed the study. The total scores of PSCSE in the post-test of the intervention group (176.24 ± 13.73 vs. 144.64 ± 13.75) and the control group (160.87 ± 14.88 vs. 142.57 ± 15.66) were higher than those in the pre-test (P < 0.01), and the total scores of PSCSE of the intervention group were higher than those of the control group (176.24 ± 13.73 vs. 160.87 ± 14.88, P < 0.01). After intervention, the scores of PSCSE in all dimensions were increased in the intervention group (P < 0.01); in the control group, the scores of patient safety competency in most dimensions were increased (P < 0.01), except for the dimensions of reporting and response to error and communication related to error (P＞ 0.05). Except for the dimensions of knowledge and attitude of error reporting and disclosing (P＞ 0.05), the scores of other dimensions in the intervention group were higher than those in the control group (P < 0.01).

Conclusion

The patient safety education program using the SPOC combined with simulation-based training can effectively improve the patient safety competency of nursing students in terms of attitude, skills, and knowledge.

Understanding complexity in a safety critical setting: A systems approach to medication administration

'Medication errors' are a significant concern and are associated with a higher incidence of adverse events and unintentional patient harm than any other aspect of healthcare. While much research has focused on adverse medication errors, limited studies have specifically examined 'normal' medication delivery performance and the interactions between tasks, agents, and information within the medication administration system. This article describes a study that applied the Event Analysis of Systemic Teamwork (EAST) model to study the hospital medication administration system to identify opportunities to optimise performance and patient safety. Key findings of this study demonstrate that this is a highly complex system, comprising many social agents and a relatively closely linked series of tasks and information. However, most of the workload relies on a small proportion of healthcare professionals. Significantly, the patient has a minimal role in the medication administration system during their hospital stay. The research has shown that this approach enables mapping networks and their interdependencies to optimise the system as a whole rather than its parts in isolation.

Medication safety education in nursing research: Text network analysis and topic modeling

OBJECTIVES

This study aimed to identify the knowledge structure of medication safety nursing education literature by developing schematic diagrams of the relationship between keywords from a macro perspective. This study also identifies the research topics and trends over time.

DESIGN

This quantitative content study used text network analysis to explore keywords and research topics using topic modeling within the medication safety nursing education literature.

DATA SOURCES

PubMed, EMBASE, and Cochrane databases were used to search for the medication safety nursing education literature published until December 2021.

METHODS

Keywords from 2085 articles were examined using text network analysis and topic modeling with NetMiner 4.4.3.

RESULTS

The keywords with the most frequency and the highest networking degree in centrality were "patient," "medication," "program," "nurse," and "care." The emerging keywords assessed by time periods were identified; the first phase ("heart failure," "insulin," "chemotherapy," and "infusion"), the second phase ("medication errors," "staff," and "information"), the third phase ("program," "management," and "data"). The results of topic modeling were as follows: safe medication administration, safe medication reconciliation process, medication education for patients, medication errors in nursing practice, and multidisciplinary teamwork for medication safety.

CONCLUSION

These findings will help nursing researchers and educators to understand the trends and insights for medication safety education and educate future nurses to provide safer nursing care.

Instruction strategies for drug calculation skills: A systematic review of the literature

BACKGROUND

Medication errors and unsafe medication practices are a leading cause of injury and avoidable harm worldwide.

OBJECTIVES

The aim of this review was to (i) explore and identify evidence-based strategies to teach medication calculation skills by determining the most common errors and assess the quality, level, and role of the evidence, and (ii) describe instruction strategies for drug calculation skills development or improvement based on seven research-based principles for smart teaching.

DESIGN

Systematic review.

DATA SOURCES

CINAHL, PubMed, and PsycINFO.

REVIEW METHODS

The review followed Whittemore and Knafl's framework steps with an assessment of the studies reporting using PRISMA, STROBE, COREQ and categorizing their methods by evidence hierarchy and roles. Two authors independently assessed eligibility and extracted data.

RESULTS

From the total 1793 articles, 51 studies met the eligibility criteria. The studies included 9210 nursing students/nurses and mainly used a quantitative approach (67.5%), followed by qualitative (22.5%) and mixed methods (10.0%), with the students/nurses doing arithmetic and conceptual mistakes. The findings presented were low levels of evidence III (23.5%) and V (41.2%), quality Level B (82.4%), and 47.1% focused on choosing the appropriate teaching and intervention approaches (role of the evidence). The teaching strategies addressed multiple smart teaching principles, but mainly prior knowledge (principle 1, 39.2%). The least used strategies were those addressing the levers that influence motivation and behaviors such as value, expectations, and environment climate (principle 3, 13.7%). Two studies addressed five principles simultaneously.

CONCLUSIONS

Regarding teaching strategies, the most recurring strategies were early diagnostic assessments on knowledge, anxiety and/or self-confidence, considering knowledge organization with scaffolding complex tasks, being explicit about objectives and expectations, and usage of e-learning. However, e-learning was mainly used after 2018. Considering the low levels and quality of evidence, we recommend higher levels of research design for future research. Randomized Controlled Trials could be conducted when randomizing teaching methods per semester or questions embedded in software. Web-base software could be used to support teaching and research approaches.

Effects of patient deterioration simulation using inattentional blindness for final year nursing students: A randomized controlled trial

BACKGROUND

Patient deterioration should be detected early and responded appropriately for patient safety. It is necessary to strengthen situational awareness regarding patient deterioration. Inattentional blindness is a major factor that hinders situational awareness about patient deterioration in the clinical setting.

OBJECTIVES

To analyze the impact of patient deterioration simulation using inattentional blindness (PDS-IB) on situational awareness and patient safety competency-attitude among final year nursing students.

DESIGN

A randomized controlled trial.

PARTICIPANTS

Final year nursing students at a university in South Korea.

METHODS

Students were randomly assigned to an experimental or control group. The experimental group (n = 47) was given a PDS-IB. The control group (n = 44) received a simple patient deterioration simulation. Situational awareness and patient safety competency-attitude were measured at baseline, post intervention, and at 2 weeks follow-up. Data were analyzed using a two-way repeated measures ANOVA.

RESULTS

There were statistically significant group effects, time effects, and group and time interaction effects in situational awareness and patient safety competency-attitude.

CONCLUSION

PDS-IB is an effective educational strategy that increases situational awareness and patient safety competency-attitude in final year nursing students.

Nurses' perceptions toward factors that cause medication errors in Jordan: A qualitative study

AIMS

The aim of this study was to investigate nurses' experiences related to medication errors (MEs) from the perspective of Jordanian nurses. This article reports the findings concerning the factors that cause MEs from the perspectives of Jordanian nurses.

BACKGROUND

MEs are critical issues facing healthcare providers and health institutions. Most of the studies on MEs were conducted in Western countries. However, there is little research that seeks to understand this issue in the developing countries and Jordan is one of these countries.

DESIGN

A qualitative descriptive approach was used in three hospitals in different clinical settings in Jordan.

METHODS

Individual semi-structured face-to-face interviews were conducted with 24 nurses.

RESULTS

The data that emerged from the interviews was arranged and contextualized in two major themes, individual and systemic factors, that explained the main causes of MEs. From the individual side, lack of knowledge and experience ranked as the highest concerns, and from the systematic side workload was the most important factor.

CONCLUSION

This study provides an opportunity for stakeholders and Jordanian managers to increase their awareness of these factors and address them in the future, thereby increasing the level of care provided in their health organizations.

Applying safety lessons from aviation to pre-licensure health professions education: A narrative critical review

BACKGROUND

Significant numbers of patients continue to be harmed annually by healthcare systems in the United States (US) and around the world. Through a lens of safety, the fields of aviation and healthcare share many similarities in the non-technical skills required by team members, including situational awareness, communication, problem-solving, and leadership. Despite these links and evidence of effective interventions in the clinical setting, there is a lack of a guidance on how to incorporate non-technical skills training into pre-licensure health professions curricula.

METHODS

Following guidance for a narrative critical review, a comprehensive literature search was conducted looking for studies incorporating non-technical skills training including crew resource management (CRM) and human factors and ergonomics (HFE) into pre-licensure health professions curricula.

RESULTS

Eleven example articles were organized into three broad themes: (1) changing the teaching paradigm around errors, (2) targeted curricular interventions, and (3) interprofessional team training. Several useful tools for evaluating training effectiveness were highlighted, but consistent measures of efficacy for CRM/HFE training are lacking. Interprofessional team training may have the most tangible and broadly applicable link to pre-licensure curricula.

IMPLICATIONS

Additional research is needed to identify best practices for consistent incorporation of non-technical skills into pre-licensure curricula. A cultural shift to focus on error management (vs. solely error avoidance) is also needed early in training with development of a common language to discuss patient safety issues and opportunities for improvement across various healthcare settings.