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Coelho F, Furtado L, Mendonça N, Soares H, Duarte H, Costeira C, Santos C, Sousa JP. Predisposing Factors to Medication Errors by Nurses and Prevention Strategies: A Scoping Review of Recent Literature. NURSING REPORTS 2024; 14:1553-1569. [PMID: 39051353 PMCID: PMC11270417 DOI: 10.3390/nursrep14030117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Medication errors have serious consequences and high costs for the patient and the system. The treatment process and the care required for critically ill patients are complex, and these patients are more vulnerable to errors and potential consequences. A scoping review using the JBI methodology was conducted across PubMed, CINAHL, and MEDLINE databases and reported by the PRISMA-ScR guidelines to explore strategies that can mitigate medication errors by nurses. The search strategy focused on references published between January 2012 and April 2023. Sixteen studies were included, and the results were organized into thematic areas. Medication errors by nurses are in the areas of preparation, administration, and documentation; organizational, system-related, procedural, personal, and knowledge and training factors are predisposing factors for errors; educational intervention, verification and safety methods, organizational changes, and error reporting are the strategic areas to mitigate medication error. The organization of the data could be different, as it depends on the reviewers' experience. Knowledge of the factors that cause medication errors and interventions to mitigate them make it possible to outline strategies to minimize their occurrence and achieve health gains. The protocol preceding this review has been registered in the Open Science Framework and published.
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Affiliation(s)
- Fábio Coelho
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Luís Furtado
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Natália Mendonça
- Flores Island Healthcare Unit, 9960-430 Flores Island, Portugal;
| | - Hélia Soares
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Hugo Duarte
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Cristina Costeira
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Cátia Santos
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Joana Pereira Sousa
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
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Abdelaziz S, Amigoni A, Kurttila M, Laaksonen R, Silvari V, Franklin BD. Medication safety strategies in European adult, paediatric, and neonatal intensive care units: a cross-sectional survey. Eur J Hosp Pharm 2024:ejhpharm-2023-004018. [PMID: 38834286 DOI: 10.1136/ejhpharm-2023-004018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/02/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES Patients in intensive care units (ICUs) are potentially more vulnerable to medication errors than patients admitted to general wards. However, little is known about medication safety strategies used in European ICUs. Our objectives were to explore the strategies being used and being planned within European ICUs, to identify areas of variation, and to inform recommendations to improve medication safety in this patient group. METHODS We distributed an online survey, in seven European languages, via professional networks and social media. The survey explored a range of medication safety strategies and whether they were in use (and if so, whether fully or partially implemented) or being planned. Demographic information about respondents and their ICUs was also captured. A descriptive analysis was conducted, which included exploring geographical variation. RESULTS We obtained 587 valid responses from 32 different countries, with 317 (54%) completed by pharmacy staff. Medication safety practices most commonly implemented were patients' allergies being visible for all staff involved in their care (fully implemented in 382 (65%) of respondents' ICUs), standardised emergency medication stored in a fixed place (337, 57%), and use of standardised medication concentrations for commonly used intravenous infusions (330, 56%). Electronic prescribing systems were fully implemented in 310 (53%). A pharmacist was reported to be fully implemented in 181 (31%) of ICUs, of which there was 126 (70%) where there was a pharmacist review of all ordered medication five days per week. Critical care pharmacists were most common in Northern European ICUs (fully implemented to ICUs in 102, 50%) and electronic prescribing in Western Europe (108, 65%). CONCLUSIONS There is considerable variation in medication safety strategies used within European ICUs, both between and within geographical areas. Our findings may be helpful to ICU staff in identifying strategies that should be considered for implementation.
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Affiliation(s)
- Shahd Abdelaziz
- Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
| | - Angela Amigoni
- Department of Women's and Child's Health, University Hospital of Padova, Padova, Italy
| | - Minna Kurttila
- Hospital Pharmacy of Kuopio University Hospital, Kuopio University Hospital, Kuopio, Finland
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Raisa Laaksonen
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Virginia Silvari
- Pharmacy Department, Cork University Hospital, Cork, Ireland
- School of Pharmacy, University College Cork, Cork, Ireland
| | - Bryony Dean Franklin
- Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
- School of Pharmacy, University College London, London, UK
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Zali M, Rahmani A, Powers K, Hassankhani H, Namdar-Areshtanab H, Gilani N. Nursing core competencies for postresuscitation care in Iran: a qualitative study. BMJ Open 2024; 14:e074614. [PMID: 38216202 PMCID: PMC10806684 DOI: 10.1136/bmjopen-2023-074614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/13/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE This study explored nurses' perceptions of the core competencies required for providing postresuscitation care in both in-hospital and out-of-hospital cardiac arrest. DESIGN Qualitative conventional content analysis. PARTICIPANTS 17 nurses selected with purposeful sampling method. SETTING Three educational hospitals in northwest of Iran. DATA COLLECTION AND ANALYSIS Semi-structured interviews were used for data collection and they were analysed using conventional content analysis. RESULTS Seven main categories have emerged from the data. The core competencies for nurses providing postresuscitation were identified as: quality assurance, providing evidence-based care, monitoring and presence, situation management, professionalism, positive attitude and providing family centred care. CONCLUSIONS The postresuscitation period is a unique and critical time requiring highly competent nursing care. Several core competencies for providing high-quality nursing care during postresuscitation period were identified through nurses' experience in caring for patients postresuscitation.
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Affiliation(s)
- Mahnaz Zali
- Department of Medical-Surgical, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Department of Medical-Surgical, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kelly Powers
- School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Hadi Hassankhani
- Department of Medical-Surgical, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Neda Gilani
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Wieduwilt F, Grünewald J, Ctistis G, Lenth C, Perl T, Wackerbarth H. Exploration of an Alarm Sensor to Detect Infusion Failure Administered by Syringe Pumps. Diagnostics (Basel) 2022; 12:diagnostics12040936. [PMID: 35453984 PMCID: PMC9032832 DOI: 10.3390/diagnostics12040936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023] Open
Abstract
Incorrect medication administration causes millions of undesirable complications worldwide every year. The problem is severe and there are many control systems in the market, yet the exact molecular composition of the solution is not monitored. Here, we propose an alarm sensor based on UV-Vis spectroscopy and refractometry. Both methods are non-invasive and non-destructive as they utilize visible light for the analysis. Moreover, they can be used for on-site or point-of-care diagnosis. UV-Vis-spectrometer detect the absorption of light caused by an electronic transition in an atom or molecule. In contrast a refractometer measures the extent of light refraction as part of a refractive index of transparent substances. Both methods can be used for quantification of dissolved analytes in transparent substances. We show that a sensor combining both methods is capable to discern most standard medications that are used in intensive care medicine. Furthermore, an integration of the alarm sensor in already existing monitoring systems is possible.
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Affiliation(s)
- Florian Wieduwilt
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
- Physical Chemistry of Nanomaterials, Institute of Chemistry and Center for Interdisciplinary Nanostructure Science and Technology (CINSaT), University of Kassel, Heinrich-Plett-Straße 40, 34132 Kassel, Germany
- Correspondence: (F.W.); (G.C.)
| | - Jasmin Grünewald
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
| | - Georgios Ctistis
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
- Correspondence: (F.W.); (G.C.)
| | - Christoph Lenth
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
| | - Thorsten Perl
- Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany;
| | - Hainer Wackerbarth
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
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