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Heydarikhayat N, Ghanbarzehi N, Sabagh K. Strategies to prevent medical errors by nursing interns: a qualitative content analysis. BMC Nurs 2024; 23:48. [PMID: 38233901 PMCID: PMC10792785 DOI: 10.1186/s12912-024-01726-1] [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: 08/02/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Nursing interns often face the serious challenges and stress of clinical training. Identifying effective strategies in reducing medical errors can improve student performance and decrease patient risk and injury from errors. The purpose of this study was to identify strategies to prevent medical errors by nursing interns in Medical Universities in Sistan and Baluchistan, Southeast of Iran. METHODS This is a qualitative study using a content analysis approach. Purposive sampling was used. The study was conducted in 3 medical universities. Ten nursing interns participated in this study. Open-ended, semi-structured, and face-to-face, interviews were used to explore the experience of nursing interns about strategies to prevent medical errors during their internship. RESULTS Findings include 20 subcategories, 6 categories and one theme. The main theme is "strategies to prevent medical errors during internship". Six categories included "strategies to prevent medical errors during internship". These included "Professional acceptance and support", "Revision of the implementation of the educational curriculum", "Retraining courses for challenging skills", "Creating learning opportunities" "Professionalization", and "Facilities and requirements". CONCLUSIONS Preventing medical errors requires different strategies before and during nursing internship. Error prevention strategies include retraining and preparatory courses for challenging areas, evaluation of students' performance, and accepting students as members of the health care team, respecting and supporting them and protecting their rights. Learning from medical errors, analysis and reflection on errors should be part of the curriculum during the internship.
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Affiliation(s)
- Nastaran Heydarikhayat
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Nezar Ghanbarzehi
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Kimiya Sabagh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
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Effects of the Interruption Management Strategy "Stay S.A.F.E." During Medication Administration. Rehabil Nurs 2023; 48:65-74. [PMID: 36792960 DOI: 10.1097/rnj.0000000000000404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PURPOSE This study measured the impact of the Stay S.A.F.E. intervention on nursing students' management of and response to interruptions during medication administration. Time to return to the primary task, performance (procedural failures and error rate), and perceived task load were evaluated. DESIGN This experimental study used a randomized prospective trial. METHODS Nursing students were randomized into two groups. Group 1 (the experimental group) received two educational PowerPoints: the Stay S.A.F.E. strategy and medication safety practices. Group 2 (the control group) received educational PowerPoint on medication safety practices. Nursing students participated in three simulations where they were interrupted during a simulated medication administration. Eye tracking of students' eye movements determined focus, time to return to the primary task, performance including procedural failures and errors, and fixation time on the interrupter. The perceived task load was measured using the NASA Task Load Index. RESULTS The intervention group, which was the Stay S.A.F.E. group, demonstrated a significant reduction in time away from task. There was a significant difference in perceived task load across the three simulations, including decreased frustration scores for this group as well. The control group members reported a higher mental demand, increased effort, and frustration. CLINICAL RELEVANCE Rehabilitation units often hire new nursing graduates or individuals with little experience. For new graduates they have typically practiced their skills without interruptions. However, interruptions in performing care, particularly in medication management, occur frequently in real-world situations. Improving the education of nursing students related to interruption management has the potential to improve their transition to practice and patient care. CONCLUSION Students who received the Stay S.A.F.E. training, a strategy to manage interruptions in care, had decreasing frustration over time and spent more time on the task of medication administration.
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Owen S, Menzies J, Pontefract S. Educational interventions to reduce nurse medication interruptions: A scoping review. NURSE EDUCATION TODAY 2023; 121:105665. [PMID: 36527755 DOI: 10.1016/j.nedt.2022.105665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Preventable harm from medicines is a global problem creating huge economic and social burden. Interruptions occur frequently in clinical environments causing medication episodes to take longer and having a cognitive cost on the nurse. AIM The aim of this scoping review is to identify and evaluate educational interventions that have been employed to reduce medication interruptions and improve medication safety. METHODS Six databases were searched for the scoping review (PubMed, Embase, Cochrane Library, CINAHL, Pishin and Medline) along with reference lists and grey literature searches. Articles were included if they were written in English, published between 2010 and 2020 and employed an education intervention (including bundled interventions). Databases were searched using keywords and Boolean operators. RESULTS Eight studies met the inclusion criteria. Seven of these studies were conducted in hospital (adults n = 6, paediatric n = 1) and one study in a university with undergraduate nurses. Four studies used a combined intervention and four exclusively employed an education intervention. Five studies found a significant decrease in the number of interruptions post intervention, but one of the studies that exclusively employed an education intervention found no significant difference. Changes in the nurses' behaviour post intervention were also cited in two studies. IMPLICATIONS FOR FUTURE RESEARCH There was a lack of exclusive education interventions, making it difficult to determine the effectiveness of education at reducing medication interruptions. This review highlights the necessity of some interruptions when performing tasks, for example, to make a nurse aware of a deteriorating patient. However, as the majority of studies used the number of interruptions to determine the effectiveness of the intervention, there is uncertainty as to whether this is the right outcome measure to use. In the future, a focus on outcome measures reflecting change in nurse behaviour may be more effective in determining the strength of an educational intervention.
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Affiliation(s)
- Samantha Owen
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Birmingham Children's Hospital, Birmingham, UK.
| | | | - Sarah Pontefract
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
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Currie J, Thompson C, Grootemaat P, Andersen P, Finnegan A, Carter M, Halcomb E. A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries. J Clin Nurs 2023; 32:283-297. [PMID: 35146817 PMCID: PMC10078692 DOI: 10.1111/jocn.16239] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 12/14/2022]
Abstract
AIM The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. BACKGROUND Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. DESIGN A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses Scoping Review extension (PRISMA-ScR) guidelines. RESULTS One hundred fifty-five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. CONCLUSION There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work-ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work-ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence-based.
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Affiliation(s)
- Jane Currie
- Queensland University of Technology, Kelvin Grove Campus, Brisbane, Queensland, Australia.,Susan Wakil School of Nursing & Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Cristina Thompson
- Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - Pam Grootemaat
- Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia.,School of Nursing, Midwifery and Social Science, CQ University, Queensland, Australia
| | - Alan Finnegan
- University of Chester, Riverside Campus, Chester, UK
| | - Michael Carter
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Davies H, Robertson S, Sundin D, Jacob E. Impact of pre-registration extended immersive ward-based simulation on student learning in preparation for clinical placement. NURSE EDUCATION TODAY 2022; 119:105575. [PMID: 36179424 DOI: 10.1016/j.nedt.2022.105575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/14/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Graduate nurses commonly experience significant challenges in transitioning to professional practice. The practice readiness of graduate nurses continues to be a concern for nurse educators and industry partners. Introduction of pre-registration extended immersive ward-based simulation can provide opportunities for students to practice the role of registered nurse before graduation. It is not clear if participation in simulation-based learning transfers to increased preparedness for dealing with real-life situations following entry into the workforce. OBJECTIVE To report on student views on how ward-based immersive simulation assisted in preparing for clinical placement and graduate practice. DESIGN A qualitative, descriptive design was used to conduct a series of face-to-face focus groups. SETTING School of Nursing and Midwifery metropolitan Western Australian university. PARTICIPANTS Final year baccalaureate nursing students who had participated in six four-hour simulation workshops between February and April 2021 were selected through purposive sampling. METHODS Focus group and interview data was transcribed from audio recordings. A six-phase approach was used to analyse data into themes and sub-themes. The study adhered to the consolidated criteria for reporting of qualitative research. RESULTS Three focus groups and one interview were conducted. Eight themes emerged. Student learning was identified as occurring in a variety of ways, such as how to work as a team and was influenced by a number of factors, such as the capacity for students to self-reflect. CONCLUSIONS Learning opportunities for students to practice how to think and work independently as a registered nurse is something that can be supported by pre-registration extended immersive ward-based simulation. Understanding of what will be expected of them once qualified can make students more prepared for professional practice enabling them to apply knowledge gained from simulated experiences to a similar situation as a graduate nurse.
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Affiliation(s)
- Hugh Davies
- School of Nursing and Mideifery, Edith Cowan University, Western Australia, Australia.
| | - Sue Robertson
- School of Nursing and Mideifery, Edith Cowan University, Western Australia, Australia.
| | - Deb Sundin
- School of Nursing and Mideifery, Edith Cowan University, Western Australia, Australia.
| | - Elisabeth Jacob
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Victoria, Australia.
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Jacob ER, Sundin D, Robertson S, Davies H. Extended immersive simulation to develop nontechnical skills: Content analysis of students' views. Collegian 2022. [DOI: 10.1016/j.colegn.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Terzulli DM. Development of an autonomic dysreflexia simulation. TEACHING AND LEARNING IN NURSING 2022. [DOI: 10.1016/j.teln.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wagner EA. Engaging Nursing Students in Quality Improvement: Teaching Safe Medication Administration. J Nurs Educ 2022; 61:268-271. [PMID: 35522765 DOI: 10.3928/01484834-20220303-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Safety and reduction of errors during medication administration is a prominent focus in nursing and nursing education. Developing simulated medication administration experiences that include opportunities for nursing students to manage interruptions in a realistic environment can help improved critical thinking and reasoning for safe administration practices. METHOD Sophomore nursing students voluntarily participated in a quality improvement project examining nursing management of interruptions during medication administration. Students observed medication administration activities for episodes of interruptions and conducted surveys in a real-time format that encouraged decision-making dialogue. RESULTS After the project, student learning outcomes included improved identification of interruptions, prioritization, critical reasoning skills, and development of management techniques for better safety. CONCLUSION Incorporating real-world experiences that allow nursing students to identify and manage interruptions during medication administration foster development of critical thinking and interruption management techniques. [J Nurs Educ. 2022;61(5):268-271.].
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Using Simulation-Based Education to Teach Interruption Management Skills: An Integrative Review. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Jones JR, Boltz M, Allen R, Van Haitsma K, Leslie D. Nursing students' risk perceptions related to medication administration error: A qualitative study. Nurse Educ Pract 2022; 58:103274. [PMID: 34922091 PMCID: PMC8792253 DOI: 10.1016/j.nepr.2021.103274] [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: 04/09/2021] [Revised: 10/06/2021] [Accepted: 12/07/2021] [Indexed: 01/03/2023]
Abstract
AIM The purpose of this study was to explore and describe pre-licensure nursing students' perceptions of risk for medication administration errors in fourth-year baccalaureate student nurses from three campuses at a large central Pennsylvania university. BACKGROUND Medication administration errors continue to be a significant safety concern in healthcare settings. Pre-licensure nursing education is a critical time period during which to have an impact on future medication administration practices. Perception of risk influences decision making and behavior, including nursing clinical decision making. DESIGN This descriptive, exploratory study involved a qualitative design. METHODS A thematic analysis of the qualitative data resulting from 60 individual, in-depth semi-structured interviews was conducted. RESULTS The participants offered rich, detailed narratives which revealed the following themes: (1) the nature of risk perceptions, (2) more opportunities to learn, (3) experiences with medication administration error, and (4) intrinsic characteristics influence errors. CONCLUSIONS The findings provide a broad description of the nature of student nurse risk perceptions for future medication administration errors. Recommendations for nursing education practice and pedagogy include additional clinical experiences, modified pharmacology curricula and instruction, and expanded simulations involving medication administration error.
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Affiliation(s)
- Joanne Roman Jones
- The Pennsylvania State University, College of Nursing, 120 Little
Branch Trail, Chapel Hill, NC 27517
| | - Marie Boltz
- Elouise Ross Eberly and Robert Eberly Endowed Chair, Professor of
Nursing, The Pennsylvania State University, College of Nursing, 306 Nursing
Sciences Building, University Park, PA 16802
| | - Rachel Allen
- Assistant Research Professor of Nursing, The Pennsylvania State
University, College of Nursing
| | | | - Douglas Leslie
- Professor and Vice Chair for Education, Department of Public Health
Sciences, Chief, Division of Health Services and Behavioral Research,
Professor, Department of Psychiatry and Behavioral Health, The Pennsylvania
State University
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The application of reusable learning objects (RLOs) in preparation for a simulation laboratory in medication management: An evaluative study. TEACHING AND LEARNING IN NURSING 2021. [DOI: 10.1016/j.teln.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Davies H, Sundin D, Robinson S, Jacob E. Does participation in extended immersive ward-based simulation improve the preparedness of undergraduate bachelor's degree nursing students to be ready for clinical practice as a registered nurse? An integrative literature review. J Clin Nurs 2021; 30:2897-2911. [PMID: 33870592 DOI: 10.1111/jocn.15796] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To determine if extended immersive ward-based simulation programmes improve the preparedness of undergraduate bachelor's degree nursing students to be ward ready for professional practice as a registered nurse. BACKGROUND The practice readiness of new graduate nurses to enter the workforce continues to raise concern among educators and industry. Often the transition period is a vulnerable time when the reality of clinical practice bears little resemblance of their experiences as a student. Simulation of a busy ward offers the opportunity for pre-registered nurses to practise a variety of situations they are likely to encounter once qualified in a safe and supportive learning environment. METHODS The review considered studies that investigated the experiences and learning outcomes of nursing students following participation in extended immersive ward-based simulation. Databases searched included CINAHL, EMBASE, Medline and Scopus. Two reviewers independently assessed retrieved studies that matched inclusion criteria using standardised critical appraisal instruments. Reporting of review followed PRISMA checklist. RESULTS Fourteen studies met the inclusion criteria. The majority of studies used a quasi-experimental mixed methods approach (10). Programme evaluations focused on self-reporting in learning satisfaction and student perceptions of performance. Six studies used a pre- and post-test design to compare the after effect on preparedness for professional practice. Two studies investigated student learning between simulated experiences and experiences gained during clinical placements. CONCLUSION Learning satisfaction was high among students who participated in programmes that incorporated extended immersive ward-based simulation experiences. Students are able to practise what they need to know and on what will be expected of them in professional practice. Evidence on whether these programmes make a difference in workplace performance, and retention of graduate nurses is yet to be established. RELEVANCE TO CLINICAL PRACTICE Extended immersive ward-based simulation allows educators the opportunity to meet the perceived needs of students in preparation for professional practice.
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Affiliation(s)
- Hugh Davies
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Deborah Sundin
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Suzanne Robinson
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Elisabeth Jacob
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Vic., Australia
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Undergraduate Nursing Students and Management of Interruptions: Preparation of Students for Future Workplace Realities. Nurs Educ Perspect 2021; 42:350-357. [PMID: 34516484 DOI: 10.1097/01.nep.0000000000000886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM The aim of this study was to investigate interruption management strategies and associative cues used by nursing students when interrupted during simulated medication administration. BACKGROUND Interruptions occur with high frequency in health care settings and are associated with increased medication errors and decreased task efficiency. The Altmann and Trafton memory for goals model, a cognitive-science model, proposes use of associative cues during an interruption to mitigate these negative effects. METHOD A mixed-methods, two-site study explored associative cues and other management strategies that nursing students used when interrupted during simulated medication administration. Data were collected via direct observation and semistructured interviews. RESULTS Students primarily multitasked (66.7 percent) during the interruption. Few students (5.5 percent) used associative cues. Students voiced the need for education and practice on how to manage interruptions. CONCLUSION Evidence-based strategies are required to prepare nursing students for workplace interruptions. Use of associative cues during interruptions warrants further investigation.
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Zhang WG, Liu JW, Yang SY, Wang QQ, Liu CX, Li Y. A Study on the Improvement of Nursing Interruption Risk by a Closed-Loop Management Model. Risk Manag Healthc Policy 2021; 14:2945-2952. [PMID: 34285608 PMCID: PMC8285302 DOI: 10.2147/rmhp.s301108] [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: 01/12/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to evaluate the effect of closed-loop management on nursing disruption risk. Methods Using a quasi-experimental research method, convenient sampling was used to extract 20 nurses working at our hospital as the research objects. The control group members were selected from January to March 2018 via the traditional method, and the experimental group members were selected from April to June 2018 via the closed-loop management method. At three months before and after the implementation of the management model, a self-designed quantitative test form and satisfaction questionnaire were used to analyze the frequency of nursing disruption events, the accuracy rate of doctors’ advice, the average drug delivery time of the static distribution center, the implementation rate of personal digital assistant (PDA) code scanning, and the report rate of risk-outcome nursing disruption events. Results After the implementation of the management model, the frequency of nursing disruptions and average drug delivery time of the static distribution center were significantly lower than before, and the differences were statistically significant (p < 0.05). Moreover, the accuracy rate of doctors’ advice, the implementation rate of PDA code scanning, and the reporting rate of risk-outcome nursing disruption events were significantly higher than before, and these differences were statistically significant as well (p < 0.05). Conclusion The application of a closed-loop management model could significantly reduce the occurrence and optimize the outcomes of nursing disruption events and improve the work processes of medical care.
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Affiliation(s)
- Wen-Guang Zhang
- Department of Nursing, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People's Republic of China
| | - Jia-Wei Liu
- School of Nursing, Shanxi Medical University, Taiyuan, 030000, People's Republic of China
| | - Su-Yun Yang
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People's Republic of China
| | - Qiao-Qian Wang
- Department of Hypertension, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People's Republic of China
| | - Chen-Xing Liu
- School of Nursing, Shanxi Medical University, Taiyuan, 030000, People's Republic of China
| | - Yao Li
- School of Nursing, Shanxi Medical University, Taiyuan, 030000, People's Republic of China
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Abstract
BACKGROUND Nurses must be adequately prepared for safe medication administration. PURPOSE The specific aims of the study were to compare first- and final-semester nursing students' medication administration performance, describe graduating nursing student performance, assess the long-term effect of an Individual Simulation-Based Experience (ISBE), and determine if nursing assistant experience impacted performance. METHODS The study was a longitudinal, descriptive, experimental, 2-group pretest-posttest design. The Medication Administration Safety Assessment Tool was used to assess nursing student (n = 68) medication administration performance at 3 points in time: after learning the skill, after participation in an ISBE or traditional practice session, and prior to graduation. RESULTS Only one-third of senior nursing students accurately demonstrated medication administration. There was no significant difference between first- and last-semester performance. CONCLUSION Findings suggest nursing students are not prepared for safe medication administration upon graduation. The reality of practice opportunities to perform this skill throughout a nursing program should be examined.
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Dilles T, Heczkova J, Tziaferi S, Helgesen AK, Grøndahl VA, Van Rompaey B, Sino CG, Jordan S. Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5973. [PMID: 34199519 PMCID: PMC8199654 DOI: 10.3390/ijerph18115973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 12/13/2022]
Abstract
Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.
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Affiliation(s)
- Tinne Dilles
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
| | - Jana Heczkova
- First Faculty of Medicine, Institute of Nursing Theory and Practice, Charles University, 11000 Prague, Czech Republic;
| | - Styliani Tziaferi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, 22100 Tripolis, Greece;
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, 1757 Halden, Norway; (A.K.H.); (V.A.G.)
| | | | - Bart Van Rompaey
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
| | - Carolien G. Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, 3584 CH Utrecht, The Netherlands;
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, Wales, UK;
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Nursing Students' Knowledge of Patient Safety and Development of Competences Over their Academic Years: Findings from a Longitudinal Study. Zdr Varst 2021; 60:114-123. [PMID: 33822834 PMCID: PMC8015659 DOI: 10.2478/sjph-2021-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/03/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Future nurses should possess the knowledge and competences necessary to ensure patient safety. However, little evidence is available on the way in which students learn patient safety-related principles over time. This study explored the progress of a cohort of Italian undergraduate nursing students as they acquired patient safety knowledge and competences from time of enrolment to graduation. Methods A longitudinal study carried out between 2015 and 2018 enrolled a cohort of 90 nursing students from two Italian Bachelor of Nursing Science Degree Courses at the Udine University, Italy. The students were followed-up on an annual basis and data collection was performed three times: at the end of the 1st, 2nd and 3rd years. The validated Italian version of the Professional Education in Patient Safety Survey tool was used to collect data. Results At the end of the 1st year, students reported an average 4.19 out of 5 patient safety knowledge acquired in classrooms (CI 95%, 4.11-4.28), which was stable at the end of the 2nd (4.16; CI 95%, 4.06-4.26) and 3rd years (4.26; CI 95%, 4.16-4.32) and no statistical differences emerged over the years. With regard to the competences acquired in clinical settings, at the end of the 1st year the students reported an average 4.28 out of 5 (CI 95%, 4.20-4.37), which decreased significantly at the end of the 2nd year (4.15; CI 95%, 4.07-4.23; p=0.02) and increased at the end of the 3rd year (4.37; CI 95%, 4.27-4.47; p<0.01). Conclusions Nursing students' competences in patient safety issues increases over time, while their knowledge remains stable. Students are more vulnerable at the end of the 1st year, when they seem to be overconfident about patient-safety issues.
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Gomes ATDL, Salvador PTCDO, Goulart CF, Cecilio SG, Bethony MFG. Innovative Methodologies to Teach Patient Safety in Undergraduate Nursing: Scoping Review. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.1.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This work sought to identify the innovative methodologies used to teach patient safety in undergraduate Nursing.
Materials and method: this is a scoping review conducted according to the recommendations by the Joanna Briggs Institute Reviewers’ Manual, through the databases: Medline/PubMed, Cumulative Index of Nursing and Allied Health, Scopus, Web of Science, Education Resources Information Center, Latin American and Caribbean Literature on Health Sciences, Catálogo de Tesis de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, The National Library of Australia’s Academic Archive Online, Digital Access to Research Theses Europe E-Theses Portal, Electronic Theses Online Service, Repositório Científico de Acesso Aberto de Portugal, National ETD Portal, and Theses Canada.
Results: the study included 19 studies, most of descriptive type (n = 8; 42.1 %) and quasi-experimental (n = 7; 36.8 %) with quantative approach (n = 11; 57.9 %), conducted in the United States (n = 4; 21.1 %), in 2013 (n = 4; 21.1 %) and 2017 (n = 4; 21.1 %). The innovative methodologies used to teach patient safety in undergraduate Nursing that were highlighted included the scenario of the care practice simulated in the laboratory (n = 14; 73.7 %) and educational videos (n = 7; 36.8 %).
Conclusions: it was identified that innovative methodologies used to teach patient safety in undergraduate Nursing were simulation, videos, staging/role playing, and films, all applied in the classroom teaching modality.
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Morelock SG, Kirk JD. An urban medical system's exploratory study of medication errors. Nurs Open 2019; 6:1197-1204. [PMID: 31367446 PMCID: PMC6650646 DOI: 10.1002/nop2.319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/21/2019] [Accepted: 05/21/2019] [Indexed: 11/06/2022] Open
Abstract
AIMS This study sought to identify patterns of medication errors with respect to shifts, day of week, unit involved, severity, medication class and cause of errors and to propose possible solutions. DESIGN This was a retrospective explorative study using a database containing 605 medication events from two medical centres. Variables assessed include medication type, the error severity, and time the medication was ordered, the unit that the error occurred on and the day of the week of the errors. METHODS Simple percentages were used to report the results, and point-biserial correlation was employed to test for significant differences between the day and night shifts. RESULTS There were no statistically significant findings when comparing event severity against the a.m. or p.m. shifts. The medication classes with the most errors were antibiotics, and the most common reason cited for errors was dose omission. The most commonly reported severity level was a 2 which requires increased patient monitoring.
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Hayes C, Power T, Davidson PM, Daly J, Jackson D. Learning to liaise: using medication administration role-play to develop teamwork in undergraduate nurses. Contemp Nurse 2018; 55:278-287. [PMID: 30092706 DOI: 10.1080/10376178.2018.1505435] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Aim: To describe undergraduate nursing students' situational awareness and understanding of effective liaison and collaboration within the nursing team during interrupted medication administration.Background: Medication errors related to interruptions are a major problem in health care, impacting on patient morbidity and mortality and increasing the burden of related costs. Effective liaison, teamwork and situation awareness are requisite skills for nurses to facilitate the safe management of interruptions during medication administration.Method: A role-play simulation was offered to 528 second-year undergraduate Bachelor of Nursing students. Qualitative written reflective responses were subsequently collected and subject to thematic analysis to derive themes.Results: Participants (451:528) reported an improved understanding of an unfamiliar and challenging situation that required cooperation and collaboration amongst the nursing team to improve outcomes.Conclusion(s): This simulation exposed undergraduate nurses with limited clinical experience to a situation otherwise unavailable to them. The skills required to engage in effective liaison and teamwork in dynamic situations are vital elements in achieving quality care and must begin to be taught at an undergraduate level.
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Affiliation(s)
- Carolyn Hayes
- Faculty of Health, University of Technology Sydney, Building 10 level 6, 235 Jones Street, Broadway, NSW, 2007, Australia
| | - Tamara Power
- Faculty of Health, University of Technology Sydney, Building 10 level 7, 235 Jones Street, Broadway, NSW, 2007, Australia
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205-2110, USA
| | - John Daly
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Debra Jackson
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
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Schroers G. Characteristics of interruptions during medication administration: An integrative review of direct observational studies. J Clin Nurs 2018; 27:3462-3471. [DOI: 10.1111/jocn.14587] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/11/2018] [Accepted: 06/16/2018] [Indexed: 11/28/2022]
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Usher K, Woods C, Conway J, Lea J, Parker V, Barrett F, O'Shea E, Jackson D. Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study. NURSE EDUCATION TODAY 2018; 66:82-89. [PMID: 29684837 DOI: 10.1016/j.nedt.2018.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/21/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Patient safety is a core principle of health professional practice and as such requires significant attention within undergraduate curricula. However, patient safety practice is complex requiring a broad range of skills and behaviours including the application of sound clinical knowledge within a range of health care contexts and cultures. There is very little research that explores how this is taught within Australian nursing curricula. OBJECTIVES To examine how Australian nursing curricula address patient safety; identify where and how patient safety learning occurs; and describe who is responsible for facilitating this learning. DESIGN A cross-sectional study. SETTING Eighteen universities across seven Australian States and Territories. PARTICIPANTS The sample consisted of 18 nursing course coordinators or those responsible for the inclusion of patient safety content within a Bachelor of Nursing course at Australian universities. METHODS An online survey was conducted to evaluate the patient safety content included and teaching methods used in Australian pre-registration nursing curricula. RESULTS Approaches to teaching patient safety vary considerably between universities where patient safety tended to be integrated within undergraduate nursing course subjects rather than explicitly taught in separate, stand-alone subjects. Three-quarters of the surveyed staff believed patient safety was currently being adequately covered in their undergraduate nursing curricula. CONCLUSION Although there is consensus in relation to the importance of patient safety across universities, and similarity in views about what knowledge, skills and attitudes should be taught, there were differences in: the amount of time allocated, who was responsible for the teaching and learning, and in which setting the learning occurred and was assessed. There was little indication of the existence of a systematic approach to learning patient safety, with most participants reporting emphasis on learning applied to infection control and medication safety.
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Affiliation(s)
- Kim Usher
- School of Health, University of New England, Armidale, NSW 2351, Australia; Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford School of Nursing and Midwifery, Faculty of Health & Life Sciences, Oxford-Brookes University, Oxford, UK.
| | - Cindy Woods
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Jane Conway
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Jackie Lea
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Vicki Parker
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Fiona Barrett
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Eilish O'Shea
- School of Health, University of New England, Armidale, NSW 2351, Australia.
| | - Debra Jackson
- School of Health, University of New England, Armidale, NSW 2351, Australia; Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford School of Nursing and Midwifery, Faculty of Health & Life Sciences, Oxford-Brookes University, Oxford, UK; Faculty of Health, University of Technology Sydney, NSW 2007, Australia.
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