A meta‐synthesis of how registered nurses make sense of their lived experiences of medication errors

Observing expert opinion of medical affairs pharmaceutical physicians on the value of their clinical experience to the pharmaceutical industry using the Jandhyala method

BACKGROUND

The pharmaceutical industry requires a highly qualified workforce with diverse skillsets. Medical affairs pharmaceutical physicians (MAPPs) have unique qualifications among pharmaceutical company employees, but the exact contribution of their education and training is unknown. This study aimed to identify the medical education and training competencies MAPPs use in the pharmaceutical industry in relation to the four external stakeholders, regulators, payors, prescribers, and patients.

METHOD

Ten MAPPs were recruited using convenience sampling via professional networks. A systematic literature review and the Jandhyala method, a two-stage qualitative online consensus method, identified which of MAPPs' medical education and training competencies they used in their work with each external stakeholder. Statistical analyses determined heterogeneity in the relevance of competencies and competency categories to each stakeholder.

RESULTS

Nine MAPPs completed the study. Of the 59 competencies identified, 54 were relevant to all external stakeholders. Relevance of competencies varied significantly between external stakeholders (p = .0434). Binary competency scores varied significantly for three pairs of stakeholders, "patient vs. payor" (p = .025), "prescriber vs. regulator" (p = .013) and "prescriber vs. payor" (p = .008). Between-stakeholder overall frequency count varied significantly for two of the nine competency categories.

CONCLUSION

MAPPs develop a highly specialized set of competencies during medical education and training from which they use distinct subsets to meet the needs of external stakeholders in the pharmaceutical industry. Undergraduate and postgraduate competency-based medical education appears to prepare MAPPs for cognitive and technical work. Further exploration may aid understanding of how they develop soft skills.

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

BACKGROUND

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

How do the older adults in nursing homes live with dignity? A protocol for a meta-synthesis of qualitative research

INTRODUCTION

As the population continuous to age and family sizes decrease, residing in nursing homes has emerged as a crucial option for older adults' care. Ensuring a dignified life for older adults in nursing homes is critical for enhancing their overall quality of life. The primary objective of this study is to synthesise the evidence of qualitative research on the feelings and experiences of dignity among older adults living in nursing homes. This will enable a better understanding of the factors influencing the perception of dignity and its preservation, ultimately assisting older adults in achieving a more comfortable and fulfilling experience in nursing homes.

METHODS AND ANALYSIS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses will guide this meta-synthesis. We conducted an initial search on 1 June 2022, for studies published between the inception of each database and 2022, using the population exposure-outcome nomenclature. We searched the Embase, Web of Science, CINAHL, Cochrane Library and PubMed databases for relevant studies. For data synthesis, we will employ the Ritchie and Spencer framework, and the Supporting the Use of Research Evidence Framework will be used for data analysis. To minimise the risk of bias, we will critically appraise the selected studies using the Qualitative Assessment and Review Instrument.

ETHICS AND DISSEMINATION

This review does not involve human participants and, therefore, does not necessitate ethical approval. We plan to disseminate the protocol and findings through relevant channels, including publication in pertinent journals, presentations at conferences and symposia, and engagement with local and international health stakeholders.

PROSPERO REGISTRATION NUMBER

CRD42022343983.

CONCLUSION

This study aims to offer comprehensive evidence to guide nursing staff in providing dignity-focused interventions for older adult residents in nursing homes.

Intensive care nurses' experiences with the new electronic medication administration record

Aim

To explore the experiences of Registered Nurses who administered medications to patients using the electronic medication administration record (eMAR) in Electronic Record for Intensive Care (eRIC) at one adult intensive care unit (ICU) in NSW, Australia.

Design

The study research design used a qualitative descriptive exploratory approach that took place in two stages.

Methods

Five participants attended one focus group followed by the observation of each participant as medications were administered to their assigned patient using the eMAR in eRIC.

Results

From the data, three themes and one subtheme were identified. Themes included forcing nurses to work outside legal boundaries; patient safety; with a subtheme titled experiencing computer fatigue; and taking time away from the patient. To practise safely, nurses were required to implement workaround practices when using the new eMAR in ICU. Nurses also were concerned that the eMAR in eRIC took time away from the patient at the bedside and ‘added more screen time’ to their day.