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Braiki R, Douville F, Gagnon MP. Factors Influencing Novice and Beginner Nurses' Intention to Report Medication Errors and Near Misses. Can J Nurs Res 2024:8445621241263438. [PMID: 39056298 DOI: 10.1177/08445621241263438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Novice and beginner nurses make more medical errors than senior nurses. However, there is significant underreporting of medication errors and near misses among novice and beginner nurses. OBJECTIVE To identify the factors that influence the intention of novice and beginner nurses to report medication errors and near misses. METHODS A cross-sectional exploratory study was carried out among third-year nursing students in a Quebec university (n = 143). Data was collected through a self-reported questionnaire based on the adapted Theory of Planned Behavior. Simple descriptive analyses and a series of contingency analyses were performed using Chi-2 or Fisher exact tests. Correction of multiple tests was done using Bonferroni test. RESULTS All theoretical constructs were significantly associated with intention. Sociodemographic factors (age, sex, experience and education program) were also associated with intention. DISCUSSION AND CONCLUSION Further studies are needed to identify the determinants of intention to report medication errors and near misses among novice and beginner nurses. More attention is required in nursing practice and education to act on these factors, thus encouraging novice and beginner nurses to report medication errors and near misses.
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Affiliation(s)
- Raouaa Braiki
- Nursing Sciences Faculty, Laval University, Québec, Canada
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Oliveira I, Costeira C, Pereira Sousa J, Santos C. Patient Safety Culture in the Context of Critical Care: An Observational Study. NURSING REPORTS 2024; 14:1792-1806. [PMID: 39051369 PMCID: PMC11270189 DOI: 10.3390/nursrep14030133] [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: 04/27/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND A robust safety culture is essential for ensuring high-quality healthcare delivery. From a nursing perspective, especially among critical patients, it fosters ongoing improvement by highlighting areas that need attention. AIMS This study aimed to evaluate the perception of patient safety culture among nurses within the critical care environment. METHODOLOGY An observational study was conducted at a central hospital in Portugal employing the Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. RESULTS The study encompassed 57, nurses predominantly female (73.7%), aged 25-64. Most participants were general nurses (77.2%), with a significant proportion (61.4%) working in the emergency department and possessing an average tenure of 13 years at the facility. The perception of critical patient safety culture (CPSC) was predominantly positive (40.6%), varying by department, with intensive care nurses reporting the highest positivity rates. Teamwork was identified as a strong point, receiving 80.7% positivity, highlighting it as a well-established domain in the CPSC, whereas other domains were recognised as requiring enhancements. CONCLUSIONS The study pinpointed both strengths and weaknesses within the CPSC, offering a foundation for developing targeted strategies to bolster patient safety culture in critical care settings.
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Affiliation(s)
- Inês Oliveira
- Médio Tejo Local Health Unit, 2304-909 Tomar, Portugal
- School of Health Science Campus 2, Polytechnic of Leiria, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (C.C.); (J.P.S.)
| | - Cristina Costeira
- School of Health Science Campus 2, Polytechnic of Leiria, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (C.C.); (J.P.S.)
- ciTechCare, Hub de Inovação, Rua das Olhalvas, Campus 5, Polytechnic of Leiria, 2414-016 Leiria, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Joana Pereira Sousa
- School of Health Science Campus 2, Polytechnic of Leiria, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (C.C.); (J.P.S.)
- ciTechCare, Hub de Inovação, Rua das Olhalvas, Campus 5, Polytechnic of Leiria, 2414-016 Leiria, Portugal
| | - Cátia Santos
- School of Health Science Campus 2, Polytechnic of Leiria, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (C.C.); (J.P.S.)
- ciTechCare, Hub de Inovação, Rua das Olhalvas, Campus 5, Polytechnic of Leiria, 2414-016 Leiria, Portugal
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Battah MM, Zainal H, Ibrahim DA, Md Hanafiah NHB, Sulaiman SAS. Evaluation of clinicians' knowledge and practice regarding pharmacotherapy of Non-Hodgkin's lymphoma: A multi-center study in Yemen. PLoS One 2024; 19:e0304209. [PMID: 38838036 PMCID: PMC11152296 DOI: 10.1371/journal.pone.0304209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
Non-Hodgkin lymphoma (NHL) is a hematological malignancy that requires effective pharmacotherapy for optimal management. There is limited information regarding Yemeni clinicians' knowledge and practice of NHL pharmacotherapy. This study aims to assess the knowledge and practice of physicians and nurses in Yemen regarding pharmacotherapy of NHL. A cross-sectional study was conducted in Sana'a, Yemen, from January 1, 2022, to January 31, 2023. Two self-administrated and validated questionnaires were distributed to 99 physicians and 164 nurses involved in pharmacotherapy for NHL in different oncology centers and units across Yemen. Convenience samples were used to recruit participants. A binary logistic regression analysis was performed to identify factors associated with nurses' and physicians' knowledge and practice. The correlation coefficient was used to examine the relationship between knowledge and practice. A total of 77 physicians and 105 nurses completed the questionnaires. The results showed that 54.3% of nurses and 66.2% of physicians had poor knowledge of NHL pharmacotherapy. In terms of practice, 83.8% of nurses and 75.3% of physicians exhibited poor practice regarding NHL pharmacotherapy. Multivariable logistic regression analysis identified that nurses who received sufficient information about chemotherapy displayed a significant association with good knowledge, while nurses working in the chemotherapy administration department were significant predictors of good practice. Among physicians, those working in the National Oncology Center (NOC) in Sana'a demonstrated good practice. Correlation analysis revealed a positive relationship between nurses' knowledge and their practice. The study's results confirm deficiencies in knowledge and practice of pharmacotherapy for NHL among physicians and nurses in Yemen. Efforts should be made to enhance their understanding of treatment guidelines and to improve patient care. Improvement in educational programs and training opportunities may contribute to improving patient outcomes in the management of NHL.
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Affiliation(s)
- Mohammed Mohammed Battah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, Yemen
| | - Hadzliana Zainal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Doa’a Anwar Ibrahim
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, Yemen
| | | | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Alrasheeday AM, Alkubati SA, Alrubaiee GG, Alqalah TA, Alshammari B, Abdullah SO, Loutfy A. Estimating Proportion and Barriers of Medication Error Reporting Among Nurses in Hail City, Saudi Arabia: Implications for Improving Patient Safety. J Multidiscip Healthc 2024; 17:2601-2612. [PMID: 38799015 PMCID: PMC11127687 DOI: 10.2147/jmdh.s466339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
Background Determining the proportion of nurses reporting medication errors (MEs) and identifying the barriers they perceive in ME reporting are crucial to encourage nurses to actively report MEs. Objective This study aimed to determine the proportion of nurses experiencing and reporting MEs, perceived barriers to reporting MEs and their association with nurses' sociodemographic and work-related characteristics. Methods A cross-sectional study was conducted among 350 nurses from June to November 2023. Data about sociodemographic and work-related characteristics, and ME reporting, were collected using a validated self-administered questionnaire. Results The study found that 34.3% of nurses reported MEs, while 11.1% reported experiencing MEs during their practice. ME reporting was higher proportion among nurses who were older than 40 years (52.1%), males (41.4%), held a master's degree (58.7%), Saudi nationals (37.8%), experienced for more than 10 years (43.1%), working in intensive care units (44.3%), working for 48 hours or more per week (39.7%), working in hospitals with a nurse-to-patient ratio of 1:3 (44.9%) and having a system for incident reporting (37.7%) and with no training on patient safety (44.6%) compared to their counterparts. The rate of experiencing MEs was higher proportion among nurses who were older than 40 years (16.7%), males (17.3%), married (14.8%), Saudi nationals (13.4%), experienced for more than 10 years (15.6%) and with no training on patient safety (15.3%) compared to their counterparts. Lack of knowledge of the person responsible for reporting MEs was the most frequent perceived barrier to ME reporting (66.6%), followed by fears of blame (65.4%). Conclusion In this study, nurses reported and experienced MEs during their practice. Most nurses perceive the lack of knowledge and fear of blame or disciplinary actions as barriers to reporting. Healthcare administrators should implement educational programs and workshops to increase nurses' awareness of ME reporting.
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Affiliation(s)
| | - Sameer A Alkubati
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Hodeidah University, Hodeida, Yemen
| | - Gamil G Alrubaiee
- Department of Community Health, University of Hail, Hail, Saudi Arabia
- Department of Community Health, Al Razi University, Sanaa, Yemen
| | - Talal A Alqalah
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
| | - Bushra Alshammari
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
| | | | - Ahmed Loutfy
- Maternal and Child Nursing Department, College of Nursing, University of Hail, Hail, 2440, Saudi Arabia
- Department of Nursing, College of Health Sciences, University of Fujairah, Fujairah, 1207, United Arab Emirates
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Alotaibi JS. Causes of medication administration errors and barriers to reporting as perceived by nurses in Saudi Arabia: A qualitative study. BELITUNG NURSING JOURNAL 2024; 10:215-221. [PMID: 38690308 PMCID: PMC11056835 DOI: 10.33546/bnj.3249] [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: 02/01/2024] [Revised: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Background Medication administration errors significantly impact patient safety, potentially leading to severe harm or fatality. Reporting such errors through active systems improves medication administration, thereby enhancing patient safety and the quality of care. However, in the context of Saudi Arabia, little is understood about the causes of medication administration errors and the obstacles hindering their reporting. Objective This study aimed to explore nurses' perceptions of the causes of medication administration errors and the barriers to reporting them. Methods The study employed a qualitative descriptive design, conducting face-to-face semi-structured interviews with 43 nurses from three hospitals in Taif Governorate, Saudi Arabia, between October and November 2023. Purposive sampling was used to recruit participants, and thematic analysis was utilized for data analysis. Results The following themes emerged regarding the causes of medication administration errors: order deficiencies, high workloads and staff shortages, and malpractice. Regarding the barriers to reporting errors, the emerging themes were fear of punishment and lack of support, lack of knowledge and awareness about reporting, and lack of feedback. Conclusion This study reveals nurses' perceptions of the causes of medication administration errors and the barriers to reporting them. Recognizing and addressing these causes and barriers are essential for patient safety and the improvement of the healthcare environment. Efforts should be directed toward implementing interventions that address high workloads, enhance staff education and awareness, and promote a workplace culture conducive to reporting errors without fear of repercussions. Additionally, supportive mechanisms, such as feedback systems and resources for professional development, should be implemented to empower nurses to actively participate in error reporting and contribute to continuous improvement in medication administration practices.
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Affiliation(s)
- Jazi Shaydied Alotaibi
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
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Martin CV, Joyce-McCoach J, Peddle M, East CE. Sleep deprivation and medication administration errors in registered nurses-A scoping review. J Clin Nurs 2024; 33:859-873. [PMID: 37872866 DOI: 10.1111/jocn.16912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/31/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
AIM To explore whether sleep deprivation contributes to medication errors in registered nurses (RNs). BACKGROUND Sleep deprivation is a potential issue for RNs, particularly those who work shifts. Sleep deprivation has been found to have a negative impact on numerous cognitive processes. Nurses administer several medications to patients a day, potentially while sleep deprived-anecdotal reports suggest that this could result in an increased risk of error occurring. DESIGN A scoping review was conducted using the Prisma-ScR extension framework to explore what is known about the effect of RNs' sleep deprivation on medication administration errors. METHODS A search of databases generated 171 results. When inclusion and exclusion criteria were applied, 18 empirical studies were analysed. Studies included retrospective analysis of errors, surveys of perceptions of causes and observational studies. RESULTS Data indicated that RNs consider fatigue, which may be caused by sleep deprivation, to be a contributing factor to medication errors. The search only identified three observer studies, which provided conflicting results as to whether lack of sleep contributes to the error rate. Of the numerous tools used to measure sleep, the Pittsburgh Sleep Quality Index was the most frequently used. CONCLUSION Although RNs anecdotally consider a lack of sleep potentially contributes to medication errors, there is insufficient research to provide robust evidence to confirm this assumption. NO PATIENT OR PUBLIC CONTRIBUTIONS Patient or public contributions were not required for this scoping review. RELEVANCE TO CLINICAL PRACTICE Sleep deprivation is a potential issue for nurses, especially those who work shifts. Poor sleep impacts cognitive processes that potentially could increase errors. Nurses should be aware of the impact sleep may have on patient safety.
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Affiliation(s)
- Christopher Vincent Martin
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Ballarat, Victoria, Australia
| | - Joanne Joyce-McCoach
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Monica Peddle
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
| | - Christine Elizabeth East
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
- Mercy Health, Melbourne, Victoria, Australia
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Asadi M, Ahmadi F, Mohammadi E, Vaismoradi M. A grounded theory of the implementation of medical orders by clinical nurses. BMC Nurs 2024; 23:113. [PMID: 38347548 PMCID: PMC10863222 DOI: 10.1186/s12912-024-01775-6] [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: 06/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To explore the process of implementing medical orders by clinical nurses, and identify specific areas of concern in the implementation process, and uncover strategies to address these concerns. BACKGROUND The implementation of medical orders is a crucial responsibility for clinical nurses, as they bear legal accountability for the precise implementation of directives issued by medical practitioners. The accurate implementation of these orders not only shapes the quality and safety of healthcare services but also presents numerous challenges that demand careful consideration. METHOD This study employed a qualitative design using a grounded theory approach to construct a comprehensive theoretical framework grounded in the insights and experiences of nurses operating within the hospital settings of Iran. The study encompassed 20 participants, comprising 16 clinical nurses, two nurse managers, and two specialist doctors working in hospital settings. The selection process involved purposeful and theoretical sampling methods to ensure diverse perspectives. Data collection unfolded through in-depth, individual, semi-structured interviews, persisting until data saturation was achieved. The analytical framework proposed by Corbin and Strauss (2015) guided the process, leading to the development of a coherent theory encapsulating the essence of the study phenomenon. FINDINGS The primary finding of the study underscores the significance of 'legal threat and job prestige' highlighting diverse repercussions in case of errors in the implementation of medical orders. At the core of the investigation, the central variable and the theory of the study was the 'selective and tasteful implementation of orders to avoid legal and organizational accountability.' This indicated a set of strategies employed by the nurses in the implementation of medical orders, encapsulated through three fundamental concepts: 'accuracy in controlling medical orders,' 'untruth documentation,' and 'concealment of events. The formidable influence of legal threats and job prestige was further compounded by factors such as heavy workloads, the doctor's non-compliance with legal instructions for giving verbal orders, the addition of orders by the doctor without informing nurses, and pressure by nursing managers to complete documentation. The resultant psychological distress experienced by nurses not only jeopardized patient safety but also underscored the intricate interplay between legal implications and professional standing within the healthcare framework. CONCLUSION Alleviating staff shortages, enhancing the professional rapport between doctors and nurses, offering legal support to nursing staff, implementing measures such as recording departmental phone conversations to deter the non-acceptance of verbal orders, fostering an organizational culture that embraces nurse fallibility and encourages improvement, and upgrading equipment can ameliorate nurses' apprehensions and contribute to the safe implementation of medical orders.
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Affiliation(s)
- Monireh Asadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran.
| | - Easa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Ta'an WF, Allama F, Williams B. The role of organizational culture and communication skills in predicting the quality of nursing care. Appl Nurs Res 2024; 75:151769. [PMID: 38490801 DOI: 10.1016/j.apnr.2024.151769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/30/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
AIMS This study aims to identify the level of nursing care quality and examine its predictors considering nurses' demographic data, organizational culture, and communication skills. BACKGROUND Quality of care is a determinant of the sustainability of any healthcare organization. Therefore, it is imperative to understand how factors may contribute to the quality of nursing care. Limited research is available on the interaction between the concepts of quality of nursing care, communication skills, and organizational culture. METHODS A cross-sectional multi-site correlational design was used in this study. A convenience sample of 200 nurses from four Jordanian hospitals was recruited. Data was collected using self-reported questionnaires. Descriptive statistics, Pearson correlations, and multiple regression were performed to achieve the study's aims. RESULTS The majority of the nurses in this study were females with bachelor's degrees. Age ranged between 22 and 53 years whereas experience ranged from 1 to 30 years. Communication skills significantly predicted the quality of nursing care; however, organizational culture was not a significant predictor of the quality of nursing care. Nevertheless, Pearson r correlation results revealed a significant correlation between organizational culture and communication skills (r = 0.57, p < 0.05). CONCLUSION Nurses and organizational managers can increase the level of quality of nursing care by investing in programs that target improving nurses' communication skills. Providing a good environment in the hospital can increase communication skills between staff members, ultimately increasing the quality of nursing care. Further studies are recommended to elaborate and further uncover concerns related to the current research.
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Affiliation(s)
- Wafa'a F Ta'an
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | - Fadi Allama
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | - Brett Williams
- Department of Paramedicine, Monash University, Clayton, Victoria, Australia.
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Hijazi R, Sukkarieh H, Bustami R, Khan J, Aldhalaan R. Enhancing Patient Safety: A Cross-Sectional Study to Assess Medical Interns' Attitude and Knowledge About Medication Safety in Saudi Arabia. Cureus 2023; 15:e50505. [PMID: 38111820 PMCID: PMC10726002 DOI: 10.7759/cureus.50505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 12/20/2023] Open
Abstract
Introduction and aim Medication errors (MEs) pose a severe threat in the medical field. Since such errors are preventable, it is paramount for all healthcare workers to be educated on the matter. This study aimed to assess medical interns' attitudes and knowledge of medication safety and errors. We also aimed to validate current university programs to educate students about medication safety and errors. Methods A cross-sectional study that utilized a self-administered online questionnaire comprised 31 questions. The questionnaire was distributed via social media networks, such as WhatsApp, Twitter, email, Instagram, and Snapchat among 100 medical, pharmacy, and nursing interns in Saudi Arabia. The study population included both Saudi and non-Saudi interns. Results The majority of participants, comprising 92% (n=92), indicated that they were familiar with the definition of medication errors (ME). Additionally, 85% (n=85) expressed their willingness to report instances of MEs when medications were not prescribed but required. Moreover, 90% (n=90) of the surveyed individuals expressed their willingness to report MEs in situations where patients did not receive medications as prescribed. In cases where patients experienced harm and required treatment due to an ME, 91% (n=91) of respondents committed to reporting such incidents. A total of 52 (52%) respondents stated that they would report MEs regardless of whether they reached/harmed the patient. A good ME knowledge level was observed in 48% of respondents. A higher likelihood of good ME knowledge was significantly associated with safety reporting system (SRS) awareness and reporting MEs regardless of whether they reached/harmed the patient (p<0.05). College, awareness/attitude, or other demographic factors were not significantly related to ME knowledge (p>0.05). Conclusion This study showed that although interns in the healthcare field do have some knowledge about MEs, there is still a significant need to improve their knowledge. This can be achieved through various ways, one of which is by implementing this topic into the university curricula.
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Affiliation(s)
- Raghad Hijazi
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | - Rami Bustami
- College of Business, Alfaisal University, Riyadh, SAU
| | - Jibran Khan
- College of Medicine, Alfaisal University, Riyadh, SAU
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Coelho F, Furtado L, Mendonça N, Soares H, Duarte H, Costeira C, Santos C, Sousa JP. Interventions to Minimize Medication Error by Nurses in Intensive Care: A Scoping Review Protocol. NURSING REPORTS 2023; 13:1040-1050. [PMID: 37606459 PMCID: PMC10443247 DOI: 10.3390/nursrep13030091] [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: 05/09/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
Medication errors represent a concern for healthcare organizations due to their negative consequences. In the nursing context, these errors represent a threat to the quality of care and patient safety. Many factors have been identified as potential causes for these errors in intensive care units. A scoping review will be developed to identify interventions/strategies to minimize the occurrence of medication errors by nurses, considering the Joanna Briggs Institute (JBI) methodology. A search will be conducted in the EbscoHost (CINAHL Complete and MEDLINE), Embase and PubMed databases. Data analysis, extraction and synthesis will be carried out by two reviewers independently. This review will attempt to map which interventions are more specific to minimizing medication error by nurses in intensive care and to recognize which factors influence this type of error to mitigate practices that may lead to error. This protocol acts as the framework for a scoping review in the strategy to map the interventions and which factors contribute to the medication error by intensive care nurses. This study was prospectively registered with the Open Science Framework on 21 April 2023 with registration number DOI 10.17605/OSF.IO/94KH3.
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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; (H.D.); (C.C.); (C.S.); (J.P.S.)
| | - Cristina Costeira
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal; (H.D.); (C.C.); (C.S.); (J.P.S.)
| | - Cátia Santos
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal; (H.D.); (C.C.); (C.S.); (J.P.S.)
| | - Joana Pereira Sousa
- Center for Innovative Care and Health Technology—ciTechCare, School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal; (H.D.); (C.C.); (C.S.); (J.P.S.)
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Pullam T, Russell CL, White-Lewis S. Frequency of Medication Administration Timing Error in Hospitals: A Systematic Review. J Nurs Care Qual 2023; 38:126-133. [PMID: 36332227 DOI: 10.1097/ncq.0000000000000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Medication administration timing error (MATE) leads to poor medication efficacy, harm, and death. Frequency of MATE is understudied. PURPOSE To determine MATE frequency, and characteristics and quality of reporting studies. METHODS A systematic review of articles between 1999 and 2021 was conducted using the Cumulative Index of Nursing and Allied Health Literature, ProQuest, and PubMed databases. Articles were scored for quality using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. RESULTS Initially, 494 articles were screened; 23 were included in this review. MATE was defined as administration beyond 60 minutes before or after the scheduled time in 13 (57%) of the included studies. Measurement procedures included data abstraction, self-report, and observation. Frequency of MATE was 1% to 72.6%. Moderate study quality was found in 78% of articles. CONCLUSION Research on MATE is characterized by inconsistent definitions, measurements procedures, and calculation techniques. High-quality studies are lacking. Many research improvement opportunities exist.
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Affiliation(s)
- Trinity Pullam
- School of Nursing and Health Studies, University of Missouri-Kansas City
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Beaudart C, Witjes M, Rood P, Hiligsmann M. Medication administration errors in the domain of infusion therapy in intensive care units: a survey study among nurses. Arch Public Health 2023; 81:23. [PMID: 36793055 PMCID: PMC9930049 DOI: 10.1186/s13690-023-01041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Despite extensive research carried out on medication administration errors (MAEs) in the domain of infusion therapy, there is limited knowledge on nurse's perceptions on the occurrence of MAEs during infusion therapy. Since nurses are responsible for medication preparation and administration in Dutch hospitals, it is vital to understand their perspectives on the risk factors for MAEs. AIM The purpose of this study is to investigate the perception of nurses, working in adult ICUs, on the occurrence of MAEs during continuous infusion therapies. METHODS A digital web-based survey was distributed among 373 ICU nurses working in Dutch hospitals. The survey investigated nurses' perceptions on the frequency, severity of consequences and preventability of MAEs, factors for the occurrence of MAEs, and infusion pump and smart infusion safety technology. RESULTS A total of 300 nurses started to fill out the survey but only 91 of them (30.3%) fully completed it and were included in analyses. Medication-related factors and Care professional-related factors were perceived as the two most important risk categories for the occurrence of MAEs. Important risk factors contributing to the occurrence of MAEs included high patient-nurse ratio, problems in communication between caregivers, frequent staff changes and transfers of care, and no/incorrect dosage/concentration on labels. Drug library was reported as the most important infusion pump feature and both Bar Code Medication Administration (BCMA) and medical device connectivity as the two most important smart infusion safety technologies. Nurses perceived the majority of MAEs as preventable. CONCLUSIONS Based on ICU nurses' perceptions, the present study suggests that strategies to reduce MAEs in these units should focus on, among other factors, the high patient-to-nurse ratio, problems in communication between nurses, frequent staff changes and transfers of care, and no/incorrect dosage/concentration on drug labels.
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Affiliation(s)
- Charlotte Beaudart
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Maureen Witjes
- grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Paul Rood
- Dutch Professional Nurses Organisation, Chapter Critical Care Nurses (V&VN IC), Utrecht, the Netherlands ,grid.450078.e0000 0000 8809 2093School of Health Studies, Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, the Netherlands ,grid.10417.330000 0004 0444 9382Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mickael Hiligsmann
- grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Jessurun JG, Hunfeld NGM, de Roo M, van Onzenoort HAW, van Rosmalen J, van Dijk M, van den Bemt PMLA. Prevalence and determinants of medication administration errors in clinical wards: A two-centre prospective observational study. J Clin Nurs 2023; 32:208-220. [PMID: 35068001 DOI: 10.1111/jocn.16215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/21/2021] [Accepted: 01/02/2022] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES To identify the prevalence and determinants of medication administration errors (MAEs). BACKGROUND Insight into determinants of MAEs is necessary to identify interventions to prevent MAEs. DESIGN A prospective observational study in two Dutch hospitals, a university and teaching hospital. METHODS Data were collected by observation. The primary outcome was the proportion of administrations with one or more MAEs. Secondary outcomes were the type, severity and determinants of MAEs. Multivariable mixed-effects logistic regression analyses were used for determinant analysis. Reporting adheres to the STROBE guideline. RESULTS MAEs occurred in 352 of 2576 medication administrations (13.7%). Of all MAEs (n = 380), the most prevalent types were omission (n = 87) and wrong medication handling (n = 75). Forty-five MAEs (11.8%) were potentially harmful. The pharmaceutical forms oral liquid (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43-7.25), infusion (OR 1.73, CI 1.02-2.94), injection (OR 3.52, CI 2.00-6.21), ointment (OR 10.78, CI 2.10-55.26), suppository/enema (OR 6.39, CI 1.13-36.03) and miscellaneous (OR 6.17, CI 1.90-20.04) were more prone to MAEs compared to oral solid. MAEs were more likely to occur when medication was administered between 10 a.m.-2 p.m. (OR 1.91, CI 1.06-3.46) and 6 p.m.-7 a.m. (OR 1.88, CI 1.00-3.52) compared to 7 a.m.-10 a.m. and when administered by staff with higher professional education compared to staff with secondary vocational education (OR 1.68, CI 1.03-2.74). MAEs were less likely to occur in the teaching hospital (OR 0.17, CI 0.08-0.33). Day of the week, patient-to-nurse ratio, interruptions and other nurse characteristics (degree, experience, employment type) were not associated with MAEs. CONCLUSIONS This study identified a high MAE prevalence. Identified determinants suggest that focusing interventions on complex pharmaceutical forms and error-prone administration times may contribute to MAE reduction. RELEVANCE TO CLINICAL PRACTICE The findings of this study can be used to develop targeted interventions to improve patient safety.
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Affiliation(s)
- Janique Gabriëlle Jessurun
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nicole Geertruida Maria Hunfeld
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Intensive Care, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Michelle de Roo
- Department of Clinical Pharmacy, Amphia Hospital, Breda, The Netherlands
| | | | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, Section of Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Patricia Maria Lucia Adriana van den Bemt
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
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Bergman F, Hammar T. Healthcare professionals' perceptions of a web-based application for using the new National Medication List in Sweden. Digit Health 2023; 9:20552076231171966. [PMID: 37188079 PMCID: PMC10176565 DOI: 10.1177/20552076231171966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objective During the first stage of implementing the National Medication List in Sweden, a web-based application called Förskrivningskollen (FK) was launched. FK includes information about a patient's prescribed and dispensed medications, and it works as a backup system until the healthcare electronic health record (EHR) systems are fully integrated. The aim of this study was to examine the healthcare professionals' experiences and perceptions of FK. Methods The study applied a mixed methods approach, with statistics about the use of FK and a survey with open and closed questions. The respondents (n = 288) were healthcare professionals who were users or potential users of FK. Results Overall there was little knowledge about FK and uncertainty regarding working routines and the regulations connected to the application. Lack of interoperability with the EHRs made FK time-consuming to use. Respondents said that the information in FK was not updated, and they were concerned that using FK could lead to a false sense of security about the accuracy of the list. Most clinical pharmacists thought FK added benefit to their clinical work, while as a group, physicians were more ambivalent about FK's benefit. Conclusions The concerns of healthcare professionals give important insights for future implementation of shared medication lists. Working routines and regulations linked to FK need to be clarified. In Sweden, the potential value of a national shared medication list will probably not be realized until it is fully integrated into the EHR in a way that supports healthcare professionals' desired ways of working.
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Affiliation(s)
- Frida Bergman
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Tora Hammar
- eHealth Institute, Department of
Medicine and Optometry, Linnaeus University, Kalmar, Sweden
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15
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Kim MJ, Lee W. What to learn from analysis of medical disputes related to medication errors in nursing care. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2023; 34:179-188. [PMID: 36442214 DOI: 10.3233/jrs-220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nurses, who are the last safeguard against and have the final opportunity to prevent medication errors (MEs), play a vital role in patient safety by managing medications. OBJECTIVE This study described the characteristics of medical dispute cases, medication information, and stage and types of MEs in Korea. METHODS We performed a descriptive analysis of 27 medical dispute cases related to MEs in nursing care in Korea. RESULTS Around 77.7% of patients suffered serious harm or died due to MEs in this study. The types of medications included anxiolytics and analgesics, and 51.9% of them were high-alert medications. Among cases of administration errors, failure to patient assessment before and after administration was the most common error followed by administering the wrong dose. CONCLUSION Nurses should perform their duties to ensure safety and improve the quality of nursing care by monitoring patients after administering medications and should be prepared to take quick action to reduce harm.
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Affiliation(s)
- Min Ji Kim
- Department of Medical Law and Ethics, Graduate School, Yonsei University, Seoul, Republic of Korea
- Korea Medical Dispute Mediation and Arbitration Agency, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
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16
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Knowledge and Attitudes Regarding Medication Errors among Nurses: A Cross-Sectional Study in Major Jeddah Hospitals. NURSING REPORTS 2022; 12:1023-1039. [PMID: 36548171 PMCID: PMC9783575 DOI: 10.3390/nursrep12040098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Medication error is a multifactorial problem that mainly involves missing or bypassing the administration, which may have life-threatening impacts on the patient. Nevertheless, there is a dearth of information on medication errors among nurses in Saudi Arabia. This study investigates the knowledge and attitudes toward medication errors and their associated factors among nurses in Saudi Arabia. A cross-sectional study was conducted in four major public hospitals by recruiting a total of 408 nurses using cluster random sampling and proportional stratified sampling techniques. Data were gathered using an online self-administered questionnaire from January to March 2022. Descriptive statistics, Chi-square tests, and binary logistic regression models were performed to analyze the data. The prevalence of medication error among the nurses was 72.1%, only 41.2% were reported, while wrong doses (46.9%) were the most common type of medication error. Approximately 55% and 50% of the respondents demonstrated good knowledge and a positive attitude toward medication errors, respectively. The prevalence of medication error was associated with age groups of less than 25, and 25-35 years old, King Fahad and King Abdulaziz hospitals, no history of attending an MER training course, poor knowledge, and negative attitude. These findings reflect a high prevalence of medication error among nurses in Saudi Arabia, and the factors identified could be considered in mitigating this important health problem.
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17
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Lin S, Wang N, Ren B, Lei S, Feng B. Use of Failure Mode and Effects Analysis (FMEA) for Risk Analysis of Drug Use in Patients with Lung Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15428. [PMID: 36497503 PMCID: PMC9739421 DOI: 10.3390/ijerph192315428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
It is crucial to investigate the risk factors inherent in the medication process for cancer patients since improper antineoplastic drug use frequently has serious consequences. As a result, the Severity, Occurrence, and Detection rate of each potential failure mode in the drug administration process for patients with lung cancer were scored using the Failure Mode and Effect Analysis (FMEA) model in this study. Then, the risk level of each failure mode and the direction of improvement were investigated using the Slacks-based measure data envelopment analysis (SBM-DEA) model. According to the findings, the medicine administration process for lung cancer patients could be classified into five links, with a total of 60 failure modes. The risk of failure modes for patient medication and post-medication monitoring ranked highly, with unauthorized use of traditional Chinese medicine and folk prescription and unauthorized drug addition (incorrect self-medication) ranking first (1/60); doctor prescription was also prone to errors. The study advises actively looking at ways to decrease the occurrence and difficulty of failure mode detection to continually enhance patient safety when using medications.
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Affiliation(s)
- Shuzhi Lin
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
| | - Ningsheng Wang
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
| | - Biqi Ren
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
| | - Shuang Lei
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
| | - Bianling Feng
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
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Nurses’ perceptions of medication administration safety in public hospitals in the Gauteng Province: A mixed method study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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19
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Daniel T, de Chevigny A, Champrigaud A, Valette J, Sitbon M, Jardin M, Chevalier D, Renet S. Answering hospital caregivers' questions at any time: proof of concept of an artificial intelligence-based chatbot in a French hospital. JMIR Hum Factors 2022; 9:e39102. [PMID: 35930555 PMCID: PMC9555819 DOI: 10.2196/39102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/24/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Access to accurate information in health care is a key point for caregivers to avoid medication errors, especially with the reorganization of staff and drug circuits during health crises such as the COVID‑19 pandemic. It is, therefore, the role of the hospital pharmacy to answer caregivers’ questions. Some may require the expertise of a pharmacist, some should be answered by pharmacy technicians, but others are simple and redundant, and automated responses may be provided. Objective We aimed at developing and implementing a chatbot to answer questions from hospital caregivers about drugs and pharmacy organization 24 hours a day and to evaluate this tool. Methods The ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model was used by a multiprofessional team composed of 3 hospital pharmacists, 2 members of the Innovation and Transformation Department, and the IT service provider. Based on an analysis of the caregivers’ needs about drugs and pharmacy organization, we designed and developed a chatbot. The tool was then evaluated before its implementation into the hospital intranet. Its relevance and conversations with testers were monitored via the IT provider’s back office. Results Needs analysis with 5 hospital pharmacists and 33 caregivers from 5 health services allowed us to identify 7 themes about drugs and pharmacy organization (such as opening hours and specific prescriptions). After a year of chatbot design and development, the test version obtained good evaluation scores: its speed was rated 8.2 out of 10, usability 8.1 out of 10, and appearance 7.5 out of 10. Testers were generally satisfied (70%) and were hoping for the content to be enhanced. Conclusions The chatbot seems to be a relevant tool for hospital caregivers, helping them obtain reliable and verified information they need on drugs and pharmacy organization. In the context of significant mobility of nursing staff during the health crisis due to the COVID-19 pandemic, the chatbot could be a suitable tool for transmitting relevant information related to drug circuits or specific procedures. To our knowledge, this is the first time that such a tool has been designed for caregivers. Its development further continued by means of tests conducted with other users such as pharmacy technicians and via the integration of additional data before the implementation on the 2 hospital sites.
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Affiliation(s)
- Thomas Daniel
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR
| | - Alix de Chevigny
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR
| | - Adeline Champrigaud
- Innovation and Transformation Department, Information Systems Directorate, Paris Saint-Joseph Hospital Group, Paris, FR
| | - Julie Valette
- Innovation and Transformation Department, Information Systems Directorate, Paris Saint-Joseph Hospital Group, Paris, FR
| | - Marine Sitbon
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR
| | - Meryam Jardin
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR
| | - Delphine Chevalier
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR
| | - Sophie Renet
- Department of Pharmacy, Paris Saint-Joseph Hospital Group, 185 Raymond Losserand Street, Paris, FR.,Learning, Training and Digital Education and Training Research Center, University of Paris Nanterre, Paris, FR
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Exploring Nurses' Attitudes, Skills, and Beliefs of Medication Safety Practices. J Nurs Care Qual 2022; 37:319-326. [PMID: 35797628 DOI: 10.1097/ncq.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Medication errors exist within health care systems despite efforts to reduce their incidence. These errors may result in patient harm including morbidity, mortality, and increased health care costs. PURPOSE The purpose of this study was to explore direct care nurses' attitudes, skills, and beliefs about medication safety practice. METHODS Researchers conducted a descriptive exploratory study using the Nurses' Attitudes and Skills around Updated Safety Concepts (NASUS) scale and the Nurse Beliefs about Errors Questionnaire (NBEQ). RESULTS Responses from 191 surveys were analyzed. Of the participants, 70% were bachelor's prepared registered nurses and 88% were female. Results of the NASUS scale revealed the median of means of the Perceived Skills subscale was 79.2 out of 100 and the Attitudes subscale was 65.8 out of 100. The mean of the belief questions related to severity of error was 7.66 out of 10; most participants agreed with reporting of severe errors, reporting errors with moderate or major adverse events, and reporting of incorrect intravenous fluids. CONCLUSIONS Understanding direct care nurses' attitudes, skills, and beliefs about medication safety practices provides a foundation for development of improvement strategies.
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Sharon I, Drach-Zahavy A, Srulovici E. The Effect of Outcome vs. Process Accountability-Focus on Performance: A Meta-Analysis. Front Psychol 2022; 13:795117. [PMID: 35572269 PMCID: PMC9094407 DOI: 10.3389/fpsyg.2022.795117] [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: 10/14/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background The foundation of a safe practice is accountability, especially outcome- rather than process-focused accountability, particularly during pandemics such as COVID-19. Accountability is an essential behavior that promotes congruence between nursing actions and standards associated with quality of care. Moreover, the scant research examining whether one accountability focus is superior in motivating humans to better task performance yields inconclusive results. Aims Systematically examine the effect of an outcome- vs. process-accountability focus on performance and identify any moderating variables. Design Systematic review and meta-analysis. Data sources PsycINFO, Medline, PubMed, Scopus, and CINAHL databases, with all publications to November 2020. Review methods A systematic search using Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Statistical analysis and forest plots were performed using MetaXL 5.3. Heterogeneity was presented using I2 statistics and Q tests, and possible publication bias was assessed with a Doi plot and the LFK index. Results Seven studies representing nine experiments involving 1,080 participants were included. The pooled effect of the nine experiments on task performance failed to show significant differences (mean = −0.09; 95% Confidence Interval [95%CI]: −0.21, 0.03), but a significant moderating effect of task complexity was demonstrated. Specifically, outcome accountability exerts a beneficial effect in complex tasks (mean = −0.48 [95%CI: −0.62, −0.33]) whereas process accountability improves the performance in simpler tasks (mean = 0.96 [95%CI: 0.72, 1.20]). Conclusion These findings demonstrated that accountability focus by itself cannot serve as a sole motivator of better performance, because task complexity moderates the link between accountability focus and task performance. Outcome accountability exerts a beneficial effect for more-complex tasks, whereas process accountability improves the performance of simpler tasks. These findings are crucial in nursing, where it is typically assumed that a focus on outcomes is more important than a focus on processes.
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Affiliation(s)
- Ira Sharon
- Faculty of Social Welfare and Health Sciences, Department of Nursing, University of Haifa, Haifa, Israel
| | - Anat Drach-Zahavy
- Faculty of Social Welfare and Health Sciences, Department of Nursing, University of Haifa, Haifa, Israel
| | - Einav Srulovici
- Faculty of Social Welfare and Health Sciences, Department of Nursing, University of Haifa, Haifa, Israel
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Serra-Barril MA, Pamias-Nogue M, Zarza-Arnau N, Esteve-Gomez A, Clopes-Estela A, Fernández-Ortega P. Usefulness and Safety Evaluation of Chemotherapy Administration Device for Nurses: Experimental Study. Semin Oncol Nurs 2022; 38:151298. [DOI: 10.1016/j.soncn.2022.151298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
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Jeong HJ, Park EY. Patient-Nurse Partnerships to Prevent Medication Errors: A Concept Development Using the Hybrid Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5378. [PMID: 35564773 PMCID: PMC9102311 DOI: 10.3390/ijerph19095378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
Medication safety is the most patient-centered aspect of nursing, and the medication process needs patients' active participation to effectively prevent medication errors. The aim of this study was to develop the concept of a patient-nurse partnership for medication safety activities. The study design used the three-phase hybrid model for concept analysis: the theoretical phase, fieldwork phase, and final phase for integration. The results of a study define the concept of patient-nurse partnership for medication safety as "a fair cooperative relationship of mutual responsibility in which patients and nurses share information and communicate with each other through mutual trust." Seven attributes were derived: mutual trust, mutual respect, mutual sharing, mutual communication, mutual responsibility, fair relationship, and mutual cooperation. The conclusion of the study of patient-nurse partnerships for medication safety was that it is necessary to ensure a balance in power between patient and nurse. This balance can be established through patient-centered nursing by implementing the active transfer of authority from nurses as professionals to patients.
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Affiliation(s)
- Hee-Ja Jeong
- Nursing Department, Shihwa Medical Center, Siheung-si 15034, Korea;
| | - Eun-Young Park
- College of Nursing, Gachon University, Incheon 21939, Korea
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Aldossary DN, Almandeel HK, Alzahrani JH, Alrashidi HO. Assessment of Medication Errors Among Anesthesia Clinicians in Saudi Arabia: A Cross-Sectional Survey Study. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2022; 5:1-9. [PMID: 37260559 PMCID: PMC10229021 DOI: 10.36401/jqsh-21-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 06/02/2023]
Abstract
Introduction Anesthetic drugs are prepared and administrated without referral to the pharmacy or other medical departments. We aimed to assess the occurrence of anesthetic drug errors in Saudi Arabia. We also determined the contributing factors, reporting strategies, and clinicians' opinions of the preventive measures. Methods We conducted a cross-sectional web-based survey study using a validated tool. A total of 300 anesthesia clinicians completed the survey (146 anesthesiologists and 154 anesthesia technology specialists). We measured descriptive statistics to describe the demographic characteristics and performed inferential statistics to examine associations and differences. Results Sixty-nine percent of respondents had experienced an anesthetic drug error at least once in their career. The two primary factors that caused drug errors were haste (60.3%) and heavy workload (60.3%). On syringe labeling, 56.3% withdrew the drug then labeled the syringe, and 43.7% labeled the syringe then withdrew the drug. The chi-square test revealed that clinicians who labeled the syringe first then withdrew the drug made errors more frequently (p = 0.036). The test also showed that clinicians with less experience had committed more errors (p = 0.015). On reporting drug errors, 77.7% of respondents identified the fear of medicolegal issues as the most common barrier to reporting errors. Respondents believed that double-checking the medication and color-coded syringe labels were the most effective strategies to reduce errors (82% and 64%, respectively). The Mann-Whiney U test revealed significant differences between the two specialties about their opinions of the preventive measures. Conclusions There was a high occurrence rate of anesthetic drug errors in Saudi Arabia. Policymakers need to unify the syringe-labeling practice, and future research needs to focus on what makes a nonpunitive culture to encourage reporting errors.
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Affiliation(s)
- Deemah Nassir Aldossary
- Anesthesia Technology Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Hussah Khalid Almandeel
- Anesthesia Technology Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Jumanah Hashim Alzahrani
- Anesthesia Technology Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Hasnaa Obaid Alrashidi
- Anesthesia Technology Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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25
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Wang N, Ren B, You H, Chen Y, Lin S, Lei S, Feng B. Assessment of medication adherence, medication safety awareness and medication practice among patients with lung cancer: A multicentre cross-sectional study. Health Expect 2022; 25:791-801. [PMID: 34989054 PMCID: PMC8957719 DOI: 10.1111/hex.13426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES We aimed to explore the current status of medication adherence, safety awareness and practice among patients with lung cancer. METHODS We conducted a questionnaire-guided cross-sectional study in Xi'an, Yulin, Hanzhong and Weinan in Shaanxi Province, China, from April to June 2021 for a period of 3 months. The study questionnaire was developed according to previous related studies reported in the literature, and includes basic demographic information and patients' medication safety questions. The data were double-entered using EpiData 3.1 software; descriptive statistics, t-test, analysis of variance, the Kruskal-Wallis test and the Mann-Whitney U-test were performed to analyse the data. RESULTS A total of 567 participants were included, and 409 valid questionnaires were finally completed, with an effective response rate of 72.13%. More than 80% of patients showed good medication adherence; the average adherence score was 22 ± 2.68 of 25. The average score for medication safety awareness was 16.40 ± 4.41, which was significantly lower than that of medication adherence (p < .001). Only 22.74% of patients always checked their medicines before a nurse administered them; 17.60% of patients never checked their medicines. Few patients actively consulted an health care professional to understand safety information before taking a medication. A significant difference existed in safety awareness scores among age groups (p = .039) and geographic regions (p < .001). Patients with three or more comorbidities had the lowest awareness scores (p = .027). CONCLUSION We found that patients with lung cancer showed better medication adherence, but their awareness about medication safety was poor. Older patients, those with comorbidities and patients in regions with poor medical resources may have worse awareness about safety. Current medication education for patients should not only aim to improve adherence but should also encourage patients to take greater responsibility for their own safety and to actively participate in their medication safety. Greater systematic and individualized medication safety information is needed for older patients, those with more comorbidities and patients in areas with poor medical resources. PATIENT CONTRIBUTION We conducted a questionnaire-guided cross-sectional study on hospitalized lung cancer patients in Shaanxi Province to explore the patients' practices related to safety medication, including medication adherence and medication safety awareness.
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Affiliation(s)
- Ningsheng Wang
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Biqi Ren
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haisheng You
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Chen
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuzhi Lin
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuang Lei
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bianling Feng
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Syyrilä T, Vehviläinen-Julkunen K, Manias E, Bucknall T, Härkänen M. Communication related to medication incidents-A concept analysis and literature review. Scand J Caring Sci 2021; 36:297-319. [PMID: 34779022 DOI: 10.1111/scs.13044] [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: 05/21/2021] [Revised: 09/26/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
AIMS (1) To identify and analyse the conceptual framework and operationalise the concept of communication issues related to medication incidents in hospital to facilitate the development of a future tool for measuring frequencies of the communication issues. (2) To determine how the concept is distinct from related concepts. DESIGN Concept analysis. DATA SOURCES Twenty-three articles from seven scientific databases covering the years 2010-2020 and two official documents. METHODS Walker and Avant's concept analysis method was used. That was started by a systematised literature review on 2 November 2020 using specified criteria. Two authors evaluated articles' quality by Joanna Brigg's Institute's criteria. Literature review results were analysed deductive-inductively; conceptual framework was developed and concept defined presenting case scenarios. EQUATOR's standards were used in study reporting. RESULTS A conceptual framework and the concept of 'communication related to medication incidents in hospitals' were defined, comprising six main attribute categories: (1) communication dyads involved in communication, (2) patients' or professionals' individual issues, (3) institutional, (4) contextual and process issues, (5) communication concerning medication prescriptions and (6) qualitative characteristics of communication. The categories consisted of 128 quantitatively measurable and 10 qualitative attributes describing communication issues. The concept is distinct from related concepts by collating fragmented communication issues into the same concept. CONCLUSION The 128-item conceptual framework and the concept of communication related to medication incidents in hospitals were defined, as there was not one. The concept assembled parts of previous theories and fragmented information to one entity. The concept needs further condensing and validation to develop a tool for measuring communication issues. IMPACT ON MEDICATION SAFETY The conceptual framework can be used in practice and education as indicative rationale for reflection of current communication issues. The concept contributes to research by providing necessary grounding for tool development for measuring communication factors relating medication incidents.
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Affiliation(s)
- Tiina Syyrilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland (UEF), Kuopio, Finland.,Abdominal Center, Helsinki University Hospital (HUS), University of Helsinki, Helsinki, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland (UEF), Kuopio, Finland.,Kuopio University Hospital (KUH), Kuopio, Finland
| | - Elizabeth Manias
- School of Nursing & Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Burwood, Vic., Australia
| | - Tracey Bucknall
- School of Nursing & Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Burwood, Vic., Australia
| | - Marja Härkänen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland (UEF), Kuopio, Finland
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Ratanto, Hariyati RTS, Mediawati AS, Eryando T. Workload as the most Important Influencing Factor of Medication Errors by Nurses. Open Nurs J 2021. [DOI: 10.2174/1874434602115010204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
This research is motivated by the fact that medication errors are serious threats to the safety of patients in hospitals. Nurses are one of the health workers who play a significant role in preventing these errors.
Objective:
The aim of this quantitative research is to determine the factors that influence the incidence of medication errors by nurses.
Methods:
The adopted method had a correlative descriptive design and used samples obtained from 164 nurses through a purposive sampling technique. The sample inclusion criteria were the nurses who worked in patient’s rooms, those who were healthy and not sick, not currently in school, and were willing to be respondents. Furthermore, the research instruments were questionnaires, which were developed through the Cronbach's alpha validity and reliability test results of 0.681 and 0.873, respectively. Analysis was conducted using the independent t test, X2 (chi-square) and multiple logistic regressions.
Results:
The results showed that the factors which influenced the incidence of medication errors were work experience, motivation, workload, managerial and environmental elements. Moreover, the variable which contributed the most, with a p-value of 0.004 and OR of 5.387 was workload.
Conclusion:
Finally, the following factors, including nurse's workload, motivation, work experience, good managerial management and environmental elements, should be considered when preventing medication errors.
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Afaya A, Konlan KD, Kim Do H. Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review. BMC Health Serv Res 2021; 21:1156. [PMID: 34696788 PMCID: PMC8547021 DOI: 10.1186/s12913-021-07187-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 10/18/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative. OBJECTIVE This review systematically identified and examined the barriers hindering nurses from reporting medication administration errors in the hospital setting. DESIGN An integrative review. REVIEW METHODS PubMed, Web of Science, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication administration error reporting from January 2016 to December 2020. Two reviewers (AA, and KDK) independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018. RESULTS Of the 10, 929 articles retrieved, 14 studies were included in this study. The main themes and subthemes identified as barriers to reporting medication administration errors after the integration of results from qualitative and quantitative studies were: organisational barriers (inadequate reporting systems, management behaviour, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons, and inadequate knowledge of errors). CONCLUSION Providing an enabling environment void of punitive measures and blame culture is imperious for nurses to report medication administration errors. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses' ability to report medication administration errors.
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Affiliation(s)
- Agani Afaya
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. .,School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
| | - Kennedy Diema Konlan
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.,School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Hyunok Kim Do
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
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Mohamed MFH, Abubeker IY, Al-Mohanadi D, Al-Mohammed A, Abou-Samra AB, Elzouki AN. Perceived Barriers of Incident Reporting Among Internists: Results from Hamad Medical Corporation in Qatar. Avicenna J Med 2021; 11:139-144. [PMID: 34646790 PMCID: PMC8500080 DOI: 10.1055/s-0041-1734386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background
Adverse events (AE) are responsible for annual deaths that exceed deaths due to motor vehicle accidents, breast cancer, and AIDS. Many AE are considered preventable. Thus, AE needs to be detected and analyzed. Incident reporting systems (IRS) are crucial in identifying AE. Nevertheless, the incident report (IR) process is flawed with underreporting, especially from the physicians' side. This limits its efficiency in detecting AE. Therefore, we aimed to assess the practice and identify the barriers associated with incident reporting among internal medicine physicians in a large tertiary hospital through a survey.
Methods
A cross-sectional descriptive study. We distributed an online survey to physicians working in the Internal Medicine Department of Qatar's largest tertiary academic institute. The questionnaire was validated and piloted ahead of the start of the trial. The response rate was 53%.
Results
A total of 115 physicians completed the survey; 59% acknowledged the availability of an institutional IRS. However, only 29% knew how to submit an online IR, and 20% have ever submitted an IR. The survey revealed that participants were less likely to submit an IR when they or a colleague is involved in the incident; 46% and 63%, respectively. The main barriers of reporting incidents were unawareness about the IRS (36%) and the perception that IR will not bring a system change (13%); moreover, there exists the fear of retaliation (13%). When asked about solutions, 57% recommended training and awareness, and 22% recommended sharing learnings and actions from previous IR.
Conclusions
IRS is underutilized by internal medicine physicians. The main barrier at the time of the survey is the lack of training and awareness. Promoting awareness and sharing previous learning and actions may improve the utilization of the IRS.
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Affiliation(s)
- Mouhand F H Mohamed
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Y Abubeker
- Department of Medicine, Brown Internal Medicine Residency, Brown University, Providence, Rhode Island, United States
| | - Dabia Al-Mohanadi
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Al-Mohammed
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdul-Badi Abou-Samra
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Abdel-Naser Elzouki
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medical College, Doha, Qatar.,Department of Medicine, College of Medicine, Qatar University, Doha, Qatar
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30
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Woo MWJ, Avery MJ. Nurses' experiences in voluntary error reporting: An integrative literature review. Int J Nurs Sci 2021; 8:453-469. [PMID: 34631996 PMCID: PMC8488811 DOI: 10.1016/j.ijnss.2021.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/26/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This integrative review aimed to examine and understand nurses' experiences of voluntary error reporting (VER) and elucidate factors underlying their decision to engage in VER. METHOD This is an integrative review based on Whittemore & Knafl five-stage framework. A systematic search guided by the PRISMA 2020 approach was performed on four electronic databases: CINAHL, Medline (PubMed), Scopus, and Embase. Peer-reviewed articles published in the English language from January 2010 to December 2020 were retrieved and screened for relevancy. RESULTS Totally 31 papers were included in this review following the quality appraisal. A constant comparative approach was used to synthesize findings of eligible studies to report nurses' experiences of VER represented by three major themes: nurses' beliefs, behavior, and sentiments towards VER; nurses' perceived enabling factors of VER and nurses' perceived inhibiting factors of VER. Findings of this review revealed that nurses' experiences of VER were less than ideal. Firstly, these negative experiences were accounted for by the interplays of factors that influenced their attitudes, perceptions, emotions, and practices. Additionally, their negative experiences were underpinned by a spectrum of system, administrative and organizational factors that focuses on attributing the error to human failure characterized by an unsupportive, blaming, and punitive approach to error management. CONCLUSION Findings of this review add to the body of knowledge to inform on the areas of focus to guide nursing management perspectives to strengthen institutional efforts to improve nurses' recognition, reception, and contribution towards VER. It is recommended that nursing leaders prioritize and invest in strategies to enhance existing institutional error management approaches to establish a just and open patient safety culture that would promote positivity in nurses' overall experiences towards VER.
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Affiliation(s)
- Ming Wei Jeffrey Woo
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore
- Department of Health Services Management, School of Medicine, Griffith University, Brisbane, Australia
| | - Mark James Avery
- Department of Health Services Management, School of Medicine, Griffith University, Brisbane, Australia
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31
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Yousef A, Abu Farha R, Da'meh K. Medication administration errors: Causes and reporting behaviours from nurses perspectives. Int J Clin Pract 2021; 75:e14541. [PMID: 34132004 DOI: 10.1111/ijcp.14541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022] Open
Abstract
Evaluation of nurses' perceptions towards medication administration errors (MAEs) reporting is a key aspect for improving patient safety, and prevention of errors repetition. Thus, this study has evaluated nurses' behaviour towards MAEs reporting practice, and factors contributing to their under-reporting of errors. This is a cross-sectional survey-based study that was conducted during February 2021. During the study period, a convenience sample of nurses working at Jordan university hospital was invited to voluntarily participate in the study and to fill an online questionnaire uploaded on an electronic data collection platform. The questionnaire assessed nurses MAEs reporting practice, their perception towards factors contributing to MAEs, factors associated with under-reporting of MAEs, and their perception towards MAEs preventive measures. A total of 150 nurses responded to the electronic questionnaire, with 54.0% of them (n = 81) were males and the majority had a bachelor's degree in nursing (n = 138, 92.0%). Regarding MAE reporting's practice, 78% of them (n = 117) indicated that they are always/often report MAEs even if it is not possible to improve the patient's health status. With regard to factors contributing to MAEs, results showed that "insufficient staffing" was the most common reason contributing to MAEs occurrence reported by nurses (n = 114, 94.0%). Personal fear from nursing administration was the primary cause of MAEs under-reporting (n = 98, 65.3%), while 94.0% of nurses (n = 141) agreed/strongly agreed that following the six rights is a way to prevent MAEs occurrence. This study indicates a positive reporting attitude towards MAEs. Nursing administration concerns were considered the main reason associated with the under-reporting of MAEs. This study shed the light on the deep need for continuous education programmes about the importance of the right MAEs reporting. As well, the need for effective and restricted rules in a non-punitive environment to prevent MAEs incidences.
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Affiliation(s)
- Alaa Yousef
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Khaled Da'meh
- School of nursing, The University of Jordan, Amman, Jordan
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Witczak I, Rypicz Ł, Šupínová M, Janiczeková E, Pobrotyn P, Młynarska A, Fedorowicz O. Patient Safety in the Process of Pharmacotherapy Carried Out by Nurses-A Polish-Slovak Prospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910066. [PMID: 34639367 PMCID: PMC8508261 DOI: 10.3390/ijerph181910066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
Pharmacotherapy, i.e., the use of medicines for combating a disease or its symptoms, is one of the crucial elements of patient care. Nursing workloads in the pharmacotherapy process prove that nurses spend 40% of their work on the management of medications. This study was aimed at the determination and comparison of safety levels at the nurse-managed stage of the pharmacotherapy process in Poland and Slovakia by identifying the key risk factors which directly affect patient safety. The study involved a group of 1774 nurses, of whom 1412 were from Poland and 362 were from Slovakia. The original Nursing Risk in Pharmacotherapy (acronym: NURIPH) tool was used. The survey questionnaire was made available online and distributed to nurses. The Cronbach's alpha coefficient was 0.832. Nurses from Slovakia most often, i.e., for six out of nine factors (items: one, five, six, seven, eight, and nine), assessed the risk factors as "significant risk (3)", and Polish nurses most often, i.e., for as many as eight out of nine risk factors (items: one, two, three, four, five, six, seven, and nine), assessed the risk factors as "very significant (5)". It has been found that the safety of the pharmacotherapy process is assessed by Polish nurses to be much lower than by Slovak nurses.
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Affiliation(s)
- Izabela Witczak
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Łukasz Rypicz
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland;
- Correspondence: ; Tel.: +48-693-251-213
| | - Mária Šupínová
- Faculty of Health, Slovak Medical University, 947-05 Bratislava, Slovakia; (M.Š.); (E.J.)
| | - Elena Janiczeková
- Faculty of Health, Slovak Medical University, 947-05 Bratislava, Slovakia; (M.Š.); (E.J.)
| | | | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Olga Fedorowicz
- Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland;
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Jemal M, Kure MA, Gobena T, Geda B. Nurse-Physician Communication in Patient Care and Associated Factors in Public Hospitals of Harari Regional State and Dire-Dawa City Administration, Eastern Ethiopia: A Multicenter-Mixed Methods Study. J Multidiscip Healthc 2021; 14:2315-2331. [PMID: 34475760 PMCID: PMC8407677 DOI: 10.2147/jmdh.s320721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Nurse–physician communication remains a public health challenge in the health care setting of developing countries. Clear and respectful nurse–physician communication is very crucial for the health of the patients. Numerous studies have shown that inter-professional communication gaps are the leading cause of adverse medical events that compromise the quality of patient care in the clinical setting. Although it has negative consequences and wider effects on patient care, nurse–physician communication in patient care is rarely studied in Africa. In eastern Ethiopia, predictors of nurse–physician communication in patient care have not been studied. Therefore, this study was aimed to assess nurse–physician communication in patient care in public hospitals of Harari Regional State and Dire-Dawa city administration, Eastern Ethiopia. Methods The multicenter-mixed methods (a quantitative cross-sectional and phenomenological qualitative) were conducted from March 07 to April 07, 2019 in public Hospitals of Eastern Ethiopia. A total of 440 nurses and physicians working in public hospitals in the Harari Regional State and Dire-Dawa administration were enrolled in the study. Participants were approached through a simple random sampling technique. Data were collected using a pretested, self-administered questionnaire and entered into Epi-Data version 3.1, and exported to STATA software (version SE 14) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Multivariable logistic regression analysis was carried out to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05. Qualitative data were collected from 10 key informants using a semi-structured questionnaire and analyzed using statistical software, Open Code (version 4.2) by thematic analysis method. Results Overall, the magnitude of the level of nurse–physician communication in patient care was found to be 53.2% [95% CI (48.9–58.0)]. In the final model of multivariable analysis, being in the age group of 31–40 [(AOR=0.42, 95% CI (0.25–0.72)], ever married nurse or physician [(AOR=2.28, 95% CI(1.41–3.69)], being a nurse professional [AOR=2.36, 95% CI (1.23–4.54)], a salary class of 2250–3562ETB [(AOR=0.25, 95% CI (0.08–0.84)], higher score for organizational related factors [(AOR=0.58, 95% CI (0.36–0.92)], and higher score for work-related attitude behaviors [(AOR=0.62, 95% CI(0.39–0.984)] were factors independently associated with the poor level of nurse–physician communication in patient care. In the qualitative findings, unattractive working environments and negative attitudes of professionals were found to be barriers to nurse–physician communication in patient care. Conclusion In this study, the nurse–physician communication in patient care was relatively low because more than half of the level of nurse–physician communication was found to be poor. Increasing in age, getting a lower monthly salary, higher report for work-related attitude, and organizational related factors were the potential predictors that would decrease the good level of nurse–physician communication in patient care. This result provides cue due attention to improving nurse–physician communication in patient care through various techniques.
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Affiliation(s)
- Mehammedamin Jemal
- Department of Nursing, Hiwot Fana Specialized University Hospital, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Dionisi S, Giannetta N, Maselli N, Di Muzio M, Di Simone E. Medication errors in homecare setting: An Italian validation study. Public Health Nurs 2021; 38:1116-1125. [PMID: 34231262 DOI: 10.1111/phn.12946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Medication errors are a concern in overall the world. Although there are studies that investigate what may be the main causes that lead to the genesis of the medication error in the home care setting, there is no tool that correlates knowledge, attitudes, and behavior to medication errors in the context of home care. This study aimed to psychometrically test to the questionnaire on knowledge, attitudes, and behaviors in the administration of medication in the new setting: home care setting. DESIGN This observational study was reported according to the STROBE checklist. SAMPLE Sixty two nurses working in home care setting responded to the online survey. MEASUREMENT The face and content validity of the items generated was assessed. An Exploratory Factorial Analysis descriptive statistical analysis was conducted. The final questionnaire is composed of 20 items. RESULTS The results of the statistical analyses allowed to validate the questionnaire, ensuring good internal consistency and reliability. Most of the sample pointed out that the use of electronic health record, medication reconciliation and the pharmacist's figure are all useful strategies for reducing the risk of medication errors. CONCLUSION The questionnaire is reliable to measure knowledge, attitude, and behavior about medication errors prevention in home care settings.
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Affiliation(s)
- Sara Dionisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Lazio, Italy
| | - Noemi Giannetta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Lazio, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Nicoletta Maselli
- Provincial Agency for Health Services of the Autonomous Province of Trento, Trento, Italy
| | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Lazio, Italy
| | - Emanuele Di Simone
- Nursing, Technical, Rehabilitation, Assistance and Research Department, IRCCS Istituti Fisioterapici Ospitalieri, IFO, Rome, Italy
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35
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Ali L, Saifan A, Alrimawi I, Atout M. Nurses' perceptions toward factors that cause medication errors in Jordan: A qualitative study. Perspect Psychiatr Care 2021; 57:1417-1424. [PMID: 33285009 DOI: 10.1111/ppc.12707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/23/2020] [Accepted: 11/22/2020] [Indexed: 12/01/2022] Open
Abstract
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.
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Affiliation(s)
- Luma Ali
- Nursing Department, Arab University College of Technology, Amman, Jordan
| | - Ahmad Saifan
- Nursing Department, Applied Science Private University, Amman, Jordan
| | - Intima Alrimawi
- School of Nursing and Health Professions, Trinity Washington University, Washinton, NE Washington, USA
| | - Maha Atout
- Faculty of Nursing, Philadelphia university, Amman, Jordan, Jordan
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Aljuaid M, Alajman N, Alsafadi A, Alnajjar F, Alshaikh M. Medication Error During the Day and Night Shift on Weekdays and Weekends: A Single Teaching Hospital Experience in Riyadh, Saudi Arabia. Risk Manag Healthc Policy 2021; 14:2571-2578. [PMID: 34188568 PMCID: PMC8232963 DOI: 10.2147/rmhp.s311638] [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: 03/18/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background The association between medication error incidence and time (day shift vs night shift) have not been extensively studied in Saudi Arabia, this study aimed to answer this question: is there a relationship between medication error incidence and time of the day (day shifts vs night shifts) on weekdays and weekends?. Objective To identify whether medication errors and their sub-categories are significantly different between day shifts, night shifts, during weekdays and weekends. Methods A retrospective analysis of medication errors reported by health-care practitioners from January 2018 to December 2019 through the Electronic-Occurrence Variance Reporting System (E-OVR) of a university teaching hospital in Riyadh, Saudi Arabia. Statistical analysis was used to determine the differences between the medication errors and their sub-categories and day and night shifts during weekdays (from Sunday to Thursday) and weekends (Friday and Saturday). Results A total of 2626 medication errors were reported over 2 years from January 2018 to December 2019. The most prevalent sub-category of medication errors was prescribing errors (55%), while the least common sub-category of medication errors was administration errors (0.6%). There was a statistically significant difference between medication errors and day of the week. Medication errors that happened on weekdays were greater than at weekends (P = 0.01). During weekends, medication errors were more likely to occur at the night shift compared to the day shift (P < 0.05). Conclusion Timing of medication errors incidence is an important factor to be considered for improving the medication use process and improving patient safety. Further researches are needed that focus on intervention to reduce these errors, especially during night shifts.
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Affiliation(s)
- Mohammed Aljuaid
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Najla Alajman
- Department of Rehabilitation, Sultan Bin Abdualaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Afraa Alsafadi
- Department of Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Farrah Alnajjar
- Yanbu General Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Mashael Alshaikh
- Department of Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia
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Aljabari S, Kadhim Z. Common Barriers to Reporting Medical Errors. ScientificWorldJournal 2021; 2021:6494889. [PMID: 34220366 PMCID: PMC8211515 DOI: 10.1155/2021/6494889] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement solutions based on root causes. Underreporting of medical errors is a common and a challenging obstacle in the fight for patient safety. The goal of this study is to review common barriers to reporting medical errors. METHODS We systematically reviewed the literature by searching the MEDLINE and SCOPUS databases for studies on barriers to reporting medical errors. The preferred reporting items for systematic reviews and meta-analyses guideline was followed in selecting eligible studies. RESULTS Thirty studies were included in the final review, 8 of which were from the United States. The majority of the studies used self-administered questionnaires (75%) to collect data. Nurses were the most studied providers (87%), followed by physicians (27%). Fear of consequences is the most reported barrier (63%), followed by lack of feedback (27%) and work climate/culture (27%). Barriers to reporting were highly variable between different centers.
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Affiliation(s)
- Salim Aljabari
- Child Health Department, University of Missouri-Columbia, Columbia, MO, USA
| | - Zuhal Kadhim
- Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, MO, USA
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Ledlow JH, Patrician PA, Miltner RS. Medication administration errors: A concept analysis. Nurs Forum 2021; 56:980-985. [PMID: 34056718 DOI: 10.1111/nuf.12617] [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: 01/19/2021] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022]
Abstract
AIM To provide an analysis of the concept of medication errors that occur during the nursing task of medication administration. BACKGROUND Medication errors occurring during medication administration have an increased risk for an adverse patient outcome. Many terms are associated with medication errors, with limited clarification for a medication administration error at the point of care delivery. DATA SOURCES Twenty-seven sources were chosen from database searches of PubMed, CINAHL, EMBASE, and Scopus. Key search terms used to narrow the search consist of the following terminology: ("bedside" OR "point-of-care" OR "nursing care*") AND "medication administration errors" AND ("acute care"). REVIEW METHODS Rodger's evolutionary method of concept analysis was used to clarify the concept of medication administration error. RESULTS The concept analysis identified three attributes of a medication administration error: nurse-provided care, administration, and point of care. Antecedents identified in the analysis are organizational factors and nurse factors. Consequences identified in the analysis are patient, nurse and organizational themes. CONCLUSION The continued occurrence of medication administration errors warrants the need for an investigation into existing safety measures. Using this concept analysis may help guide the study of the healthcare environment and determine empirical measures to assess the impact that a medication administration error has.
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Affiliation(s)
- Jennifer H Ledlow
- Acute, Chronic, and Continuing Care Department, The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Patricia A Patrician
- Family, Community, and Health System Department, The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Rebecca S Miltner
- Family, Community, and Health System Department, The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
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Mahsoon AN. Safety culture and systems thinking for predicting safety competence and safety performance among registered nurses in Saudi Arabia: a cross-sectional study. J Res Nurs 2021; 26:19-32. [PMID: 35251220 PMCID: PMC8894781 DOI: 10.1177/1744987120976171] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Medical errors are a worldwide concern and the contribution of nurses' safety competence and performance to these errors is a high priority. It has been over 20 years since the first report of the need to address medical errors. New approaches are needed for enhancing safety competence and performance. AIMS This study explored the relationships among systems thinking, educational level, safety culture, safety competence and safety performance among registered nurses working in medical and surgical units in Saudi Arabia. METHODS A correlational cross-sectional design with a convenience sample of 84 registered nurses was used. RESULTS Systems thinking predicted 16% of safety knowledge (F[2, 81] = 7.61, P = 0.001), while safety culture, baccalaureate education and completion of safety training predicted 19% of safety skill (F[3, 78] = 2.80, P = 0.001). A safety culture that promoted learning from mistakes predicted 15% of safety performance measured based on nurses' self-report of the number of errors in the past 3 months (F[3, 75] = 2.86, P = 0.008). CONCLUSIONS Professional development including systems thinking and safety training are the necessary next steps for nurses. In addition, policy changes facilitating organisations to support learning from mistakes will contribute to reducing medical errors.
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Affiliation(s)
- Alaa Nabil Mahsoon
- Assistant Professor, Department of Public Health, Faculty
of Nursing, King Abdul-Aziz University, Saudi Arabia
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Al-Surimi K, Alwabel AM, Bawazir A, Shaheen NA. Road towards promoting patient safety practices among hospital pharmacists: Hospital-based baseline patient safety culture assessment cross-sectional survey. Medicine (Baltimore) 2021; 100:e23670. [PMID: 33466122 PMCID: PMC7808443 DOI: 10.1097/md.0000000000023670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 09/10/2020] [Accepted: 11/09/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Patient safety is a fundamental aspect of a healthcare system. The aim of this study was to assess the perception and determinants of the patient safety culture of pharmacists in hospitals, in Riyadh, Saudi Arabia.A survey was conducted with pharmacists in the pharmacies of governmental, /military and private hospitals in Riyadh, Saudi Arabia. The pharmacy survey on patient safety culture questionnaire developed by Agency for Healthcare Research and Qualtity, a hard copy was distriuted to the pharmacists. The positive response rate (RR) was calculated and compared across hospitals using a chi-square test. The predictors of patient safety grades were identified using the generalized estimating equation. The data was analyzed using SAS.A total of 538 questionnaires were distributed, of which 411 responded (RR 76.4%). Of the participants, 229 (56%) were females. The majority 255 (62%) were in the 18 to 34 years age range, and 361 (88%) had a bachelor's degree. The majority of the sample 376 (92%) was a pharmacist. The Positive RR (PRR) ranged between (25.6%-74%). The highest PRR was observed in teamwork (74.4%), followed by 'staff, training and skills' (68%), and 'organizational learning continuous improvement' (66%). The lowest PRR was observed in 'staffing, work pressure, and pace' (25.5%). Comparing the PPR of the various healthcare sectors, the governmental hospitals scored the highest in all patient safety domains. Generalized Estimating Equation analysis showed that with increase in scores of all patient safety culture domains increased the likelihood of reporting a better patient safety grade, whereas respondents' demographic characteristics had no effect except the working experience years 6 years and above had odds of poor reporting of the patient safety grade (odds ratio = 2.54, 95% confience interval (1.543, 4.194), (P = .0003).The grades achieved in the various domains of patient safety culture by pharmacists in Riyadh are below the expected standard. The highest scores were achieved in teamwork, with the lowest scores in staffing, work pressure and pace. Overall, pharmacists in government hospital settings have a better perception of patient safety than their peers in other settings. These results provide the baseline evidence for developing future interventional studies aiming at improving patient safety culture in hospital pharmacy settings.
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Affiliation(s)
- Khaled Al-Surimi
- College of Public Health and Health Informatics
- King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center
| | - Ali Mohammed Alwabel
- College of Public Health and Health Informatics
- King Saud bin Abdulaziz University for Health Sciences
| | - Amen Bawazir
- College of Public Health and Health Informatics
- King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center
| | - Naila A. Shaheen
- King Saud bin Abdulaziz University for Health Sciences
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
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Salman M, Mustafa ZU, Rao AZ, Khan QUA, Asif N, Hussain K, Shehzadi N, Khan MFA, Rashid A. Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey. Front Pharmacol 2020; 11:1026. [PMID: 32765259 PMCID: PMC7381221 DOI: 10.3389/fphar.2020.01026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Deaths-related to medications errors are common in Pakistan but these are not accurately reported. Recently, the death of a 9 months old baby due to abrupt administration of 15% potassium chloride injection sparked the issue of high alert medications (HAMs) related errors in the country. Since drug administration is the prime responsibility of the nurses, it is pivotal that they possess good knowledge of HAMs. Since there is no published data regarding the knowledge of HAMs among Pakistani nurses, we aimed to assess knowledge of HAMs among registered nurses of Pakistan. Methods A cross-sectional study was conducted among registered nurses, recruited using a convenient sampling technique, from 29 hospitals all over the Punjab Province. Data were collected using a validated self-administered instrument. All data were entered and analyzed using SPSS version 22. Results The study sample was comprised of 2,363 registered nurses (staff nurses = 94.8%, head nurses = 5.2%). Around 63% were working in tertiary hospitals whereas almost 25 and 12% were from district headquarter hospitals and tehsil headquarter hospitals, respectively. Around 84% of the study participants achieved scores <70%, indicating majority of Pakistani nurses having poor knowledge of HAMs administration as well as regulation. There was no significant difference of overall knowledge among age, hospitals, departments, training, designations, qualification, and experience categories. Major obstacles encountered during HAMs administration were "getting uncertain answers from colleagues" (72.9%), "unavailability of suitable person to consult" (61.1%) and "receiving verbal orders" (55.6%). Conclusion Our study revealed the serious inadequacies in HAMs knowledge among Pakistani nurses which may lead to adverse patient outcomes. Nurses should receive comprehensive pharmacology knowledge not only during in-school nursing education but also as hospital-based continuing education. Moreover, it is of immense importance to bridge the gaps between physicians, clinical pharmacists, and nurses through effective communication as this will help reduce medication errors and improve patient care.
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Affiliation(s)
- Muhammad Salman
- Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Zia Ul Mustafa
- Department of Pharmacy, District Headquarter Hospital, Pakpattan, Pakistan
| | - Alina Zeeshan Rao
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Qurat-Ul-Ain Khan
- Department of Pharmacy, Punjab Institute of Cardiology, Lahore, Pakistan
| | - Noman Asif
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Khalid Hussain
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Naureen Shehzadi
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | | | - Amir Rashid
- Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Islamabad, Pakistan
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O'Reilly R, Ramjan LM, Fatayer M, Stunden A, Gregory LR. First year undergraduate nursing students' perceptions of the effectiveness of blended learning approaches for nursing numeracy. Nurse Educ Pract 2020; 45:102800. [PMID: 32485538 DOI: 10.1016/j.nepr.2020.102800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 11/15/2022]
Abstract
The ability to safely calculate and administer medications are indispensable, core nursing skills in nursing education and practice. Therefore, it is imperative that nursing students are adequately prepared with the necessary numeracy skills during their undergraduate nursing studies. The focus of this study, conducted at a single multi-campus university in the western Sydney region of Australia, was to determine the effectiveness of a suite of blended learning approaches on numeracy self-efficacy from the students' perspective. Surveys were administered as part of the study and included open-ended questions. 525 students provided open-ended responses that were analysed by the research team. Four main themes were identified from the open-ended responses: (i) Self-realisation; (ii) Practice, practice, practice; (iii) Boosting confidence; and (iv) Wanting more. The themes captured students' perceptions of the benefits of having a rigorous learning design in blended learning approaches. The study showed that a structured pedagogical approach to nursing numeracy in undergraduate programs improved students' self-reported self-efficacy with mathematics and assisted students in realising the importance of learning and applying these skills as nursing clinicians.
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Affiliation(s)
- Rebecca O'Reilly
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Lucie M Ramjan
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Mais Fatayer
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Annette Stunden
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Linda R Gregory
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Molala W, Downing C. Experiences of newly qualified critical care nurses caring for post-cardiothoracic surgery paediatric patients in a private hospital in gauteng. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Al Najjar H, Bano N. Experiences of nursing interns with the application of knowledge and skills in drug administration: A qualitative study. SAUDI JOURNAL FOR HEALTH SCIENCES 2020. [DOI: 10.4103/sjhs.sjhs_78_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Machen S, Jani Y, Turner S, Marshall M, Fulop NJ. The role of organizational and professional cultures in medication safety: a scoping review of the literature. Int J Qual Health Care 2019; 31:G146-G157. [PMID: 31822887 PMCID: PMC7097989 DOI: 10.1093/intqhc/mzz111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/16/2019] [Accepted: 10/08/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This scoping review explores what is known about the role of organizational and professional cultures in medication safety. The aim is to increase our understanding of 'cultures' within medication safety and provide an evidence base to shape governance arrangements. DATA SOURCES Databases searched are ASSIA, CINAHL, EMBASE, HMIC, IPA, MEDLINE, PsycINFO and SCOPUS. STUDY SELECTION Inclusion criteria were original research and grey literature articles written in English and reporting the role of culture in medication safety on either organizational or professional levels, with a focus on nursing, medical and pharmacy professions. Articles were excluded if they did not conceptualize what was meant by 'culture' or its impact was not discussed. DATA EXTRACTION Data were extracted for the following characteristics: author(s), title, location, methods, medication safety focus, professional group and role of culture in medication safety. RESULTS OF DATA SYNTHESIS A total of 1272 citations were reviewed, of which, 42 full-text articles were included in the synthesis. Four key themes were identified which influenced medication safety: professional identity, fear of litigation and punishment, hierarchy and pressure to conform to established culture. At times, the term 'culture' was used in a non-specific and arbitrary way, for example, as a metaphor for improving medication safety, but with little focus on what this meant in practice. CONCLUSIONS Organizational and professional cultures influence aspects of medication safety. Understanding the role these cultures play can help shape both local governance arrangements and the development of interventions which take into account the impact of these aspects of culture.
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Affiliation(s)
| | - Yogini Jani
- Centre for Medicines Optimisation Research and Education, UCLH NHS Foundation Trust, UCL School of Pharmacy, UK
| | - Simon Turner
- School of Management, University of Los Andes, Colombia
| | - Martin Marshall
- UCL Research Department of Primary Care & Population Health, UK
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Alshammari M, Duff J, Guilhermino M. Barriers to nurse-patient communication in Saudi Arabia: an integrative review. BMC Nurs 2019; 18:61. [PMID: 31827387 PMCID: PMC6892156 DOI: 10.1186/s12912-019-0385-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/15/2019] [Indexed: 12/03/2022] Open
Abstract
Background Effective nurse–patient communication is important in improving quality of health care. However, there are several barriers to nurse–patient communication in Saudi Arabia. This is attributed to the increasing number of non-Saudi expatriate nurses providing health care to patients. In particular, there are differences in culture, religion and language among non-Saudi nurses and patients. This integrative review aims to identify and synthesize quantitative and qualitative evidence on the current practice in nurse–patient communication in Saudi Arabia and its effect on service users’ quality of care, safety and satisfaction. Methods An integrative review based on Whittemore and Knafl’s approach (Whittemore and Knafl, J Adv Nurs 52:546–553, 2005) was used to conduct the review. Peer-reviewed articles containing any of a series of specific key terms were identified from sources such as CINAHL, EMBASE, Medline, PubMed and PsychINFO. The review included studies that focused on nurse–patient communication issues, communication barriers, and cultural and language issues. The search was limited to papers about the Saudi Arabian health system published in English and Arabic languages between 2000 and 2018. A data extraction form was developed to extract information from included articles. Results Twenty papers were included in the review (Table 1). Ten papers employed quantitative methods, eight papers used qualitative methods and two used mixed methods. The review revealed two major themes: ‘current communication practices’ and ‘the effect of communication on patients’. Some of the communication practices rely on non-verbal methods due to a lack of a common language, which often results in the meaning of the communication being misinterpreted. Many non-Saudi nurses have limited knowledge about Saudi culture and experience difficulty in understanding, and in some cases respecting, the cultural and religious practices of patients. Further, limited nurse–patient communication impacts negatively on the nurse–patient relationship, which can affect patient safety and lead to poor patient satisfaction. Conclusions Current nurse–patient communication practices do not meet the needs of Saudi patients due to cultural, religious and language differences between nurses and patients. The barriers to effective nurse–patient communication adversely effects patient safety and patient satisfaction. Further research from the perspective of the patient and family is needed.
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Affiliation(s)
- Mukhlid Alshammari
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
| | - Jed Duff
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
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Shitu Z, Moe Thwe Aung M, Tuan Kamauzaman TH, Ab Rahman AF. Factors Associated With Medication Errors at a Teaching Hospital in Malaysia. Hosp Pharm 2019; 56:259-264. [PMID: 34381259 DOI: 10.1177/0018578719890092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Medication errors (MEs) continue to pose a significant problem to health care systems across the world, not only causing harm and death in patients but also consuming approximately $42 billion annually in health care expenditure. The emergency department (ED) is considered a high-risk area of having MEs to occur. Little is known about the associated factors of ME in the ED of hospitals in Malaysia. Objective: The objective of this study was to determine the factors associated with ME in an ED of a teaching hospital. Methods: A cross-sectional study was conducted on patients who visited the ED of Hospital Universiti Sains Malaysia over 9 weeks during normal working hours (ie, 8:00 am-5:00 pm). A total of 547 patients who satisfied the inclusion criteria were enrolled for the study. Patient demographic information, clinical characteristics, and medication orders and procedures were observed and recorded. The required number of patient data (n = 311) were selected randomly for analysis. Multiple logistic regression method was employed to determine factors associated with ME. Results: Of the 311 patient data, 95 (30.5%) patients had at least 1 ME. The factors found to be associated with ME were number of medications (adjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.51-2.41), triage (adjusted OR, 0.11; 95% CI, 0.04-0.27), gender (adjusted OR, 0.50; 95% CI, 0.26-0.93), and time of patient visit (adjusted OR, 0.34; 95% CI, 0.52-0.75). Conclusion: Medication error was not uncommon in our ED setting. Patients with a higher number of medications prescribed during visit to the ED were found to be particularly at risk. Identification of such factors may guide intervention measures to prevent MEs in this setting.
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Affiliation(s)
- Zayyanu Shitu
- Hospital Services and Management Board, Ministry of Health, Zamfara State, Nigeria
| | - Myat Moe Thwe Aung
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, Kuala Terengganu, Malaysia
| | | | - Ab Fatah Ab Rahman
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Besut Campus, Kuala Terengganu, Malaysia
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Medication errors in hospitals in the Middle East: a systematic review of prevalence, nature, severity and contributory factors. Eur J Clin Pharmacol 2019; 75:1269-1282. [PMID: 31127338 DOI: 10.1007/s00228-019-02689-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim was to critically appraise, synthesise and present the evidence of medication errors amongst hospitalised patients in Middle Eastern countries, specifically prevalence, nature, severity and contributory factors. METHODS CINAHL, Embase, Medline, Pubmed and Science Direct were searched for studies published in English from 2000 to March 2018, with no exclusions. Study selection, quality assessment (using adapted STROBE checklists) and data extraction were conducted independently by two reviewers. A narrative approach to data synthesis was adopted; data related to error causation were synthesised according to Reason's Accident Causation model. RESULTS Searching yielded 452 articles, which were reduced to 50 following removal of duplicates and screening of titles, abstracts and full-papers. Studies were largely from Iran, Saudi Arabia, Egypt and Jordan. Thirty-two studies quantified errors; definitions of 'medication error' were inconsistent as were approaches to data collection, severity assessment, outcome measures and analysis. Of 13 studies reporting medication errors per 'total number of medication orders'/ 'number of prescriptions', the median across all studies was 10% (IQR 2-35). Twenty-four studies reported contributory factors leading to errors. Synthesis according to Reason's model identified the most common being active failures, largely slips (10 studies); lapses (9) and mistakes (12); error-provoking conditions, particularly lack of knowledge (13) and insufficient staffing levels (13) and latent conditions, commonly heavy workload (9). CONCLUSION There is a need to improve the quality and reporting of studies from Middle Eastern countries. A standardised approach to quantifying medication errors' prevalence, severity, outcomes and contributory factors is warranted.
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Barriers to Nursing Performance from the Perspective of Nurses Working in Intensive Care Units. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/ccn.64815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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