Measures to prevent medication errors in intensive care units

Quality of life as a mediating factor in the relationship between fatigue and perception of safety among critical care nurses in the United Arab Emirates

BACKGROUND

A scientific understanding of the relationships between intensive care unit nurses' well-being and patient safety will allow nurse managers, administrators, and policymakers to simultaneously manage crucial organisational goals of nurses' health and patient safety. Understanding predictors of fatigue among intensive care unit nurses may help to balance personal and organisational impacts (e.g., turnover intention, sick leave) and provide a way to positively influence their safety perception.

OBJECTIVE

The aim of this study was to explore the association between work fatigue and perception of patient safety among nurses working in critical care units and determine whether their quality of life levels mediated this relationship.

METHODS

This study used a cross-sectional correlational comparative design. Participants were a sample of 250 intensive care unit nurses recruited conveniently from three large hospitals in the United Arab Emirates. The self-reported questionnaire included the Nursing Quality of Life Scale, the Fatigue Severity Scale, and the Safety Attitudes Questionnaire (SAQ)-ICU version, as well as sociodemographic characteristics and work-related information.

RESULTS

Of the 250 participating nurses, 76.8 % reported low QoL. There was a statistically significant correlation between nurses' Quality of Life and fatigue levels (r = 0.234, P = 0.000). Overall, 52.8 % of the sample had high fatigue and 49.6 % had poor safety perception. Multiple regression analysis using the Baron and Kenny approach showed that QoL, marital status, gender, and work environment were predictors of nurses' perception of safety.

CONCLUSION

Intensive care unit nurses had high levels of fatigue and poor Quality of Life. High Quality of Life and a favourable work environment were independent predictors of good patient safety perception. Efforts should be directed to maximize staffing resources that positively impact patient safety. These findings are comparable with international studies, suggesting that these issues may be ubiquitous.

IMPLICATIONS FOR CLINICAL PRACTICE

Intensive care practitioners, managers and policymakers should adopt measures to modify intensive care nurses' exhausting working conditions and provide a supportive environment. these interventions might improve nurses' perception of patient safety and consequently prevent safety incidents.

Intravenous Medication Errors Among ICU Nurses: Differences In Knowledge Attitudes And Behavior

Background:

Intravenous (IV) medication errors can lead to serious complications for ICU patients. ICU nurses' knowledge, training, attitudes, and behaviors toward medication errors are insufficiently investigated.

Objectives:

This study aims at investigating knowledge, behaviors, training, and attitudes among ICU nurses during the preparation and administration of IV medications and examining their differences according to certain variables.

Methods:

A cross-sectional-correlational design was used in this study. A convenience sampling technique included 206 ICU nurses from different types of hospitals in Jordan. The knowledge, attitudes and behavior related to medication errors questionnaire were used to collect data. Descriptive statistics, t-test, Pearson correlation, and Kruskal-Wallis H test were used to analyze the data.

Results:

ICU nurses showed adequate knowledge regarding IV medication preparation and administration, with gaps in basic professional behaviors. About 81.6% of the ICU nurses considered dosage calculation of intravenous drugs to reduce preparation errors. 81.1% of respondents agreed that clinical skills about the safe management of drug therapy should be regularly evaluated. Only (87.9%) of the ICU nurses agreed that handwashing is necessary before drug preparation and administration. Despite that 90.8% received training related to the preparation and administration of IV medications during undergraduate study, about 23.3% didn’t receive topics related to the preparation and administration of IV drugs treated during the POST-basic courses. This study showed a strong positive correlation between ICU nurses' knowledge, attitudes, and behaviors.

Conclusion:

Education is essential to nurses’ feeling safe at administering medications, especially in critical care units, which may affect their attitudes and behaviors. Continuous education that meets the needs of nurses is essential, along with continuous monitoring and evaluation of clinical practices to maintain safe and efficient medication practices and reduce related errors.