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Arab F, Saeedi M. The effect of the case-based learning approach on the level of satisfactions and learning of nursing students in Iran: A randomized controlled trial. Heliyon 2024; 10:e35149. [PMID: 39157409 PMCID: PMC11328019 DOI: 10.1016/j.heliyon.2024.e35149] [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: 08/25/2023] [Revised: 07/12/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction Nurses must have sufficient knowledge and skills in the field of medications and medication management. This study was designed to investigate the effect of the case-based learning (CBL) approach on the level of satisfaction and learning of nursing students. Materials and methods This study was conducted using a randomized controlled trial on 70 Iranian third-semester nursing students during a pharmacology internship in 2023. After considering the inclusion criteria, the samples were entered into the study by census method and then they were placed in either the control (35 people) or intervention (35 people) groups by simple random method. Pharmacology training was done in the control group by the usual method (lectures by the instructor and conferences with students) and in the intervention group by the Kaddoura case-based learning method. Data collection tools included a demographic questionnaire, satisfaction of educational approach questionnaire, and exam scores before and after the internship. SPSS version 26 software was used for statistical analysis. Results There was no statistically significant difference (P = 0.88) in the mean scores of the pharmacology pre-test in the control (10.54 ± 2.74) and intervention groups (10.6 ± 3.49) before the intervention. Also, there was no statistically significant difference (P = 0.19) between the pharmacology post-test scores in the control (17.7 ± 1.15) and intervention groups (18.07 ± 0.91). A comparison of pre-test and post-test scores in both control and intervention groups showed that the post-test scores in both groups increased significantly (P < 0.001). The results showed that the intervention group was significantly (P = 0.008) more satisfied with the learning method. Conclusion The case-based educational approach resulted in improved satisfaction among students in the pharmacology course. It is recommended to incorporate this learning method alongside traditional teaching methods, in nursing education, particularly in pharmacology instruction.
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Affiliation(s)
- Farzaneh Arab
- MSc of Nursing, Nursing Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Maryam Saeedi
- Ph.D. of Nursing, Nursing Department, Saveh University of Medical Sciences, Saveh, Iran
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Coelho F, Furtado L, Mendonça N, Soares H, Duarte H, Costeira C, Santos C, Sousa JP. Predisposing Factors to Medication Errors by Nurses and Prevention Strategies: A Scoping Review of Recent Literature. NURSING REPORTS 2024; 14:1553-1569. [PMID: 39051353 PMCID: PMC11270417 DOI: 10.3390/nursrep14030117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Medication errors have serious consequences and high costs for the patient and the system. The treatment process and the care required for critically ill patients are complex, and these patients are more vulnerable to errors and potential consequences. A scoping review using the JBI methodology was conducted across PubMed, CINAHL, and MEDLINE databases and reported by the PRISMA-ScR guidelines to explore strategies that can mitigate medication errors by nurses. The search strategy focused on references published between January 2012 and April 2023. Sixteen studies were included, and the results were organized into thematic areas. Medication errors by nurses are in the areas of preparation, administration, and documentation; organizational, system-related, procedural, personal, and knowledge and training factors are predisposing factors for errors; educational intervention, verification and safety methods, organizational changes, and error reporting are the strategic areas to mitigate medication error. The organization of the data could be different, as it depends on the reviewers' experience. Knowledge of the factors that cause medication errors and interventions to mitigate them make it possible to outline strategies to minimize their occurrence and achieve health gains. The protocol preceding this review has been registered in the Open Science Framework and published.
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Affiliation(s)
- Fábio Coelho
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Luís Furtado
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Natália Mendonça
- Flores Island Healthcare Unit, 9960-430 Flores Island, Portugal;
| | - Hélia Soares
- Department of Nursing, Mental Health, and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal; (L.F.); (H.S.)
| | - Hugo Duarte
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Cristina Costeira
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Cátia Santos
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Joana Pereira Sousa
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences, Polytechnic of Leiria, 2411-090 Leiria, Portugal (C.C.); (C.S.); (J.P.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
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Fathizadeh H, Mousavi SS, Gharibi Z, Rezaeipour H, Biojmajd AR. Prevalence of medication errors and its related factors in Iranian nurses: an updated systematic review and meta-analysis. BMC Nurs 2024; 23:175. [PMID: 38481264 PMCID: PMC10938711 DOI: 10.1186/s12912-024-01836-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Nurses may make medication errors during the implementation of therapeutic interventions, which initially threaten the patient's health and safety and prolong their hospital stay. These errors have always been a challenge for healthcare systems. Given that factors such as the timing, type, and causes of medication errors can serve as suitable predictors for their occurrence, we have decided to conduct a review study aiming to investigate the prevalence of medication errors and the associated factors among Iranian nurses. METHODS In this systematic review and meta-analysis, studies were searched on PubMed, Web of Science, Scopus, Google Scholar, IranMedex, Magiran, and SID databases using a combination of keywords and Boolean functions. The study that reported the prevalence of medication errors among nurses in Iran without time limitation up to May 2023 was included in this study. RESULTS A total of 36 studies were included in the analysis. The analysis indicates that 54% (95% CI: 43, 65; I2 = 99.3%) of Iranian nurses experienced medication errors. The most common types of medication errors by nurses were wrong timing 27.3% (95% CI: 19, 36; I2 = 95.8%), and wrong dosage 26.4% (95% CI: 20, 33; I2 = 91%). Additionally, the main causes of medication errors among nurses were workload 43%, fatigue 42.7%, and nursing shortage 38.8%. In this study, just 39% (95% CI: 27, 50; I2 = 97.1%) of nurses with medication errors did report their errors. Moreover, the prevalence of medication errors was more in the night shift at 41.1%. The results of the meta-regression showed that publication year and the female-to-male ratio are good predictors of medical errors, but they are not statistically significant(p > 0.05). CONCLUSIONS To reduce medication errors, nurses need to work in a calm environment that allows for proper nursing interventions and prevents overcrowding in departments. Additionally, considering the low reporting of medication errors to managers, support should be provided to nurses who report medication errors, in order to promote a culture of reporting these errors among Iranian nurses and ensure patient safety is not compromised.
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Affiliation(s)
- Hadis Fathizadeh
- Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
| | | | - Zahra Gharibi
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Ghorbani A, Momeni M, Yekefallah L, Shahrokhi A. The association between chronotype, sleep quality and medication errors among critical care nurses. Chronobiol Int 2023; 40:1480-1486. [PMID: 37955061 DOI: 10.1080/07420528.2023.2256862] [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: 12/06/2021] [Accepted: 09/01/2023] [Indexed: 11/14/2023]
Abstract
Medication administration errors could result in severe complications in critical care units. This study investigated an association between chronotype, sleep quality and medication errors among essential nurses of care in Qazvin teaching hospitals in Iran. In this multicenter, cross-sectional study, all registered nurses of critical care units of Qazvin teaching hospitals were recruited. Data were collected through anonymous questionnaires, including socio-demographic data, Morning-Evening Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and medication errors data. Data were analyzed with SPSS v.24 by using the Chi-square test, Mann-Whitney U test, and logistic regression analysis. P values less than 0.05 were considered significant. The mean age and work experience were 33.12 ± 6.74 and 9.11 ± 5.96, respectively. One hundred sixty-six nurses (96%) have been working in rotating shifts. Nurses with intermediate chronotypes were predominant (n = 122; 70.5%). The majority of nurses (68.2%) had poor sleep quality (n = 118). Logistic regression analysis showed eveningness chronotype was associated with 4.743 fold increased risk of medication error (P < 0.033). No association was found between medication error and sleep quality (p < 0.95). There was no significant relationship between chronotype and sleep quality (P < 0.257). Our study showed that nurses with eveningness chronotype make more medication errors; therefore, considering the individual circadian preference before deciding on their shift timing assignment will be an important issue in reducing nurses' medication errors and improving patient safety in critical care units.
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Affiliation(s)
- Azam Ghorbani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Momeni
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Qazvin University of Medical sciences
| | - Leili Yekefallah
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Qazvin University of Medical sciences
| | - Akram Shahrokhi
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Bell T, Sprajcer M, Flenady T, Sahay A. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs 2023; 32:5445-5460. [PMID: 36707921 DOI: 10.1111/jocn.16620] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Medication administration errors (MAEs) cause preventable patient harm and cost billions of dollars from already-strained healthcare budgets. An emerging factor contributing to these errors is nurse fatigue. Given medication administration is the most frequent clinical task nurses undertake; it is vital to understand how fatigue impacts MAEs. OBJECTIVE Examine the evidence on the effect of fatigue on MAEs and near misses by registered nurses working in hospital settings. METHOD Arksey and O'Malley's scoping review framework was used to guide this review and PAGER framework for data extraction and analysis. The PRISMA checklist was completed. Four electronic databases were searched: CINAHL, PubMed, Scopus and PsycINFO. Eligibility criteria included primary peer review papers published in English Language with no date/time limiters applied. The search was completed in August 2021 and focussed on articles that included: (a) registered nurses in hospital settings, (b) MAEs, (c) measures of sleep, hours of work, or fatigue. RESULTS Thirty-eight studies were included in the review. 82% of the studies identified fatigue to be a contributing factor in MAEs and near misses (NMs). Fatigue is associated with reduced cognitive performance and lack of attention and vigilance. It is associated with poor nursing performance and decreased patient safety. Components of shift work, such as disruption to the circadian rhythm and overtime work, were identified as contributing factors. However, there was marked heterogeneity in strategies for measuring fatigue within the included studies. RELEVANCE TO CLINICAL PRACTICE Fatigue is a multidimensional concept that has the capacity to impact nurses' performance when engaged in medication administration. Nurses are susceptible to fatigue due to work characteristics such as nightwork, overtime and the requirement to perform cognitively demanding tasks. The mixed results found within this review indicate that larger scale studies are needed with particular emphasis on the impact of overtime work. Policy around safe working hours need to be re-evaluated and fatigue management systems put in place to ensure delivery of safe and quality patient care.
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Affiliation(s)
- Tracey Bell
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Madeline Sprajcer
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Tracey Flenady
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Ashlyn Sahay
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
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Alemu W, Cimiotti JP. Meta-Analysis of Medication Administration Errors in African Hospitals. J Healthc Qual 2023; 45:233-241. [PMID: 37276257 DOI: 10.1097/jhq.0000000000000396] [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: 06/07/2023]
Abstract
ABSTRACT The incidence of medication administration errors (MAEs) and associated patient harm continue to plague hospitals worldwide. Moreover, there is a lack of evidence to address this problem, especially in Africa. This research synthesis was intended to provide current evidence to decrease the incidence of MAEs in Africa. Standardized search criteria were used to identify primary studies that reported the incidence and/or predictors of MAEs in Africa. Included studies met specifications and were validated with a quality-appraisal tool. The pooled incidence of MAEs in African hospitals was estimated to be 0.56 (CI: 0.4324-0.6770) with a 0.13-0.93 prediction interval. The primary estimates were highly heterogeneous. Most MAEs are explained by system failure and patient factors. The contribution of system factors can be minimized through adequate and ongoing training of nurses on the aspects of safe medication administration. In addition, ensuring the availability of drug use guidelines in hospitals, and minimizing disruptions during the medication process can decrease the incidence of MAEs in Africa.
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Tabatabaee SS, Ghavami V, Javan-Noughabi J, Kakemam E. Occurrence and types of medication error and its associated factors in a reference teaching hospital in northeastern Iran: a retrospective study of medical records. BMC Health Serv Res 2022; 22:1420. [PMID: 36443775 PMCID: PMC9703779 DOI: 10.1186/s12913-022-08864-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Medication errors are categorized among the most common medical errors that may lead to irreparable damages to patients and impose huge costs on the health system. A correct understanding of the prevalence of medication errors and the factors affecting their occurrence is indispensable to prevent such errors. The purpose of this study was to investigate the prevalence and types of medication errors among nurses in a hospital in northeastern Iran. METHODS The present descriptive-analytical research was conducted on 147 medical records of patients admitted to the Department of Internal Medicine at a hospital in northeastern Iran in 2019, selected by systematic sampling. The data were collected through a researcher-made checklist containing the demographic profiles of the nurses, the number of doctor's orders, the number of medication errors and the type of medication error, and were finally analyzed using STATA version 11 software at a significance level of 0.05. RESULTS Based on the findings of this study, the mean prevalence of medication error per each medical case was 2.42. Giving non-prescription medicine (47.8%) was the highest and using the wrong form of the drug (3.9%) was the lowest medication error. In addition, there was no statistically significant relationship between medication error and the age, gender and marital status of nurses (p > 0.05), while the prevalence of medication error in corporate nurses was 1.76 times higher than that of nurses with permanent employment status (IRR = 1.76, p = 0.009). The prevalence of medication error in the morning shift (IRR = 0.65, p = 0.001) and evening shift (IRR = 0.69, p = 0.011) was significantly lower than that in the night shift. CONCLUSION Estimating the prevalence and types of medication errors and identified risk factors allows for more targeted interventions. According to the findings of the study, training nurses, adopting an evidence-based care approach and creating interaction and coordination between nurses and pharmacists in the hospital can play an effective role in reducing the medication error of nurses. However, further research is needed to evaluate the effectiveness of interventions to reduce the prevalence of medication errors.
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Affiliation(s)
- Seyed Saeed Tabatabaee
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- grid.411583.a0000 0001 2198 6209Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Javan-Noughabi
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Edris Kakemam
- grid.412888.f0000 0001 2174 8913Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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The relationship between patient safety culture and patient safety competency with adverse events: a multicenter cross-sectional study. BMC Nurs 2022; 21:292. [PMID: 36319970 PMCID: PMC9628064 DOI: 10.1186/s12912-022-01076-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Background Patient safety culture and patient safety competency could be associated with adverse events (AEs). This study aimed to investigate the associations between nurses’ perceptions of patient safety culture, patient safety competency, and AEs. Methods A cross-sectional study was carried out among 338 nurses employed in three university hospitals in Qom, Iran between 17 August 2021 and 12 November 2021. Data were collected using three questionnaires: patient safety culture, patient safety competency, and AEs. Data were analyzed using SPSS-21 software. A multiple logistic regression model was used to analyze the data. Results The results of this study showed that medication errors were significantly associated with “frequency of events reported” (OR = 0.706, P = 0.012), “supervisor/manager expectations and actions promoting patient safety” (OR = 0.733, P = 0.048), and “management support for patient safety” (OR = 0.755, P = 0.012). Pressure ulcers were significantly associated with “supervisor/manager expectations and actions promoting patient safety” (OR = 0.729, P = 0.039), “handoffs and transition” (OR = 0.707, P = 0.034), and “comfort speaking up about patient safety” (OR = 0.614, P = 0.016). Falls were significantly associated with “teamwork within units” (OR = 0.735, P = 0.031), “feedback and communication about error” (OR = 0.756, P = 0.046), and “handoffs and transition” (OR = 0.660, P = 0.012). The use of restraints for ≥8 hr. was significantly associated with “management support for patient safety” (OR = 0.701, P = 0.021). Conclusions According to the results of this study, AEs are associated with some dimensions of patient safety culture and patient safety competency. Further research is needed to confirm these findings and identify interventions to reduce the occurrence of AEs.
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Alshammari B, AlEnazy A, Alshammari F, Madkhali N, Al-Masaeed M. Investigation of the Level and Factors Influencing Emergency Department Nurses Fatigue: A Case Study of the Saudi Arabian Context. Healthcare (Basel) 2022; 10:healthcare10071294. [PMID: 35885820 PMCID: PMC9318690 DOI: 10.3390/healthcare10071294] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Work-related fatigue is a common health problem among nurses which can affect their performance and decision making. Significance and Aim: The study explores the levels of fatigue and its associated factors among emergency department (ED) nurses in Saudi Arabia. Methods: The study was developed through a cross-sectional quantitative study design. This included the collection of primary quantitative data with a questionnaire prepared and published on REDCap. The study questionnaire was adapted from two tools, namely the OFER 15 and the Copenhagen II tools, respectively. Results: The study established that the Saudi Arabian ED nurses have high acute fatigue (OFER 15 score = 81.11), moderate-high chronic fatigue (OFER 15 score = 74.17), and a high inter-shift recovery index (OFER 15 score = 78.01). In terms of the predictor factors, the study established that for the demographic factors, gender has an impact on chronic and acute fatigue, while work experience impacted acute fatigue and the number of dependents impacted on inter-shift recovery index. On the psycho-social factors, chronic fatigue is influenced by emotional demand (which is a variable used to evaluate the levels to which the nurse is invested, gaining education/skills thus increases job satisfaction) (−0.289), influence at work (−0.310), commitment at the workplace (0.376), rewards (−0.187), stress (0.420), and burnout (0.293), respectively. Acute fatigue is influenced by the emotional demands (0.336), role clarity (−0.128), and the nurses’ well-being and health (−0.034). Finally, the inter-shift recovery index is influenced by the ED nurses’ burnout levels (−0.877). Conclusions: The study indicates a high level of nursing fatigue among the Saudi Arabian ED nurses.
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Affiliation(s)
- Bushra Alshammari
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
- Correspondence: (B.A.); (A.A.)
| | - Albandry AlEnazy
- Buraidah Central Hospital, Al-Qassim 52361, Saudi Arabia
- Correspondence: (B.A.); (A.A.)
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia;
| | - Norah Madkhali
- Department of Nursing, College of Nursing, Jazan University, Jazan 45142, Saudi Arabia;
| | - Mahmoud Al-Masaeed
- Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia;
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Atashzadeh-Shoorideh F, Shirinabadi Farahani A, Pishgooie AH, Babaie M, Hadi N, Beheshti M, Zadeh EF, Skerrett V. A comparative study of patient safety in the intensive care units. Nurs Open 2022; 9:2381-2389. [PMID: 35633148 PMCID: PMC9374399 DOI: 10.1002/nop2.1252] [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: 03/08/2021] [Revised: 01/16/2022] [Accepted: 05/08/2022] [Indexed: 11/14/2022] Open
Abstract
Aim This study aimed to assess patient‐safety principles in ICUs. Design This is a descriptive‐comparative study. Methods The research environment includes ICUs of hospitals affiliated to the two universities of medical sciences in Tehran. Sampling was done by census using Time and Event Sampling methods. Research instrument was “Patient Safety Principles Checklist”. Data analysis was performed using SPSS‐20 and descriptive‐inferential statistics with a significance level of 0.05. Results There is no significant difference (p‐value = .15) in the level of observance of patient‐safety principles in two university‐affiliated hospitals A (133.26 ± 9.14) and B (128.16 ± 18.01). Evaluation of the mean scores obtained in each dimension and in each of the ICUs was showed that only in dimension No.3 the difference was significant (F[68,2] = 5.20, p‐value = .008) and in the AICUs (16.13 ± 1.8) (p‐value = .04), it was significantly lower than other ICUs. Identifying risk factors for the patient’s immunity reduces the side effects of patient care.
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Affiliation(s)
- Foroozan Atashzadeh-Shoorideh
- Department of Psychiatric Nursing and Management, School of Nursing & Midwifery, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Shirinabadi Farahani
- Department of Pediatric Nursing, Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohadese Babaie
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Hadi
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Beheshti
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ensieh Fathollah Zadeh
- School of Nursing & Midwifery, Flinders University of Medical Sciences, Adelaide, Australia
| | - Victoria Skerrett
- School of Nursing & Midwifery, Birmingham City University, Birmingham, UK
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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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Parthasarathi A, Puvvada R, Patel H, Bhandari P, Nagpal S. Evaluation of Medication Errors in a Tertiary Care Hospital of a Low- to Middle-Income Country. Cureus 2021; 13:e16769. [PMID: 34354894 PMCID: PMC8328840 DOI: 10.7759/cureus.16769] [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] [Accepted: 07/30/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Medication errors (MEs) are a major public health concern as they are detrimental to patient safety, compromise patients' confidence in the healthcare system, increase healthcare costs, and adversely affect the patient's quality of life. This is especially true in low to middle-income countries where the significance of MEs is largely undervalued. This study aims to investigate the prevalence of MEs and analyze the causes, medicines involved, reporting, and severity of MEs in a tertiary care setting. Methods A prospective observational study was conducted from March 2020 to February 2021 in a tertiary care teaching hospital in South India. The data was collected after reviewing patient medical records, by interviewing patients and healthcare professionals. National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index was used to evaluate MEs. Results A total of 557 MEs were identified from 3798 patients with a prevalence of 14.6%. Prescribing errors were the most commonly observed ME followed by errors related to documentation of medical records, administration-related errors, and dispensing errors. Lack of time for documentation of medication records, shift change and work overload were common causes of MEs. The majority of MEs were category A and B of the NCC MERP severity index. Conclusion Antibiotics and proton pump inhibitors were the most common medicines involved in MEs. Prescribing and documentation errors were most prevalent. Implementation of systems like strict adherence to treatment guidelines, computerized provider order entry (CPOE), barcode medication administration, and closed-loop electronic medication management systems may greatly help reduce MEs. All healthcare institutions should undertake routine audits to determine the prevalence and causes of medication errors.
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Affiliation(s)
| | - Rahul Puvvada
- Physiology, Anatomy, and Microbiology, College of Science, Health and Engineering, La Trobe University, Melbourne, AUS
| | - Himanshu Patel
- Pharmacology and Therapeutics, International Society of Oncology Pharmacy Practitioners, North Vancouver, CAN
| | - Pooja Bhandari
- Public Health, Madhavnagar Government Hospital, Ujjain, IND
| | - Sagar Nagpal
- Internal Medicine, Erie County Medical Center, Buffalo, USA
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13
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Kerari A, Innab A. The Influence of Nurses' Characteristics on Medication Administration Errors: An Integrative Review. SAGE Open Nurs 2021; 7:23779608211025802. [PMID: 34222653 PMCID: PMC8223601 DOI: 10.1177/23779608211025802] [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: 02/13/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022] Open
Abstract
Background Medication administration errors (MAEs) are a frequent cause of morbidity and mortality in acute care settings and can result in a prolonged hospital stay. The WHO estimated that medication errors cost up to $42 billion globally per a year. Therefore, MAEs was among the most common medical errors to occur in acute care settings. Studies of medication error usually focus on system factors, thus creating a gap between what researchers know about the causes of MAEs, and what frontline nurses actually do in the clinical setting. The purpose of this review is to fill a gap in the existing literature by focusing on the relationship between nurses' characteristics and MAEs. Methods Online databases were accessed, including CINAHL, PsycINFO, PubMed, Scopus, and Google Scholar from 2007-2020 period. This review was guided by the methods described by Whittemore and Knafl. Studies that addressed the occurrence of medication errors based on RN demographics were included in this review. The included studies were reviewed and analyzed by the two authors. Results Of the 1141 publications retrieved, 19 studies met inclusion criteria. The result provided strong evidence that nurses' level of education, length of experience, and attendance at training courses, are directly associated with the occurrence of MAEs. There is weak evidence of MAEs being influenced by the age and gender of nurses. Other nurse characteristics, such as cognitive load, frustration with technology, negligence, lack of attentiveness, and nurse ethnicity, are not adequately examined across the reviewed studies necessitates further research. Conclusion Focusing on nurses' characteristics might facilitate other researchers to suggest appropriate interventions that may reduce the incidence of MAEs. Interventional studies may provide convincing evidence as to whether one variable has a causal effect on another variable, and control the influence of confounding variables to enhance the generalizability of the findings.
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Affiliation(s)
- Ali Kerari
- Medical Surgical Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Adnan Innab
- Nursing Administration and Education Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
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14
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Leviatan I, Oberman B, Zimlichman E, Stein GY. Associations of physicians' prescribing experience, work hours, and workload with prescription errors. J Am Med Inform Assoc 2021; 28:1074-1080. [PMID: 33120412 DOI: 10.1093/jamia/ocaa219] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/05/2020] [Accepted: 08/21/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE We aimed to assess associations of physician's work overload, successive work shifts, and work experience with physicians' risk to err. MATERIALS AND METHODS This large-scale study included physicians who prescribed at least 100 systemic medications at Sheba Medical Center during 2012-2017 in all acute care departments, excluding intensive care units. Presumed medication errors were flagged by a high-accuracy computerized decision support system that uses machine-learning algorithms to detect potential medication prescription errors. Physicians' successive work shifts (first or only shift, second, and third shifts), workload (assessed by the number of prescriptions during a shift) and work-experience, as well as a novel measurement of physicians' prescribing experience with a specific drug, were assessed per prescription. The risk to err was determined for various work conditions. RESULTS 1 652 896 medical orders were prescribed by 1066 physicians; The system flagged 3738 (0.23%) prescriptions as erroneous. Physicians were 8.2 times more likely to err during high than normal-low workload shifts (5.19% vs 0.63%, P < .0001). Physicians on their third or second successive shift (compared to a first or single shift) were more likely to err (2.1%, 1.8%, and 0.88%, respectively, P < .001). Lack of experience in prescribing a specific medication was associated with higher error rate (0.37% for the first 5 prescriptions vs 0.13% after over 40, P < .001). DISCUSSION Longer hours and less experience in prescribing a specific medication increase risk of erroneous prescribing. CONCLUSION Restricting successive shifts, reducing workload, increasing training and supervision, and implementing smart clinical decision support systems may help reduce prescription errors.
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Affiliation(s)
- Ilona Leviatan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bernice Oberman
- Gertner Institute for Epidemiology and Health Policy Research, Tel HaShomer, Ramat Gan, Israel
| | - Eyal Zimlichman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Management Wing, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
| | - Gideon Y Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Internal Medicine "A," Meir Medical Center, Clalit Health Services, Kfar Saba, Israel
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15
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Alharaibi MA, Alhifany AA, Asiri YA, Alwhaibi MM, Ali S, Jaganathan PP, Alhawassi TM. Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia. Ann Saudi Med 2021; 41:147-156. [PMID: 34085548 PMCID: PMC8176371 DOI: 10.5144/0256-4947.2021.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN Retrospective database review. SETTING Large tertiary care setting in Riyadh. PATIENTS AND METHODS We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE 315 166 prescriptions screened. RESULTS Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P<.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, P<.01). CONCLUSION Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors. LIMITATIONS Polypharmacy was not considered; the data are from a single healthcare system. CONFLICT OF INTEREST None.
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Affiliation(s)
- Maryam Ali Alharaibi
- From the Department of Pharmaceutical Services, King Saud Medical City, Riyadh, Saudi Arabia.,From the College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- From the Clinical Pharmacy Department, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Yousif A Asiri
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira M Alwhaibi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sheraz Ali
- From the School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | | | - Tariq M Alhawassi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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16
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Mrayyan MT, Al-Atiyyat N, Al-Rawashdeh S, Sawalha M, Awwad M. Comparing rates and causes of, and views on reporting of medication errors among nurses working in different-sized hospitals. Nurs Forum 2021; 56:560-570. [PMID: 33884638 DOI: 10.1111/nuf.12581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Medication errors are detrimental to patient safety and the quality of hospital services. PURPOSE The purpose of the study was to compare registered nurses working in the small-, medium-, and large-sized Jordanian hospitals' responses in terms of reported rate and cause of medication errors and their views on medication error reporting. METHODS This was a cross-sectional comparative design, with a total sample of 229 nurses working in different-sized hospitals. RESULTS The rates of reported medication errors were significantly different across hospitals representing 53.5% in small-sized, 41.8% in medium-sized, and 32.8% in large-sized hospitals. No significant differences between hospitals regarding the nurses' reported causes of medication errors. Nurses' views were significantly different in all aspects of their reporting except in their failure to report (drug) error. CONCLUSIONS The hospital's size may associate with nurses' reporting rate and nurses' views on reporting such errors. There is an urgent need for more diligent systematic efforts to prevent, detect, and report medication errors. Collaboration with other health team members, including information technology members, will enhance the outcomes associated with medication administration. The findings of this study warranted further investigations.
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Affiliation(s)
- Majd T Mrayyan
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Nijmeh Al-Atiyyat
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Sami Al-Rawashdeh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Murad Sawalha
- Department of Maternal, Child, and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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17
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Campbell AA, Harlan T, Campbell M, Mulekar MS, Wang B. Nurse's Achilles Heel: Using Big Data to Determine Workload Factors That Impact Near Misses. J Nurs Scholarsh 2021; 53:333-342. [PMID: 33786985 DOI: 10.1111/jnu.12652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore how big data can be used to identify the contribution or influence of six specific workload variables: patient count, medication count, task count call lights, patient sepsis score, and hours worked on the occurrence of a near miss (NM) by individual nurses. DESIGN A correlational and cross-section research design was used to collect over 82,000 useable data points of historical workload data from the three unique systems on a medical-surgical unit in a midsized hospital in the southeast United States over a 60-day period. Data were collected prior to the start of the Covid-19 pandemic in the United States. METHODS Combined data were analyzed using JMP Pro version 12. Mean responses from two groups were compared using a t-test and those from more than two groups using analysis of variance. Logistic regression was used to determine the significance of impact each workload variable had on individual nurses' ability to administer medications successfully as measured by occurrence of NMs. FINDINGS The mean outcome of each of the six workload factors measured differed significantly (p < .0001) among nurses. The mean outcome for all workload factors except the hours worked was found to be significantly higher (p < .0001) for those who committed an NM compared to those who did not. At least one workload variable was observed to be significantly associated (p < .05) with the occurrence or nonoccurrence of NMs in 82.6% of the nurses in the study. CONCLUSIONS For the majority of the nurses in our study, the occurrence of an NM was significantly impacted by at least one workload variable. Because the specific variables that impact performance are different for each individual nurse, decreasing only one variable, such as patient load, will not adequately address the risk for NMs. Other variables not studied here, such as education and experience, might be associated with the occurrence of NMs. CLINICAL RELEVANCE In the majority of nurses, different workload variables increase their risk for an NM, suggesting that interventions addressing medication errors should be implemented based on the individual's risk profile.
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Affiliation(s)
- Amy A Campbell
- Professor, College of Nursing, Department of Community Mental Health, University of South Alabama, Mobile, AL, USA
| | - Todd Harlan
- Chair and Professor, College of Nursing, Department of Community Mental Health, University of South Alabama, Mobile, AL, USA
| | - Matt Campbell
- Professor, School of Computing, Department of Information Systems Technology, University of South Alabama, Mobile, AL, USA
| | - Madhuri S Mulekar
- Chair and Professor, Department of Mathematics and Statistics, University of South Alabama, Mobile, AL, USA
| | - Bin Wang
- Professor, Department of Mathematics and Statistics, University of South Alabama, Mobile, AL, USA
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18
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Forte ECN, Pires DEPD, Schneider DG, Padilha MICDS, Ribeiro OMPL, Martins MMFPDS. THE OUTCOME OF NURSING ERROR AS ATTRACTIVE TO THE MEDIA. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2019-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to interpret, from the perspective of the Theory of Communicative Action, how the outcome of nursing errors can become attractive to the media, highlighting the main implications for the image of the profession and the imaginary of society. Method: qualitative research, carried out in documentary sources using news published in the major newspapers available online in two countries, Brazil and Portugal, from 2012 to 2016. The analysis of the findings was carried out following the steps of hermeneutics, based on the Theory of Communicative Action. The data were organized and coded in the ATLAS.ti software. Results: the research included 112 published news. Four categories emerged from the analysis: The highlights in the headlines - The beginning of persuasion; Combining image and initial text - An explosive mix; The error that is not an error - The error that is a crime; and Applying the validity claims in the discourses. Conclusion: the media are continuous producers of ideologies and, therefore, possess social responsibility by inducing misinterpretations that can negatively interfere in the nurse-patient interaction. Giving greater emphasis to the outcome of the error, the media influences negatively the people perception of nursing labour which has a unique social importance.
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19
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Bakhshi F, Mitchell R, Nasrabadi AN, Varaei S, Hajimaghsoudi M. Behavioural changes in medication safety: Consequent to an action research intervention. J Nurs Manag 2020; 29:152-164. [PMID: 32955774 DOI: 10.1111/jonm.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore the extent to which action research assists developing medication safety behaviours among emergency medicine staff. BACKGROUND Health care staff involved in medication therapy are frequently required to implement progressive changes. To permanently improve medication safety, we must consider staff behaviour. This study utilizes action research to engage health care workers and engender behavioural changes. METHOD Two cycles of action research were implemented. Data were collected through pre- and post-medication safety surveys, unstructured interviews and field notes. Staff in the emergency department worked together to progress the study cycles. RESULTS The pre-evaluation phase revealed deficiencies in staff medication safety behaviour. Subsequent to the implementation of safety initiatives, pre- to post-evaluation comparison indicated significant improvement in medication safety behaviours. In response to qualitative reflection phase data in reflection, ward pharmacists were placed in the emergency department and anew policy on responding to medication error was developed. Analysed field notes revealed improved safe patient care, enhanced pharmaceutical knowledge and changes in the emergency department climate. CONCLUSIONS Through action research, this study introduced actions to improve medication safety behaviours in the emergency department. Staff involvement led to changed safety behaviours. IMPLICATION FOR NURSING MANAGEMENT This study advises nurse managers of the benefit of pharmacist-led medication therapy, interprofessional medication safety courses and active communication between front-line staff and managers regarding medication safety.
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Affiliation(s)
- Fatemeh Bakhshi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Macquarie Business School, Macquarie University, Sydney, NSW, Australia
| | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, NSW, Australia
| | | | - Shokoh Varaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Hajimaghsoudi
- Research Development Center of Shahid Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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20
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Hosseini Marznaki Z, Pouy S, Salisu WJ, Emami Zeydi A. Medication errors among Iranian emergency nurses: A systematic review. Epidemiol Health 2020; 42:e2020030. [PMID: 32512668 PMCID: PMC7644927 DOI: 10.4178/epih.e2020030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran. METHODS We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran. RESULTS Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses. CONCLUSIONS Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.
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Affiliation(s)
- Zohreh Hosseini Marznaki
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Somaye Pouy
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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21
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Alrabadi N, Haddad R, Haddad R, Shawagfeh S, Mukatash T, Al-rabadi D, Abuhammad S. Medication errors among registered nurses in Jordan. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2020. [DOI: 10.1111/jphs.12348] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Objectives
Medication error (ME) is like a venom dispersing in clinical practice, particularly the process of drugs’ administration. Nurses, as the direct drug administrators, are in critical defense lines to prevent its occurrence. Therefore, our aims were to explore nurses’ understanding, perception, attitude and prevalence of MEs and thereafter defining the main factors associated with its occurrence and needed for designing proper policies for its sufficient prevention.
Methods
Self-reported questionnaires were obtained from 156 nurses distributed almost equally between the 3 major teaching hospitals in Jordan. The questionnaires aimed at measuring their understanding, attitudes, and the prevalence of MEs.
Key findings
The majority of respondents were males (51.3%), young (25–34, 75%), hold a BSc degree (84.6%). Most of their experiences were less than 5 years (67.3%). The level of understanding of the definition, associated factors, and the consequences of ME was acceptable between registered nurses in Jordanian teaching hospitals. Nurses who had the lowest experience (0–5 years) were the highest in committing MEs (P-value = 0.006). Otherwise, gender, age, and education were not significantly associated with MEs. The participants reported that the most common causes of medication error were setting the infusion devices incorrectly, distraction, labeling and packaging problems. Participants declared that the incidents of MEs are underreported (Reporting rate (28.3%)) and they believed that it was most likely due to the fear of losing their job, misjudgment on the seriousness of the incidence that warrant reporting, and fear from coworkers' actions.
Conclusions
MEs are common and may be underreported among registered nurses in Jordan. National policymakers should take critical steps to encourage the nurses to report any error in medication administration and therefore reducing its occurrence.
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Affiliation(s)
- Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rabia Haddad
- King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan
| | - Razan Haddad
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shaima Shawagfeh
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq Mukatash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Daher Al-rabadi
- King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan
| | - Sawsan Abuhammad
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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22
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Myers K, Giblin E, Zell‐Kanter M. It's Just Math-Unless It's Toxic! AEM EDUCATION AND TRAINING 2020; 4:64-67. [PMID: 31989072 PMCID: PMC6965668 DOI: 10.1002/aet2.10378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/02/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The objective was to determine emergency medicine residents' ability to perform pharmaceutical calculations. METHODS A six-question needs-assessment survey of emergency medicine residents was conducted at a citywide conference in 2016. Residents performed simple pharmaceutical calculations and were queried regarding resources they typically use to aid in performing calculations. RESULTS Fifty-three emergency medicine residents out of 110 attendees (48%) completed the survey (postgraduate year [PGY]-1 n = 27, PGY-2 n = 13, PGY-3 n = 8, PGY-4 or above n = 5). Nearly 80% (n = 42) of all residents responded correctly to at least four of six questions (PGY-1 = 70%, PGY-2 = 86%, PGY-3 = 88%, and PGY-4 and above = 100%). Sixty-five percent of PGY-1s, 50% of PGY-2s, and 75% of PGY-3s thought that it was very important to correctly perform basic calculations. Google and Up To Date were frequently used to assist with calculations. More than 70% of all residents utilize clinical pharmacy (PharmD) staff for calculating doses. PharmD services were available at all times in the majority of survey responses. CONCLUSIONS Emergency medicine residents performed poorly when completing pharmaceutical calculations. This may contribute to increased patient morbidity and mortality. Internet resource use increased as the years of training increased. PharmD services were extensively utilized by all resident regardless of years of training.
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Affiliation(s)
- Kayla Myers
- Rosalind Franklin University and Northwestern Memorial HospitalChicagoIL
| | - Elisabeth Giblin
- Department of Emergency MedicineNorthwest Community HospitalArlington HeightsIL
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23
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Forte ECN, Pires DEPD, Martins MMFPDS, Padilha MICDS, Ghizoni Schneider D, Trindade LDL. Work process: a basis for understanding nursing errors. Rev Esc Enferm USP 2019; 53:e03489. [PMID: 31433019 DOI: 10.1590/s1980-220x2018001803489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/14/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify work process-related causes associated with nursing errors reported in newspapers. METHOD This was a documentary and qualitative study based on the work process theory and hermeneutic analysis that examined 112 news articles published between 2012 and 2016 in 21 high-circulation Brazilian newspapers, organized and codified using Atlas.ti software. RESULTS The causes associated with the reported errors were associated with workforce (lack of professionals and training, turnover, work overload, lack of information, recklessness, negligence, and distraction); work instruments (similar labels or packages, storage, lack of product identification and information, and medical prescriptions); and the object of nursing work (overcrowding and specific characteristics of patient). CONCLUSION Analysis of the possible causes of reported errors identified the negative outcomes of nursing work, while also identifying elements of the work process that influenced these results. The findings emphasize the importance of understanding these errors so they can be avoided and of reviewing nursing work conditions to guarantee quality and safety of care.
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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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Forte ECN, Pires DEPD, Martins MMFPDS, Padilha MICDS, Schneider DG, Trindade LDL. Nursing errors in the media: patient safety in the window. Rev Bras Enferm 2019; 72:189-196. [PMID: 30942362 DOI: 10.1590/0034-7167-2018-0113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/19/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the nursing errors reported by the journalistic media and interpret the main implications of this communication for the visibility of this problem. METHOD Documental research, qualitative, descriptive and exploratory, with data collected in news reports from Brazil and Portugal, analyzed through hermeneutics with resources of Atlas Software. RESULTS We analyzed 112 news items published between 2012 and 2016 that resulted in six categories: Year - highest occurrence in 2012; Age group of the patient - children; Professional category - nurses; Type of error - medication; Outcome - death; Possible attributed cause - occupational conditions. FINAL CONSIDERATIONS Nursing mistakes are a challenge for the profession, and the way they are communicated by the media is not very explanatory, contributing to a negative visibility of the profession, and to making society insecure. Improving the way they are served in the media contributes to the visibility of the problem without affecting the professional image.
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Zyoud SH, Khaled SM, Kawasmi BM, Habeba AM, Hamadneh AT, Anabosi HH, Fadel AB, Sweileh WM, Awang R, Al-Jabi SW. Knowledge about the administration and regulation of high alert medications among nurses in Palestine: a cross-sectional study. BMC Nurs 2019; 18:11. [PMID: 30936779 PMCID: PMC6425670 DOI: 10.1186/s12912-019-0336-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Medication errors (MEs) are unintended failures in the drug treatment process that can occur during prescription, dispensing, storing, preparation or administration of medications. High alert medications (HAMs) are defined as those medications that bear the highest risk of causing significant patient harm when used incorrectly, either due to their serious adverse events or to a narrow therapeutic window. Nurses are responsible for administration of HAMs; incorrect administration can have a significant clinical outcome. This study aimed to assess the level of knowledge of HAMs among nurses in government hospitals in West Bank, Palestine. METHODS A cross-sectional study was conducted in 2015, in West Bank, Palestine. Data were collected via a face to face interview questionnaire, which was taken from a previous study. Data were collected by convenient sampling. The questionnaire consisted of four parts: demographic characteristics of the nurses, drug administration knowledge (10 true-false questions), drug regulation knowledge (10 true-false questions), and self-evaluation. RESULTS A total of 280 nurses participated in the study; these nurses were working in the emergency room (ER), intensive care unit (ICU), paediatric or medical ward. The response rate was 93%. Nurses were found to have insufficient knowledge about HAMs; 67.1% of participants had a score of less than 70%, with a mean total score of 59.9 ± 15.1. Factors associated with sufficient knowledge among nurses were HAMs training and ICU training, both with p-values of 0.002. Nurses with a master degree, those working in the ICU ward, head nurses, and male nurses were the most knowledgeable groups, with a p-values < 0.001. 81.8% of respondents hoped to obtain additional training. The leading obstacles reported were inconsistent opinions between doctors and nurses (37.9%), and no established standard operating procedure for HAMs (37.1%). CONCLUSIONS Lack of knowledge was one of the obstacles that nurses encountered during administration of HAMs which might result in MEs. Nurses reported that they would like to have additional training to update their pharmacology knowledge. Nurses could benefit from additional continuing education and training programs.
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Affiliation(s)
- Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samar M. Khaled
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Baraa M. Kawasmi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahed M. Habeba
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ayat T. Hamadneh
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Hanan H. Anabosi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Asma’a Bani Fadel
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Rahmat Awang
- 0000 0001 2294 3534grid.11875.3aWHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), 11800 Penang, Malaysia
| | - Samah W. Al-Jabi
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Alsaleh FM, Abahussain EA, Altabaa HH, Al-Bazzaz MF, Almandil NB. Assessment of patient safety culture: a nationwide survey of community pharmacists in Kuwait. BMC Health Serv Res 2018; 18:884. [PMID: 30466436 PMCID: PMC6251142 DOI: 10.1186/s12913-018-3662-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/29/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Medication errors have been the largest component of medical errors threatening patient safety worldwide. Several international health bodies advocate measuring safety culture within healthcare organizations as an effective strategy for sustainable safety improvement. To the best of our knowledge, this is the first study conducted in a Middle Eastern country at the level of community pharmacy, to examine safety culture and to evaluate the extent to which patient safety is a strategic priority. METHODS A descriptive cross-sectional study was conducted. The Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ), was used to collect data. PSOPSC is a self-administered questionnaire which was previously tested for validity and reliability. The questionnaire was distributed among pharmacists who work in community pharmacies from the five governorates of Kuwait (Capital, Hawalli, Farwaniya, Jahra, and Ahmadi). The Statistical Package for Social Science (SPSS) software, version 24 was used for analysing data. RESULTS A total of 255 community pharmacists from the five governorates were approached to participate in the study, of whom 253 returned a completed questionnaire, with the response rate of 99%. Results from the study showed that patient safety is a strategic priority in many aspects of patient safety standards at the level of community pharmacies. This was reflected by the high positive response rate (PRR) measures demonstrated in the domains of "Teamwork" (96.8%), "Organizational Learning-Continuous Improvement" (93.2%) and "Patient Counselling" (90.9%). On the other hand, the lowest PRR was given to the "Staffing, Work Pressure, and Pace" domain which scored 49.7%. CONCLUSIONS Understanding community pharmacists' perspectives of patient safety culture within their organization is critical. It can help identify areas of strength and those that require improvement, which can help support decision about actions to improve patient safety. The current study showed that urgent attention should be given to the areas of weakness, mainly in the dimension of "Staffing, Work Pressure and Pace." The pharmacists pointed the need for adequate breaks between shifts and less distractible work environment to perform their jobs accurately.
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Affiliation(s)
- Fatemah Mohammad Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Eman Ali Abahussain
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Hamed Hamdi Altabaa
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Mohammed Faisal Al-Bazzaz
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Noor Barak Almandil
- Department of Clinical Pharmacy Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, 31441 Dammam, Saudi Arabia
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SHEIKHTAHERI A, SADEQI-JABALI M, HASHEMI-DEHAGHI Z. Physicians' Perspectives on Causes of Health Care Errors and Preventive Strategies: A Study in a Developing Country. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:720-728. [PMID: 29922615 PMCID: PMC6005985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND To prevent health care errors, the main causes and preventive strategies should be identified. The purpose of this study was to identify the causes and preventive strategies of health care errors from the perspectives of physicians. METHODS We surveyed 250 randomly selected physicians in five teaching hospitals in Tehran, Iran, in 2015. We used a questionnaire with 29 questions regarding causes and 17 ones regarding the preventive strategies. The participants were asked to answer the questions based on Likert's five-point score (1=very low to 5= very high). The data was analyzed using descriptive (frequency, and mean scores) and inferential statistics in SPSS. RESULTS Managerial factors (3.6±0.7), personal factors of providers (3.5±0.6), factors related to the patients (3.4±0.71), and the factors pertinent to laboratory and pharmacy (3.2±0.8) were the main causes respectively. The most important preventive strategies were improvement of academic education, better taking past medical history, implementing electronic prescription and increasing healthcare budget. CONCLUSION Heavy workloads, long work shifts, failure to do thorough examination and to collect detailed history information, providers' fatigue, patients' reluctance to follow orders or to give their complete information, failure to give detailed instruction to patients about the medications, lack or insufficient monitoring and supervising systems, and lack of enough budget were some of the most important causes of errors. Using IT to access patients' information, improving patients' adherence, reducing workload, developing efficient methods for collecting patients' information, dedicating adequate budget for improvement programs are recommended.
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Affiliation(s)
- Abbas SHEIKHTAHERI
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran, Dept. of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Monireh SADEQI-JABALI
- Dept. of Health Information Technology, Faculty of Paramedical, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra HASHEMI-DEHAGHI
- Dept. of Management and Accounting, School of Management, Islamic Azad University, South Tehran Branch, Tehran, Iran, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Salmasi S, Wimmer BC, Khan TM, Patel RP, Ming LC. Quantitative exploration of medication errors among older people: a systematic review. DRUGS & THERAPY PERSPECTIVES 2017. [DOI: 10.1007/s40267-017-0468-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Yücesan A, Alkaya SA. Bireylerin Tıbbi Hatalarla İlgili Görüş ve Deneyimleri. DICLE MEDICAL JOURNAL 2017. [DOI: 10.5798/dicletip.298577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Svitlica B, Simin D, Milutinović D. Potential causes of medication errors: perceptions of Serbian nurses. Int Nurs Rev 2017; 64:421-427. [DOI: 10.1111/inr.12355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B.B. Svitlica
- Department of Nursing; Faculty of Medicine; University of Novi Sad; Novi Sad Serbia
- Clinic of the Pediatrics; Institute for Child and Youth Health Care of Vojvodina; Serbia
| | - D. Simin
- Department of Nursing; Faculty of Medicine; University of Novi Sad, Secondary Medical School Novi Sad; Novi Sad Serbia
| | - D. Milutinović
- Department of Nursing; Faculty of Medicine; University of Novi Sad; Novi Sad Serbia
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Forte ECN, Pires DEPD, Padilha MI, Martins MMFPDS. NURSING ERRORS: A STUDY OF THE CURRENT LITERATURE. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-07072017001400016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to characterize what the current literature states about nursing errors, with a specific review on how these errors are communicated to society by the media. Method: a qualitative documental research, characterized as an integrative literature review, performed using four databases and guided by a formal protocol, in the period from 2011 to 2015, by two independent collaborators. The analysis of the studies occurred through the analysis of thematic content articulated with the resources of the Atlas.ti software. Results: 32 studies were analyzed and organized into two macro categories: main errors practiced by the nursing team; reported forms of prevention to avoid errors. Such categories reveal that most of the errors are made with medication, the main causes are related to work overload and management problems, and the main sources of prevention are to improve working conditions, continuing education and safety culture. Conclusion: nursing errors are determined by multiple factors and their coping requires professional and institutional measures.
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Souta MM, Telles Filho PCP, Vedana KGG, Pedrão LJ, Miasso AI. MEDICATION SYSTEM: ANALYSIS OF ACTIONS TAKEN BY PROFESSIONALS IN PSYCHIATRIC UNITS. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016000170015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This study analyzed the medication systems in psychiatric units of a general hospital and a psychiatric hospital in the state of São Paulo, Brazil. It is a quantitative and cross-sectional, exploratory survey study with 144 professionals from the areas of medication, nursing and pharmacy. Data were collected by direct, non-participative observation and by medical records review. Data were analyzed using descriptive statistics. Factors that affect patient safety, such as interruptions during prescription, handwritten changes to electronic prescriptions, limited handling of the electronic prescription system, unavailable clinical pharmacy, mistakes in activities related to the preparation and administration of medications and other factors were identified. The study reveals the susceptible points for the occurrence of medication errors in psychiatric hospitalization departments and discusses recommendations and technological resources that can promote security in the medication system.
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