Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals

Abstract

Objectives: To determine the association of medication administration errors with interruption among nurses working at public sector tertiary care hospitals in Karachi, Pakistan.
 Methods: An analytical cross-sectional study was accomplished at two public sector healthcare facilities Civil Hospital, and Dow University Hospital, Karachi. The study was carried out from October 2017 to July 2018 over a period of 10 months. The sample was calculated by using OpenEpi version 3.0. By taking 56.4% of medication administration errors, 5% margin of error and 95% confidence level. The calculated sample size was 204 of both genders. The subjects both male and female nurses having a valid license from Pakistan Nursing Council and one year of clinical experience were enrolled in the study. The subjects were approached by using non-probability purposive sampling method. Validated and adapted questionnaire utilized to gather the data. Data was entered and analyzed by using SPSS version 21.0.
 Results: In this study, total 204 nurses were included, almost half (52%) of them were male. Majority of (82.3%) study participants had age between 25-35 years old. There were total 716 medications given by 204 nurses. Out of these, 295 (41.2%) were antibiotics, other common medications were acid-suppressive, analgesic and antiemetic 14.5%, 15.9% and 11.2% respectively. Among all 716 medications, 644 (89.9%) were given intravenously whereas only 6.7% drugs given orally. A significant association has been found between medication administration errors and interruption like talking with other health care personnel, patients or attendant queries, phone calls (p-value=<0.001). Nearly 91% of the study nurses who were interrupted during medication committed medication errors.
 Conclusion: It is concluded that there is a significant association between medication administration errors with interruption among nurses.
 doi: https://doi.org/10.12669/pjms.35.5.287
 How to cite this:Raja, Badil, Ali S, Sherali S. Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.287
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Clinical and economic impact of medication administration errors among neonates in neonatal intensive care units

“…Interestingly, interruptions were not found to be significantly associated with the severity of MAEs in our study, contrary to findings from previous research [ 62 , 63 ]. For instance, prior study has reported a doubling of the estimated risk of majorly severe errors in the presence of four interruptions [ 63 ].…”

“…One plausible explanation for this contradicting finding lies in the differing prevalence of interruptions across studies. In our investigation, only 11.8% of nurses experienced interruptions or distractions during medication preparation and administration, compared to a markedly higher rate of 90.8% reported in another study [ 62 ]. Moreover, despite the implementation of interventions such as the ’Do Not Disturb’ vests and their inclusion as a parameter in the annual nursing audit in this study, adherence to wearing the safety vest remained low at 4.8%.…”

Effects of different types of interference on nurses' working memory: An ERP study

“…Recent studies from different countries have shown that the frequency of such interference in the clinical setting is particularly high, even more than 10 times/h (Kwon et al, 2021; Lin, Hsieh, et al, 2021, Lin, Feng, et al, 2021; Sharma et al, 2021), especially during the documentation of patient care (Sasangohar, 2015). Negative effects of interference have also been reported, such as increasing the time for task completion (Campoe & Giuliano, 2017; Forsyth et al, 2018), jeopardizing patient safety (Flynn et al, 2016; Raja et al, 2019), and psychological and cognitive overload of nurses (Kim et al, 2019). Solutions have been developed to reduce the occurrence of interference, such as the Sterile Cockpit (Hohenhaus & Powell, 2008), No Interruption Zone (Anthony et al, 2010), Do Not Disturb Vest (Craig et al, 2013), Task‐Severity Awareness Tool (Sasangohar, 2015), and other interventions for medication verification and administration tasks (Kavanagh & Donnelly, 2020).…”

Undergraduate Nursing Students and Management of Interruptions: Preparation of Students for Future Workplace Realities

“…Nurses are often interrupted during MA, with observational studies finding interruption rates of 94.51 percent (Zhao et al, 2019) and 99 percent (M. Johnson, Sanchenz et al, 2017) for nurses in hospital settings. Interruptions are associated with an increased frequency (Raja et al, 2019;Westbrook et al, 2010) of medication administration errors (MAEs), placing patient safety at risk. Not surprisingly, interruptions also lead to increased nursing task completion times, resulting in decreased task efficiency (Cooper et al, 2016).Interventions aimed to reduce interruptions during the MA process have been implemented in health care settings, such as nurses donning "do not disturb" vests or preparing medication in "nointerruption zones."…”

“…Nurses are often interrupted during MA, with observational studies finding interruption rates of 94.51 percent (Zhao et al, 2019) and 99 percent (M. Johnson, Sanchenz et al, 2017) for nurses in hospital settings. Interruptions are associated with an increased frequency (Raja et al, 2019;Westbrook et al, 2010) of medication administration errors (MAEs), placing patient safety at risk. Not surprisingly, interruptions also lead to increased nursing task completion times, resulting in decreased task efficiency (Cooper et al, 2016).…”