Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study

Heneka, Nicole; Bhattarai, Priyanka; Shaw, Tim; Rowett, Debra; Lapkin, Samuel; Phillips, Jane

doi:10.1177/0269216319832799

Cited by 14 publications

(25 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Data familiarisation was achieved through multiple readings of the transcripts and field notes (NH). The procedures used to ensure trustworthiness of the data findings have been reported elsewhere (Heneka et al, 2019). The Consolidated Criteria for Reporting Qualitative Research (COREQ) has guided the reporting of these findings (Tong, Sainsbury, & Craig, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Details of recruitment and data collection have been reported in detail elsewhere (Heneka et al, 2019). All participants provided informed, written consent.…”

Section: Recruitment and Data Collectionmentioning

confidence: 99%

“…Compared to other healthcare settings, opioid delivery for the vast majority of palliative care patients includes: multiple opioid orders and formulations, including regular and as needed ('PRN') orders, often administered via different routes (Heneka, Shaw, Rowett, Lapkin, & Phillips, 2019). There is a higher frequency of opioid delivery in inpatient palliative care services than in the acute care setting, with considerably higher opioid doses also used compared to all other healthcare settings (Australian Institute of Health and Welfare, 2018; Heneka et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, palliative care clinicians perceive the prevalence of opioid errors in specialist palliative care inpatient services to be low, given the high frequency of opioid delivery in this setting. While factors contributing to opioid errors in inpatient palliative care services are becoming better understood (Heneka, Shaw, Rowett, Lapkin, & Phillips, 2018b;Heneka et al, 2019), little is known about the factors that mitigate opioid errors in these services. Identifying opioid error mitigating factors is essential to better understand how to foster and support safe opioid delivery in specialist palliative care inpatient services.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mitigating opioid errors in inpatient palliative care: A qualitative study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Opioids are a high-risk medicine used in high doses and volumes in specialist palliative care inpatient services to manage palliative patients' pain and other symptoms. Despite the high volume of opioid use in this care setting, serious errors with opioids are exceedingly rare. However, little is known about the factors that mitigate opioid errors in specialist palliative care inpatient services. Aim: To explore palliative care clinicians' perceptions of factors that mitigate opioid errors in specialist palliative care inpatient services. Methods: Design: A qualitative study using focus groups and semi-structured interviews. Participants and setting: Registered nurses, doctors, and/or pharmacists ('clinicians') who were involved with and/or had oversight of the services' opioid delivery and/or opioid quality and safety processes, employed by one of three specialist palliative care inpatient services in metropolitan NSW. Findings: Fifty-eight participants took part in this study, three-quarters (76%) of which were palliative care nurses. A positive opioid safety culture was central to mitigating opioid errors in specialist palliative care inpatient services. This culture of opioid safety was founded on clear and consistent safety messages from leadership, clinicians empowered to work together and practise safely, and a non-punitive approach to errors when they occurred. The clinical nurse educator was seen as pivotal to shaping, driving and reinforcing safe opioid delivery practices across the palliative care service. Conclusion: Creating and sustaining a positive opioid safety culture, and promoting a nonpunitive approach to opioid error and reporting, is essential to mitigating opioid errors in the specialist palliative care inpatient setting.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Details of recruitment and data collection have been reported in detail elsewhere (Heneka et al, 2019). All participants provided informed, written consent.…”

Section: Recruitment and Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mitigating opioid errors in inpatient palliative care: A qualitative study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Active failures such as slips, lapses and mistakes are inevitable in opioid delivery, and are the major contributing factor to opioid errors in palliative care inpatient services [1]. One aspect prone to active failure is opioid dose conversion [2]. There is wide variability in prescriber competence in performing these calculations.…”

Section: Introductionmentioning

confidence: 99%

The Safer Prescription of Opioids Tool (SPOT): A Novel Clinical Decision Support Digital Health Platform for Opioid Conversion in Palliative and End of Life Care—A Single-Centre Pilot Study

Flint

Buchanan

Jamieson

et al. 2019

IJERPH

View full text Add to dashboard Cite

Opioid errors are a leading cause of patient harm. Active failures in opioid dose conversion can contribute to error. Conversion is complex and is currently performed manually using tables of approximate equivalence. Apps that offer opioid dose double-checking are available but there are concerns about their accuracy and clinical validation. This study evaluated a novel opioid dose conversion app, The Safer Prescription of Opioids Tool (SPOT), a CE-marked Class I medical device, as a clinician decision support (CDS) platform. This single-centre prospective clinical utility pilot study followed a mixed methods design. Prescribers completed an initial survey exploring their current opioid prescribing practice. Thereafter prescribers used SPOT for opioid dosage conversions in parallel to their usual clinical practice, then evaluated SPOT through a survey and focus group. SPOT matched the Gold Standard result in 258 of 268 (96.3%) calculations. The 10 instances (3.7%) when SPOT did not match were due to a rounding error. Users had a statistically significant increase in confidence in prescribing opioids after using SPOT. Focus group feedback highlighted benefits in Quality Improvement and Safety when using SPOT. SPOT is a safe, reliable and validated CDS that has potential to reduce harms from opioid dosing errors.

show abstract

A Study on the Status and Contributory Factors of Adverse Events Due to Negligence in Nursing Care

et al. 2021

View full text Add to dashboard Cite

Background: Patient safety issues in medical institutions have received worldwide attention. Nurses play a pivotal role in providing health care at the bedside and the interception of adverse events (AEs). A knowledge of contributory factors for these AEs is vital to individuals, institutional procedures, and also national policy. The goals of this study are to analyze medical litigation related to nursing practice and to determine the most common contributory factors of AEs due to negligence in nursing care.Methods: A qualitative content analysis was conducted for AEs related to nursing care to determine the general characteristics and contributory factors. The contributory factors for each case were examined using a modified version of the Yorkshire Contributory Factors Framework. Results:The most common types of AEs in nursing involved surgeries, procedures/interventions, and medications. The analysis also revealed that situational factors and communication and culture factors contributed most to AEs. Individual staff factors and staff training and education were the most frequent subfactors contributing to AEs.Conclusions: Adverse events were associated with various contributory factors that varied according to AE type. Thus, strategies need to be developed based on the understanding of these contributory factors related to the different AE types so that comprehensive approaches to improving patient safety and quality of nursing care can be implemented.

show abstract

Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study

Cited by 14 publications

References 46 publications

Mitigating opioid errors in inpatient palliative care: A qualitative study

Mitigating opioid errors in inpatient palliative care: A qualitative study

The Safer Prescription of Opioids Tool (SPOT): A Novel Clinical Decision Support Digital Health Platform for Opioid Conversion in Palliative and End of Life Care—A Single-Centre Pilot Study

A Study on the Status and Contributory Factors of Adverse Events Due to Negligence in Nursing Care

Contact Info

Product

Resources

About