Development and validation of a risk prediction model for medication administration errors among neonates in the neonatal intensive care unit: a study protocol

Basil, Josephine Henry; Premakumar, Chandini Menon; Ali, Adliah Mhd; Tahir, Nurul Ain Mohd; Seman, Zamtira; Shah, Noraida Mohamed

doi:10.1136/bmjpo-2022-001765

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…The comprehensive details of the data collection procedure are outlined in our published protocol for the development and validation of a risk prediction tool aimed at identifying neonates at risk of MAEs [ 24 ]. In summary, the flowchart for the direct observational study is shown below ( Fig 1 ).…”

Section: Methodsmentioning

confidence: 99%

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

Henry Basil,

Mohd Tahir,

Menon Premakumar

et al. 2024

PLoS ONE

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Despite efforts in improving medication safety, medication administration errors are still common, resulting in significant clinical and economic impact. Studies conducted using a valid and reliable tool to assess clinical impact are lacking, and to the best of our knowledge, studies evaluating the economic impact of medication administration errors among neonates are not yet available. Therefore, this study aimed to determine the potential clinical and economic impact of medication administration errors in neonatal intensive care units and identify the factors associated with these errors. A national level, multi centre, prospective direct observational study was conducted in the neonatal intensive care units of five Malaysian public hospitals. The nurses preparing and administering the medications were directly observed. After the data were collected, two clinical pharmacists conducted independent assessments to identify errors. An expert panel of healthcare professionals assessed each medication administration error for its potential clinical and economic outcome. A validated visual analogue scale was used to ascertain the potential clinical outcome. The mean severity index for each error was subsequently calculated. The potential economic impact of each error was determined by averaging each expert’s input. Multinomial logistic regression and multiple linear regression were used to identify factors associated with the severity and cost of the errors, respectively. A total of 1,018 out of 1,288 (79.0%) errors were found to be potentially moderate in severity, while only 30 (2.3%) were found to be potentially severe. The potential economic impact was estimated at USD 27,452.10. Factors significantly associated with severe medication administration errors were the medications administered intravenously, the presence of high-alert medications, unavailability of a protocol, and younger neonates. Moreover, factors significantly associated with moderately severe errors were intravenous medication administration, younger neonates, and an increased number of medications administered. In the multiple linear regression analysis, the independent variables found to be significantly associated with cost were the intravenous route of administration and the use of high-alert medications. In conclusion, medication administration errors were judged to be mainly moderate in severity costing USD 14.04 (2.22–22.53) per error. This study revealed important insights and highlights the need to implement effective error reducing strategies to improve patient safety among neonates in the neonatal intensive care unit.

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Section: Methodsmentioning

confidence: 99%

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

Henry Basil,

Mohd Tahir,

Menon Premakumar

et al. 2024

PLoS ONE

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Prevalence and factors associated with medication administration errors in the neonatal intensive care unit: A multicentre, nationwide direct observational study

Henry Basil,

Premakumar,

Mhd Ali

et al. 2024

Journal of Advanced Nursing

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Aim(s)To determine the prevalence of medication administration errors and identify factors associated with medication administration errors among neonates in the neonatal intensive care units.DesignProspective direct observational study.MethodsThe study was conducted in the neonatal intensive care units of five public hospitals in Malaysia from April 2022 to March 2023. The preparation and administration of medications were observed using a standardized data collection form followed by chart review. After data collection, error identification was independently performed by two clinical pharmacists. Multivariable logistic regression was used to identify factors associated with medication administration errors.ResultsA total of 743 out of 1093 observed doses had at least one error, affecting 92.4% (157/170) neonates. The rate of medication administration errors was 68.0%. The top three most frequently occurring types of medication administration errors were wrong rate of administration (21.2%), wrong drug preparation (17.9%) and wrong dose (17.0%). Factors significantly associated with medication administration errors were medications administered intravenously, unavailability of a protocol, the number of prescribed medications, nursing experience, non‐ventilated neonates and gestational age in weeks.ConclusionMedication administration errors among neonates in the neonatal intensive care units are still common. The intravenous route of administration, absence of a protocol, younger gestational age, non‐ventilated neonates, higher number of medications prescribed and increased years of nursing experience were significantly associated with medication administration errors.Implications for the Profession and/or Patient CareThe findings of this study will enable the implementation of effective and sustainable interventions to target the factors identified in reducing medication administration errors among neonates in the neonatal intensive care unit.Reporting MethodWe adhered to the STROBE checklist.Patient or Public ContributionAn expert panel consisting of healthcare professionals was involved in the identification of independent variables.

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Investigating pediatric nurses’ perceptions of factors contributing to MAEs at Yendi hospital, Ghana

Nukpezah,

Anyaba,

Osman

2024

BMC Pediatr

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Background Medication administration errors (MAEs) are a critical concern in pediatric healthcare, contributing to adverse drug events (ADEs) and negatively impacting patient health. Objectives This study explores pediatric nurses’ perceptions of factors contributing to MAEs at Yendi Municipal Hospital to develop interventions enhancing patient safety. Methods A descriptive cross-sectional survey was conducted among 143 nurses at Yendi Municipal Hospital using structured questionnaires. Data were analysed using SPSS 26.0 and Excel 2016. Bivariate analysis examined relationships between socio-demographic characteristics and MAEs. Results Contributing factors to MAEs included inadequate training (91.6%), misunderstanding medical abbreviations (88.8%), poor supervision (92.3%), eagerness to sign out shifts (70.6%), improper handover (88.8%), inadequate staff (77.6%), dosage miscalculations (83.9%), and illegible handwriting (81.8%). Significant associations were found between MAEs and the type of unit/ward (X²=6.25, p = 0.012) and educational level (Fisher Exact test = 4.20, p = 0.036). Conclusion Inadequate training, poor supervision, and communication issues are major contributors to MAEs in pediatric settings. Targeted interventions can significantly improve patient safety and care quality.

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Development and validation of a risk prediction model for medication administration errors among neonates in the neonatal intensive care unit: a study protocol

Cited by 3 publications

References 39 publications

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

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

Prevalence and factors associated with medication administration errors in the neonatal intensive care unit: A multicentre, nationwide direct observational study

Investigating pediatric nurses’ perceptions of factors contributing to MAEs at Yendi hospital, Ghana

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