Medication Errors in Critically Ill Adults: A Review of Direct Observation Evidence

Abstract

Objective To systematically review clinical evidence gathered by direct observation of medication errors in adult patients in intensive care units. Methods Articles published between 1985 and 2008 in Englishlanguage journals indexed by the Cumulative Index for Nursing and Allied Health Literature and PUBMED were searched for studies on medication errors made by intensive care unit nurses. Studies in which errors were detected via direct observation were included. Results Six studies met the inclusion criteria, and error incidence varied considerably among them. Wrong dose, wrong administration time and rate, and dose omission were the most common errors. Antibiotics, electrolytes, and cardiovascular drugs were commonly associated with errors, but the evidence about factors contributing to errors was inconclusive. Increased monitoring was the most common consequence of medication errors, whereas life-threatening and fatal adverse events were rare. Conclusions Identification of patterns and characteristics of medication errors can guide preventive interventions. Factors contributing to errors, as well as drugs and error types associated with severe adverse events, deserve further investigation.

<b> Erros de administração de medicamentos em unidades de terapia intensiva neonatal / Medication administration errors in neonatal intensive care units <b>

“…Pesquisa que avaliou a incidência relatada, causas e relatórios de erros de medicação em unidades de terapia intensiva (UTI) e enfermarias de hospitais de ensino da Jordânia em 2010, mostrou que a média da incidência de erros de medicação para toda a amostra foi de 35%, sendo 36,4% em UTI e 33,8% nas enfermarias (3) .No que diz respeito, especificamente, aos erros de administração de medicamentos em ambientes de cuidados de saúde, as taxas chegam a atingir 59,1% do total das oportunidades de erro (4) e nas unidades de cuidados críticos alcançam72,5% (5) . Investigação realizada com enfermeiros de Unidades de Cuidados Intensivos Neonatais e Unidades Neonatais de cinco hospitais de ensino de ShahidBeheshti (Irã), revelou que 37,8% dos participantes haviam cometido de um a dois erros de medicação nos últimos seis meses.…”

Nurses' experiences with errors in nursing

“…Licensed registered nurses who worked in an adult intensive care unit (ICU) as direct patient caregivers comprised the study sample. ICUs were chosen because high rates of errors are reported on nursing units that provide acute care for critically ill patients, such as intensive care units (Brunsveld-Reinders, Arbous, De Vos, & De Jonge, 2016;Landrigan et al, 2004), and critically ill patients experience higher rates of adverse events and errors than other patient populations (Balas, Scott, & Rogers, 2006;Kiekkas, Karga, Lemonidou, Aretha, Karanikolas, 2011).…”

Obstacles' And Facilitators Facing Safe Administration Of Chemotherapy by Oncology Nurses

“…In the current study about half of nurses reported that the lack of safety guidelines and training program at their work place considered obstacles facing safe chemotherapy administration. This is confirmed by research Kikase (2011) [33] study findings revealed that incompetency in practice and poor level of knowledge of nurses ' administering chemotherapy. Also this finding in line with Orujulus (2016) [34] study findings which revealed that slightly more than half and one of nurses reported that lack of safety guidelines and training programs at their workplaces respectively.…”