Multifactorial Influences on and Deviations from Medication Administration Safety and Quality in the Acute Medical/Surgical Context

Popescu, Andrea; Currey, Judy; Botti, Mari

doi:10.1111/j.1741-6787.2010.00212.x

Cited by 31 publications

(64 citation statements)

References 38 publications

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“…Quanto à classe farmacológica mais envolvida nos erros, destacaram-se os antimicrobianos, com uma variação de 8,4% a 18,5%, destacando-se os erros de horário (87,7%) e de dose (6,9%) como os mais constantes (4) . Erro na administração das medicações tem um impacto significativo sobre os pacientes em termos de morbidade, mortalidade, evento adverso de drogas e aumento de tempo de permanência hospitalar, além de aumentar os custos para os sistemas de saúde (5) .…”

Section: Introductionunclassified

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

et al. 2016

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RESUMO: Objetivou-se avaliar as conformidades e não conformidades no preparo e administração de antibacterianos. Estudo observacional e transversal, realizado de agosto a dezembro de 2014 em unidades de clínica médica de um hospital-escola em Fortaleza-Ceará. A amostra foi composta por 265 doses de antibacterianos, que tiveram suas etapas de preparo e administração observadas com dois checklist nos três turnos de trabalho. Os dados foram analisados por estatística descritiva e analítica, e todos os procedimentos éticos foram seguidos. Destaca-se que a não conformidade mais frequente em ambas as etapas foi o cumprimento dos preceitos da semiotécnica 265 (100%). A organização foi associada com o erro na escolha do medicamento (p=0,027), e o uso da prescrição e confirmação do nome do paciente não tiveram relação com os erros (p=0,942). Assim, conclui-se que modificações comportamentais no processo de trabalho precisam ser implementadas para reduzir as não conformidades e consequentemente os erros de medicação. DESCRITORES: Antibióticos; Segurança do paciente; Erros de medicação; Enfermagem; Serviços de enfermagem. CONFORMIDADES E NÃO CONFORMIDADES COMPLIANCE AND NON-COMPLIANCE IN THE PREPARATION AND ADMINISTRATION OF ANTIBACTERIAL DRUGSABSTRACT: The present study aimed to assess compliance and non-compliance in the preparation and administration of antibacterial drugs. Observational and cross-sectional study conducted from August to December 2014 in medical wards of a teaching hospital in Fortaleza-Ceará. The sample was composed by 265 doses of antibacterial drugs whose preparation and administration stages were observed during the three work shifts, with two checklists. Data were analyzed using descriptive statistics, and all ethical procedures were fulfilled. The most frequent non-compliance observed in both stages was compliance withthe requirements of the several techniques performed by nursing professionals (semiotechnique), 265 (100%). The hospital organization was associated with error in the choice of the (p=0.027), and the use of prescription and confirmation of patient's identity were not related to the errors (p=0.942). Thus, it is concluded that behavioral changes in the work process should be implemented to reduce non-compliance and, consequently, medication errors. CUMPLIMIENTO Y INCUMPLIMIENTO EN EL PREPARO Y ADMINISTRACCIÓN DE ANTIBACTERIANOS:IMPLICACIONES PARA LA SEGURIDAD DEL PACIENTE RESUMEN: El presente estudio tuvo como objetivo evaluar el cumplimiento y el incumplimiento en la preparación y administración de fármacos antibacterianos. Estudio observacional y transversal realizado entre agosto y diciembre de 2014 en las alas médicas de un hospital universitario en Fortaleza-Ceará. La muestra fue compuesta por 265 dosis de fármacos antibacterianos cuya etapas del preparación y administración fueron observados durante los tres turnos de trabajo, con dos listas de comprobación. Los datos fueron analizados utilizando estadística descriptiva, y se cumplieron todos los procedimientos éticos. El incu...

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Section: Introductionunclassified

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

et al. 2016

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“…Three healthcare professionals are involved in the medication cycle: medical officers who prescribe medications, pharmacists who dispense medications, nurses who administer medications; with the monitoring of a therapeutic outcome a shared responsibility (Bullock et al, 2010;Popescu et al, 2011). The process of medication administration accounts for a large proportion of nurses' time.…”

Section: Introductionmentioning

confidence: 99%

“…Research indicates medication events or errors are often a result of system failures, that is, errors related to team, task, environment, individual and system factors (Deans, 2005;Evans, 2009;Popescu et al, 2011;Roughead and Semple, 2009). The multifaceted nature of medication administration involves the contribution of medical staff, pharmacists and nurses.…”

Section: Introductionmentioning

confidence: 99%

“…More recently there has been recognition in the literature that medication adverse events are related to systems failures (i.e. team, task, environment, individual and system factors) (Deans, 2005;Evans, 2009;Popescu et al, 2011;Roughead and Semple, 2009) associated with the complex process of medication administration, rather than individual or professional group factors (Roughead and Semple, 2009). Reported factors that increase the likelihood of a medication error occurring include knowledge-based mistakes, poor communication (Nichols et al, 2008), polypharmacy, and poor compliance with medication assessment practices such as medication reconciliation (Latimer et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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An education intervention to improve nursing students' understanding of medication safety

Hewitt

Tower

Latimer

2015

Nurse Education in Practice

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“…8,12 System failures such as missing medications and access to equipment and supplies were also identified as sources of interruptions that are potentially avoidable. 7,8,[12][13][14][15][16] Other avoidable interruptions cited in the literature are the tendency of nurses to interrupt each other with conversations unrelated to medication administration 7,[17][18][19] while preparing medications and to respond immediately to requests from others when interrupted. 7,15,20 These findings support the idea that interruptions are an accepted part of nursing practice and suggest the Attendance at the National Teaching Institute was the inspiration for this project and the springboard for addressing existing nursing concerns about interruptions.…”

Section: Review Of the Literaturementioning

confidence: 99%

Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

Flynn

Evanish

Fernald

et al. 2016

Critical Care Nurse

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BACKGROUND Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. OBJECTIVES To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. METHODS The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. RESULTS Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. CONCLUSIONS Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety. (Critical Care Nurse. 2016;36[4]:19-35) This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Describe similarities between the principles of the sterile cockpit concept used in the aviation industry and the Nurses Uninterrupted Passing Medications Safely (NUPASS) guidelines to promote safety 2. Discuss the current evidence supporting use of interruption limiting strategies to reduce medication administration errors in the acute care setting 3. Implement evidence-based strategies to limit interruptions during medication administration To complete evaluation for CE contact hour(s) for test #C1642, visit www.ccnonline.org and click the "CE Articles" button. No CE test fee for AACN members. This test expires on August 1, 2019.The American Association of Critical-Care Nurses is an accredited provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AACN has been approved as a provider of continuing education in nursing by the State Boards of Registered Nursing of California (#01036) and Louisiana (#LSBN12). N urses play a critical role in promoting patient safety through surveillance and interception of errors that cause patient harm as hospitals and health care systems strive to become high-reliability organizations. APRN, MS, Advocate Christ Medical Center, 4400 W 95th St, Oak Lawn,.To purchase electronic or print reprints, contact the American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org. patient harm, and strategies to reduce interruptions and manage them appropriatel...

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Multifactorial Influences on and Deviations from Medication Administration Safety and Quality in the Acute Medical/Surgical Context

Abstract: Nurses displayed behaviours that increased medication administration quality and safety; however, violations of practice standards were observed. These findings will inform future intervention studies to improve medication quality and safety.

Cited by 31 publications

References 38 publications

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

An education intervention to improve nursing students' understanding of medication safety

Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

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