Nurses’ perceptions of high‐alert medication administration safety: A qualitative descriptive study

Sessions, Laura C.; Nemeth, Lynne S.; Catchpole, Ken; Kelechi, Teresa J.

doi:10.1111/jan.14173

Cited by 25 publications

(39 citation statements)

References 38 publications

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“…Findings related to work environmental issues, such as rushing because of excessive workload or lack of (competent) employees, were found in our free text descriptions. Similar issues have been found in other studies concerning MA incidents demonstrating that inadequate staffing levels, workload, and working in haste (Härkänen, Vehviläinen‐Julkunen, Murrells, et al, 2020), as well as nurse workload or distractions during medication tasks (Sessions, Nemeth, Catchpole, & Kelechi, 2019) may increase the risk of omissions and other types of errors.…”

Section: Discussionsupporting

confidence: 82%

Factors contributing to reported medication administration incidents in patients’ homes – A text mining analysis

Härkänen

Franklin

Murrells

et al. 2020

Journal of Advanced Nursing

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Aims To describe the characteristics of medication administration (MA) incidents reported to have occurred in patients’ own homes (reporters’ profession, incident types, contributing factors, patient consequence, and most common medications involved) and to identify the connection terms related to the most common contributing factors based on free text descriptions. Design A retrospective study using descriptive statistical analysis and text mining. Methods Medication administration incidents (N = 19,725) reported to have occurred in patients’ homes between 2013–2018 in one district in Finland were analysed, describing the data by the reporters’ occupation, incident type, contributing factors, and patient consequence. SAS® Text Miner was used to analyse free text descriptions of the MA incidents to understand contributing factors, using concept linking. Results Most MA incidents were reported by practical (lower level) nurses (77.8%, N = 15,349). The most common category of harm was ‘mild harm’ (40.1%, N = 7,915) and the most common error type was omissions of drug doses (47.4%, N = 9,343). The medications most commonly described were Marevan [warfarin] (N = 2,668), insulin (N = 811), Furesis [furosemide] (N = 590), antibiotic (N = 446), and Panadol [paracetamol] (N = 416). The contributing factors most commonly reported were ‘communication and flow of information’ (25.5%, N = 5,038), ‘patient and relatives’ (22.6%, N = 4,451), ‘practices’ (9.9%, N = 1,959), ‘education and training’ (4.8%, N = 949), and ‘work environment and resources’ (3.0%, N = 598). Conclusion There is need for effective communication and clear responsibilities between home care patients and their relatives and health providers, about MA and its challenges in home environments. Knowledge and skills relating to safe MA are also essential. Impact These findings about MA incidents that have occurred in patients’ homes and have been reported by home care professionals demonstrate the need for medication safety improvement in home care.

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Section: Discussionsupporting

confidence: 82%

Factors contributing to reported medication administration incidents in patients’ homes – A text mining analysis

Härkänen

Franklin

Murrells

et al. 2020

Journal of Advanced Nursing

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“…Other barriers cited by nurses who contributed to errors were excessive workload and distractions, such as interruptions by family members and other health professionals. 11 According to Trbovich et al, 12 the highest rate of interruptions referred to nursing colleagues (35.2%), followed by patients (29.6%) and, lastly, infusion pump alarms (20.4%). 12 In a systematic review by Queres et al, 13 13 of the 58 studies evaluated pointed out that minor mistakes and lapses at…”

Section: Resultsmentioning

confidence: 99%

Conhecimento de profissionais de enfermagem sobre medicamentos de alta vigilancia em hospital universitário de grande porte

Pereira¹,

Caon²,

Pinto³

et al. 2021

Rev Bras Farm Hosp Serv Saude

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Objetivos: O objetivo deste estudo foi caracterizar o conhecimento sobre medicamentos de alta vigilância (MAV’s) entre profissionais da enfermagem que atuam em uma unidade de terapia intensiva (UTI). Métodos: Foi realizado um estudo transversal em fevereiro de 2019. Por meio de amostragem por conveniência, foram incluídos 100 enfermeiros e técnicos de enfermagem atuando na UTI de um hospital universitário de grande porte, nos três turnos de trabalho. Os participantes responderam questionário de autopreenchimento sobre auto avaliação e experiência com MAV’s, obstáculos encontrados no processo de utilização, conhecimento sobre administração e procedimentos clínicos envolvendo MAV’s. O conhecimento foi pontuado por meio de escores de acerto (menor que 70 pontos, de 70-89 e acima de 90). Foram realizadas análises descritivas por meio de frequência relativa, media e desvio padrão, ou mediana e intervalo interquartílico. O teste Exato de Fisher foi utilizado para verificar as associações entre o escore obtido e variáveis sociodemográficas e laborais, considerando um nível de significância de 5%. As análises foram realizadas no SPSS versão 18.0.0. Resultados: O escore médio de conhecimento de MAV’S foi de 73,2 (+16,4); 36% dos participantes apresentaram escore abaixo de 70, 54% de 70 a 89, e 10% acima de 90. Os principais obstáculos foram prescrição verbal (50%), prescrição médica confusa (39%) e conhecimento insuficiente (35%). Conclusão: Apenas um em cada 10 profissionais apresentaram escore acima de 90 pontos, sugerindo uma situação de fragilidade na prática assistencial na UTI envolvendo MAV’s.

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“…Organizational factors are influences occurring within the healthcare system before the point of care delivery with the patient that may contribute to a MAE. These factors include communication problems, equipment problems, and workflow problems 23–26 . Communication problems may lead to incorrect information being shared and increasing the risk of a medication error 25 .…”

Section: Resultsmentioning

confidence: 99%

“…These factors include communication problems, equipment problems, and workflow problems 23–26 . Communication problems may lead to incorrect information being shared and increasing the risk of a medication error 25 . Equipment problems may involve technology, including poorly designed computer programs and slow computer speeds, which may impede the medication administration process 24 .…”

Section: Resultsmentioning

confidence: 99%

Medication administration errors: A concept analysis

2021

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Aim To provide an analysis of the concept of medication errors that occur during the nursing task of medication administration. Background Medication errors occurring during medication administration have an increased risk for an adverse patient outcome. Many terms are associated with medication errors, with limited clarification for a medication administration error at the point of care delivery. Data Sources Twenty‐seven sources were chosen from database searches of PubMed, CINAHL, EMBASE, and Scopus. Key search terms used to narrow the search consist of the following terminology: (“bedside” OR “point‐of‐care” OR “nursing care*”) AND “medication administration errors” AND (“acute care”). Review Methods Rodger's evolutionary method of concept analysis was used to clarify the concept of medication administration error. Results The concept analysis identified three attributes of a medication administration error: nurse‐provided care, administration, and point of care. Antecedents identified in the analysis are organizational factors and nurse factors. Consequences identified in the analysis are patient, nurse and organizational themes. Conclusion The continued occurrence of medication administration errors warrants the need for an investigation into existing safety measures. Using this concept analysis may help guide the study of the healthcare environment and determine empirical measures to assess the impact that a medication administration error has.

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Nurses’ perceptions of high‐alert medication administration safety: A qualitative descriptive study

Cited by 25 publications

References 38 publications

Factors contributing to reported medication administration incidents in patients’ homes – A text mining analysis

Factors contributing to reported medication administration incidents in patients’ homes – A text mining analysis

Conhecimento de profissionais de enfermagem sobre medicamentos de alta vigilancia em hospital universitário de grande porte

Medication administration errors: A concept analysis

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