Safeguarding in medication administration: understanding pre-registration nursing students' survey response to patient safety and peer reporting issues

Abstract

Nurse managers are role models for nursing students in the clinical setting. Nursing management must lead, by example, the patient safety agenda in the clinical setting.

Final year nursing students self-reported understanding of the relevance of bioscience

“…Focus group discussions with final year students in a study completed by Adhikari et al (2014) revealed limited knowledge, insufficient understanding, lack of confidence and a need for more learning sessions on medication management and applied pharmacology. A lack of knowledge in pharmacology may be attributed to a lack of in-service training and integration of theory and practical (Lim and Honey, 2006;Ndosi and Newell, 2009;Davis, 2010) and has implications for patient safety (Andrew and Mansour, 2014).…”

“…To ensure patient safety (Andrew and Mansour, 2014) nurses need a good foundational knowledge of bioscience. Consequently, the South African Nursing Council (SANC) has legislated for the inclusion of biological and natural sciences (anatomy, physiology, chemistry, biophysics, microbiology and parasitology) *Corresponding author.…”

Student nurses’ thinking during medication administration

“…Although nurse researchers did not provide information related to what students were thinking while administering medications, some did report that students and new graduates expressed concern about patient safety [6,9,11,13,15] . Student comments during Thompson and Bonnel's [11] pharmacologic simulation debriefing and evaluation indicated, "they had learned a valuable lesson [about medication administration] in a safe environment."…”

“…Student comments during Thompson and Bonnel's [11] pharmacologic simulation debriefing and evaluation indicated, "they had learned a valuable lesson [about medication administration] in a safe environment." In a qualitative questionnaire following a medication administration scenario, Andrew and Mansour [15] also reported student concerns related to their experiences with patient safety. Third year nursing student responses encompassed four themes: a) protecting patient safety (actions they would take to protect patients from errors), b) willingness to compromise (or act outside the boundaries of correct medication procedures or policies), c) avoiding responsibility (not wanting to get involved in medication errors or accepting that potential errors may happen to them), and d) consequences resulting from actions (concern that there may be penalties or backlash if they report unsafe practices).…”

“…Overall, the studies revealed that numerous factors contribute to student nurses making errors in medication administration including: a) failure to use medication administration rights, b) system factors, c) gaps in knowledge, d) performance deficits, e) lack of time to process knowledge, f) lack of time to look up drugs, g) lack of practice for medication administration skills and decision-making regarding medication choices, h) lack of confidence, i) information overload, j) feeling overwhelmed and stressed, k) lack of self-confidence, l) inexperience, m) distraction, n) poor adherence to the five rights, o) too much time between medication administration theory and practice, p) deficient education, and q) little time for reflection upon medication administration experiences [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . How students think during the medication administration process was not specifically addressed.…”