Student nurses’ thinking during medication administration

Abstract

Background: The thought processes of student nurses during medication administration relative to prevention of patient harm or errors or promoting therapeutic responses are not well known. Nursing students may be focused more on the rules and procedures rather than anticipatory problem solving and concurrent patient teaching that occurs with practicing nurses. The Quality and Safety Education for Nurses (QSEN) project provides nursing faculty with a framework to assure that graduates are able to demonstrate quality and safety competencies, including that of medication administration.Methods: This qualitative study examined student nurses' reported thinking during medication administration in a simulated experience involving care of a post-operative patient reporting pain. Forty-eight students from 5 baccalaureate nursing programs participated in a video recorded simulation with a standardized post-operative patient. Students independently completed a patient assessment and administered pain medication from a variety of options. Following the simulation, semi-structured debriefing interviews containing 8 open-ended questions were conducted and audiotaped. Results:Students administered a variety of pain medication during the simulation. Analysis of transcriptions revealed five themes including 1) safety, 2) clinical reasoning, 3) uncertainty and need for validation, 4) lessons learned, and 5) perception of realism. Safety was the most predominant theme that emerged from the data. Conclusion:Students must be able to more fully understand clinical decision making around medication administration (e.g., best practice, individual experiences with pain, patient preferences, patient conditions, etc.). Implementing teaching strategies that integrate opportunities for several valid nursing interventions encourage students to move away from a linear perspective to examine their thinking and the complexity of clinical practice. Findings will inform faculty relative to curricular design, pedagogy, and evaluation in educating nursing students to become safe and competent nurses.

The Effect of Multitasking and Grade Performance of Undergraduate Nursing Students

“…Errors in patient care can be detrimental to patient outcome and can even mean a difference in life and death for patients. This study affirms the results of the studies where interruptions and multitasking of registered nurses resulted in medication errors [4]; and students who were not focused on the tasks during a simulation activity made errors in medication administration [6]. This study also affirms that nursing students are similar to students in other fields of study where research shows that distractions from multitasking can affect learning and result in poor grade performance [2] [3].…”

“…This is a dangerous trend among nursing students to use technology while caring for patients where patient safety is crucial. Researchers who studied thinking of student nurses during a simulation activity found that students who did not focus on the task made errors during medication administration [6]. A study [7] found that multitasking resulted in a significant reduction in learning when the information was presented in verbal form to the learner.…”

Student nurses’ leadership and management competencies and key performance indicators (KPIs) for patient safety outcomes in Nakhon Pathom, Thailand

“…On the other hand, the majority of respondents (31.5%) reported that they made medication errors as pre-licensure students in Canada (Harding and Petrick, 2008). It was also noted that during clinical evaluations of the medication administration process, Minnesota nursing students demonstrated deficiencies in their medication administration skills (Simones et al, 2014).…”

PRN Medicines Optimization and Nurse Education

“…Nursing students need to be competent to make independent clinical decisions on PRN medicines management, based on patient requests and their own clinical judgment, and including structured monitoring for adverse side effects [ 41 ]. They should examine their own thinking process and be prepared for unexpected and complex incidents in the medication process [ 98 ]. As a priority, they should be educated to take responsibility for nurse-led care initiatives and assess the effects of their own role on patients’ overall wellbeing and care outcomes [ 99 ].…”