Supervising medication administration by undergraduate nursing students: influencing factors

Abstract

The factors influencing the supervision provided by registered nurses needs further exploration that effective strategies can be implemented to ensure safe practices in relation to medication administration can be implemented.

Learning in the traditional-faculty supervised teaching Model: PART 1-The nursing students’ perspective

“…[55,61,62] Students have reported that it is easier to learn about potential adverse event alerts with a smaller student-to-teacher ratio. [63] It is, therefore, critical that nursing students should receive optimal supervision in order to become safe, competent and independent health care practitioners.…”

The traditional-faculty supervised teaching model: Nursing faculty and clinical instructors’ perspectives

“…[10,22] Inadequate supervision has been associated with medication errors among nursing students. [23][24][25][26] For example, previous studies by Searl-Reid, et al [25,26] and Dolansky et al [24] revealed that nursing students do not always receive the level of supervision that is legally required and that this was identified as the leading to medication errors or near misses. Reid-Searl et al [25,26] explored nursing students' experiences of administering medication in the clinical setting and found that approximately one third of the participants reported making an actual or "near miss" medication error.…”

“…[21] This implies that the responsibility of supervising nursing skills such as medication administration, often, fall on the RNs on the units. [24,25] This overreliance on RNs, however, not only overburdens already overworked staff, but has the potential to lead to resentment by those nurses who are not interested in working with students. [21] Given the need for students to prepare for the full scope of practice as an RN, [2] faculty and CIs must ensure that students are provided with opportunities to contextually experience complex skills such as decision making, delegation, and clinical reasoning.…”

“…Therefore, it is important that students receive the "best possible" supervision for them to become safe, competent and independent future health care practitioners and ensure safe practice while they learn to nurse. As Reid-Searl et al [25] noted, the impact of supervision must become a priority for research and practice in undergraduate nursing education programs.…”

“…[3,10,61] With large clinical groups, there exists the possibility of errors or safety issues especially during medication administration [3,25] or enactment of technical skills, due to inability of the CI to adequately monitor eight students simultaneously. As stated earlier, a study conducted by Reid-Searl et al [25] revealed that about a third of nursing students reported making an actual or "near miss" medication error during administration of drugs. Where the medication errors occurred, the students reported not receiving direct and appropriate supervision from a registered nurse or CI.…”