The Nurse’s Medication Day

Abstract

The medication administration stage of the medication-use process is especially vulnerable to error because errors are least likely to be caught before reaching the patient. Medication administration, however, remains poorly understood. In this article we describe medication administration as observed in an ethnographic study conducted on one medical and one surgical unit. A central finding was that medication administration entailed a complex mixture of varied and often competing demands that temporally structured the nurses' entire workday. Articulation work was evident in time management strategies nurses used to handle demands from institutional policies, technical devices, patients, the physical environment, and the medications themselves. The average number of doses of medication per patient was more than double the number policy groups have indicated. Medication administration is neither simply the giving of drugs nor does it have clearly defined temporal boundaries. Because of its inseparability from other nurses' work, medication administration inherently entails interruption, thereby calling into question the current emphasis on reducing interruptions as a tactic to decrease medication errors.

Improving patient safety using the sterile cockpit principle during medication administration: a collaborative, unit-based project

“…The administration of medication requires a complex mixture of varied and often competing responsibilities that structure the nurses’ work day (Jennings et al. 2011).…”

Administração De Medicamentos – Carga De Trabalho Da Equipe De Enfermagem Em Unidade De Internação Clínica

“…Estudo observacional mostrou resultado semelhante, com média de 9,7 medicamentos prescritos por paciente e variação de 0 a 20 fármacos (19) . Entretanto, os achados de outras pesquisas divergem dos números encontrados, demonstrando uma ampla variação de número de doses prescritas por paciente em diferentes contextos (11,20) . Essas variações em achados de estudos locais e internacionais quanto ao número de medicamentos prescritos por paciente, apontam a necessidade de maiores estudos para descrever a magnitude desse fenômeno no cenário brasileiro e reforçam a importância da presente investigação.…”

“…Os erros de medicação foram significativamente associados ao aumento do número de pacientes atribuídos às enfermeiras (20,22) e foi evidenciado que a maior frequência desses erros nos hospitais ocorrem em unidades de internação (23) .…”

“…Estudos observacionais demonstraram semelhantes resultados e relataram que as principais vias empregadas são as vias parenteral, oral e enteral (19)(20) .…”

Improving Medication Administration Safety: Using Naïve Observation to Assess Practice and Guide Improvements in Process and Outcomes

“…The turbulent hospital environment in which nurses administer medications was explicated by Jennings, Sandelowski, and Mark () in an ethnographic study of MA on two adult acute care units in a large community hospital. Following field observations and interviews, the authors concluded “the nurse's day was defined by medication administration” (p. 1442).…”