Background: Health care services are associated with risks for their recipients. Medication errors can lead to many negative consequences for the health care system, including prolonged hospital stay and increased cost per patient. The aim of this study was to investigate the nursing staff's perspective regarding reasons for medication errors in Ayatollah Kashani hospital, Shahrekord, Iran. Methods: 207 nurses working in the ICUs of the hospital were selected by convenience sampling and their comments about effective factors in the incidence of medication errors were investigated by a researcher-made questionnaire. To examine the reliability and validity of the questionnaire, we offered it to 5 nursing experts and necessary corrections were made based on the comments. The reliability of the questionnaire was also investigated by Cronbach's alpha coefficient that gave the value of 85%. The first section of the questionnaire consisted of questions about demographic characteristics and the second section investigated the reasons for medication errors in nursing-related area, workplace-related area, director of nursing-related area, and drug-related area. For each item, there were four choices, i.e. none, little, moderate, and much and therefore, the level of importance scored between 0 and 3. The data were analyzed by SPSS 17. Results: In this study, the most important reasons for medication errors were related to workload-induced fatigue (mean: 2.37) in the nurses-related area, high labor-intensity in department (mean: 2.32) in the workplace-related area, insufficient nursing staff proportional to the number of patients in department (mean: 2.41) in the director of nursing-related area, and drug name confusion in the drug-related area (mean: 2.04). Conclusions:The officials of health care systems should focus on the effective processes in reducing medication errors including appropriate training of the staff and holding in-service training sessions about drug information as well as appropriate planning for employment of adequate workforce.
Background Decision making regarding the treatment of neonates with poor prognoses is difficult for healthcare staff working in the neonatal intensive care unit (NICU). This study aimed to investigate the attitudes of physicians and nurses about the value of life and ethical decision making when encountering neonates with poor prognosis in the NICU. Methods This cross-sectional study was conducted in five NICUs of five hospitals in Tehran city, Iran. The attitudes of 144 pediatricians, gynecologists and nurses were assessed using the questionnaire of attitude toward the value of life and agreement on intensive care management based on three hypothetical case scenarios of neonates with poor prognosis. Data were analyzed using descriptive and inferential statistics via the SPSS software. Results The negative agreement on the no initiation of intensive care measures and the discontinuation of resuscitation in neonates with poor prognosis was more than the positive agreement. Also, various factors influenced the participants’ decision making for the provision of care to neonates. Regarding the case scenarios, the participants agreed on the provision of aggressive, conservative, and palliative care with various frequencies. This study confirms the importance of healthcare providers’ perspectives and their impacts on ethical decision making. The participants favored the value or sacredness of life and agreed on the use of all therapeutic measures for saving the lives of neonates with poor prognosis. Conclusion More studies are required to improve our understandings of factors influencing ethical decision making by healthcare providers when encountering neonates with poor prognosis in NICUs.
Introduction: Decision making regarding the treatment of neonates with poor prognoses is difficult for healthcare staff working in the neonatal intensive care unit (NICU). This study aimed to investigate the attitude of physicians and nurses towards the value of life and ethical decision making when encountering neonates with poor prognosis in the NICU. Methods: A cross-sectional study was conducted in 2016. This study was carried out in five NICUs of five hospitals in Tehran city, Iran. The perspectives of 144 paediatricians, gynaecologist and nurses were assessed using the questionnaire of attitude toward the value of life and agreement on intensive care management on three hypothetical cases scenarios of neonates with poor prognosis. Data was analysed using descriptive and inferential statistics. Results: The negative agreement on the no initiation of intensive care measures and the discontinuation of resuscitation in neonates with poor prognosis was more than the positive agreement. Also, various factors influenced the participants’ decision making for the provision of care to neonates. Regarding the case scenarios, the participants agreed on the provision of aggressive, conservative, and palliative care with various frequencies. This study confirms the importance of healthcare providers’ perspectives and their impacts on ethical decision making. The participants in this study favoured the value or sacredness of life and agreed on the use of all therapeutic measures for neonates with poor prognosis. Conclusion: More studies are required to improve our understandings of factors influencing ethical decision makings by healthcare providers when encountering neonates with poor prognosis in NICUs. Key words: Decision making, ethics, neonatal intensive care unit, poor prognosis, value of life
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