Decision‐making processes used by nurses during intravenous drug preparation and administration

Abstract

Implications for practice included: exploring new and effective methods of education based on behavioural theories; involving staff in updating policies and procedures; formal assessment of staff during intravenous preparation and administration.

Nurses’ workarounds in acute healthcare settings: a scoping review

“…Empirical evidence on workarounds arises predominantly from studies conducted in acute care settings in the United States of America (USA) (n=29). The United Kingdom (UK) (n=8) [34-41], Australia (n=5) [42-46], The Netherlands (n=5) [47-51], Canada (n=3) [52-54], Japan (n=1) [55], Lebanon (n=1) [56] and Thailand (n=1) [57] also hosted studies examining workarounds. Additionally, four studies were conducted in both Canada and the USA [1,24,58,59] (Table 2).…”

“…Other justifications included a perception that rules and policies are not always in the best interest of the patient [36,42,66], the importance of customising care to the need of patients [4,6,42,72,84], patient isolation [4,68,84] and unavailability [6,34] and concern about the impact of adhering to policy on patients’ perceptions (e.g. wearing gowns, gloves and masks [57] and repeatedly checking patient identification [41]).…”

“…Psychological gratification and a heroic attitude about their ability and competence to creatively and persistently solve problems and care for their patients without having to depend on a colleague’s help, causes many nurses to workaround rather than employ second order problem solving [24]. Laziness offered by a participant is reported in one study as a contributor to circumventing a protocol [41]. However, evidence from the reviewed studies suggests that workaround behaviours reflect nurses’ attempts to deliver patient centred care when workflow processes make that difficult [48,49] and that they are more likely to bend the rules if distressed and when morale is low [43].…”

Applying Theory to Understand and Modify Nurse Intention to Adhere to Recommendations regarding the Use of Filter Needles: An Intervention Mapping Approach

“…In a context where nurses are largely responsible for the preparation and handling of parenteral medication in hospital settings [6, 18–20], it is important to work on their perceptions since these perceptions can influence their willingness to follow current recommendations on the issue [21], including the use of filter needles in their practice.…”

Medication errors in ED: Do patient characteristics and the environment influence the nature and frequency of medication errors?

“…8,[10][11][12][13][14][15][16][17][18] There was one prospective study identified through the literature review, this paper described the frequency of medication administration and prescription errors in ED. 13 It was identified that 60% of patients had one or more medication errors (178 errors in 192 patients) and 37% of medication errors reached the patient.…”