Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study

Abstract

BackgroundNurses experience insufficient medication knowledge; particularly in drug dose calculations, but also in drug management and pharmacology. The weak knowledge could be a result of deficiencies in the basic nursing education, or lack of continuing maintenance training during working years. The aim of this study was to compare the medication knowledge, certainty and risk of error between graduating bachelor students in nursing and experienced registered nurses.MethodsBachelor students in closing term and registered nurses with at least one year job experience underwent a multiple choice test in pharmacology, drug management and drug dose calculations: 3x14 questions with 3–4 alternative answers (score 0–42). Certainty of each answer was recorded with score 0–3, 0–1 indicating need for assistance. Risk of error was scored 1–3, where 3 expressed high risk: being certain that a wrong answer was correct. The results are presented as mean and (SD).ResultsParticipants were 243 graduating students (including 29 men), aged 28.2 (7.6) years, and 203 registered nurses (including 16 men), aged 42.0 (9.3) years and with a working experience of 12.4 years (9.2). The knowledge among the nurses was found to be superior to that of the students: 68.9%(8.0) and 61.5%(7.8) correct answers, respectively, (p < 0.001). The difference was largest in drug management and dose calculations. The improvement occurred during the first working year. The nurses expressed higher degree of certainty and the risk of error was lower, both overall and for each topic (p < 0.01). Low risk of error was associated with high knowledge and high sense of coping (p < 0.001).ConclusionsThe medication knowledge among experienced nurses was superior to bachelor students in nursing, but nevertheless insufficient. As much as 25% of the answers to the drug management questions would lead to high risk of error. More emphasis should be put into the basic nursing education and in the introduction to medication procedures in clinical practice to improve the nurses’ medication knowledge and reduce the risk of error.

Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication‐use system

“…Thus, work experience did not provide a significant advantage in terms of the ability to detect errors in the medication‐use system. However, several studies report that fewer medication errors were detected by more senior caregivers . However, Raurell‐Torredà et al observed that more experienced nurses committed more ‘rule‐based errors’, such as the absence of patient identification or absence of allergy verification, than did nursing students .…”

A comparison of the version 4 and version 5 service quality standards in terms of the medication safety in hospitals

“…Bu hatalar, yanlış ilaç veya doz, ilacın yanlış formunun kullanılması, yanlış zamanda uygulanması veya doz atlama şeklinde olabilir 30,31 .Bir çalışmada farklı kategoriler için hata oranları yanlış zamanda uygulama % 43; doz atlama % 30; yanlış doz % 17 ve izinsiz ilacın kullanımı % 4 olarak saptanmıştır 32 . Hataların oluşumunu ya da tekrarını önlemek için, düzenli olarak eğitimler verilmesi, bildiriminin yapılması, düzeltici çalışmaların planlanması ve izlenebilirliğin sağlanması gerekmektedir 33,34 . Çalışma ortamındaki stres ve uygunsuz çevresel faktörler de hatalara neden olabileceğinden, ortam şartları sağlıklı uygulama için uygun hale getirilmelidir 35,36 .…”

A dangerous lack of pharmacology education in medical and nursing schools: A policy statement from the American College of Clinical Pharmacology

“…Consequently, some medical schools have terminated pharmacology courses entirely and have gone solely to an organ‐based curriculum. Published studies have reported that undergraduate medical and nursing pharmacology training in other countries is insufficient as well.…”