Investigation of interventions to reduce nurses’ medication errors in adult intensive care units: A systematic review

Mohanna, Zamzam; Kusljic, Snezana; Jarden, Rebecca

doi:10.1016/j.aucc.2021.05.012

Cited by 8 publications

(3 citation statements)

References 54 publications

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“…In addition, factors such as low nurse/patient ratio, excessive workload and fatigue due to overwork were stated to be among the most important factors affecting the incidence of medication errors (36). Similarly, in another study, nurses' knowledge, attention and workload were listed among the most frequently identified causes of medication errors (37). The International Labor Organization (ILO) has recommended that nurses should not work more than 8 hours per day and 40 hours per week (38).…”

Section: Discussionmentioning

confidence: 93%

Hemşi̇releri̇n İlaç Hatalarinin Nedenleri̇ne İli̇şki̇n Algilari Ve Hata Nedenleri̇ni̇ Bi̇ldi̇rmeme Sebepleri̇ni̇n İncelenmesi̇

Bayer

Gölbaşı

Zor

et al. 2022

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Çalışma hemşirelerin ilaç hatalarının nedenlerine yönelik algıları ve hata nedenlerini bildirmeme sebeplerinin incelenmesi amacıyla yapılmıştır. Araştırma Ankara’da Şehir hastanelerinin Çocuk Hastanesi biriminde yapılmış tanımlayıcı bir çalışmadır. Araştırma verileri Haziran-Temmuz 2021 tarihleri arasında toplanmıştır. Araştırmada evreni bilinen örneklem yöntemi kullanılmış ve çalışmaya 287 hemşire katılmıştır. Veriler İlaç Uygulama Hatası Ölçeği ile toplanmıştır. Verilerin analizinde Mann Whitney U testi, Kruskal-Wallis Varyans analizi, basit ve çoklu regresyon analizi kullanılmıştır. Hemşirelerin ilaç uygulama hatalarının oluşma nedenlerine yönelik algıları ve hata bildirimi yapılmama nedenlerinin yönelik algı düzeyleri ölçek toplam puanları ortalamanın üzerinde bulunmuştur. Hemşirelerin ilaç hatası bildirilmeme nedenleri hata oluşma nedenlerini %26,5’ni açıklamaktayken (β=0,517) hata üzerinde anlaşmazlık puanının %30,6’sını açıklamaktadır (β=0,555). Yönetici hemşirelerde ilaç hatalarına yönelik algılar ve hataları bildirmeme düzeyleri servis hemşirelerinden daha düşüktür. Vardiya usulü çalışanların Hata oluşumuna yatkınlık puan ortalaması sürekli gündüz-sürekli gece çalışanların ortalamasından daha yüksektir. İlaç hatalarının nasıl oluştuğu ve hatanın tanımı hemşirelerin ilaç hatası bildirilmeme nedenleri üzerinde etkilidir. Çalışma pozisyonu, ilaç hataları ve bildirilmeme düzeylerini etkilerken çalışma periyotları hata oluşumuna yatkınlığı artırmaktadır.

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Section: Discussionmentioning

confidence: 93%

Hemşi̇releri̇n İlaç Hatalarinin Nedenleri̇ne İli̇şki̇n Algilari Ve Hata Nedenleri̇ni̇ Bi̇ldi̇rmeme Sebepleri̇ni̇n İncelenmesi̇

Bayer

Gölbaşı

Zor

et al. 2022

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“…MAEs are the most common clinical error in ICUs with an average of 1.7 daily errors of which 78% are considered serious clinical errors 15 . In ICUs, MAEs are more likely to cause harm as patient acuity is high and patient often have altered mentation 14,16 . Paediatric and neonatal patients are three times more likely to be affected by MEs than adults 7 .…”

Section: Introductionmentioning

confidence: 99%

“…15 In ICUs, MAEs are more likely to cause harm as patient acuity is high and patient often have altered mentation. 14,16 Paediatric and neonatal patients are three times more likely to be affected by MEs than adults. 7 Higher error rates are evident during the prescribing and administration stages.…”

Section: Introductionmentioning

confidence: 99%

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel

Dick‐Smith,

Fry,

Salter

et al. 2023

Nursing in Critical Care

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BackgroundIntensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the ‘5 rights’). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety.AimsTo identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel).Study DesignA dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56‐bedded adult intensive care unit and a 6‐bedded neonatal intensive care unit in Sydney, Australia.Incident monitoring data were examined. Direct semi‐covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel.ResultsNo medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the ‘5 rights’ and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling.ConclusionsThis study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses.Relevance to clinical practiceThis novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling.

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Targeting zero medication administration errors in the pediatric intensive care unit: A Quality Improvement project

Ghezaywi,

Alali,

Kazzaz

et al. 2024

Intensive and Critical Care Nursing

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Investigation of interventions to reduce nurses’ medication errors in adult intensive care units: A systematic review

Cited by 8 publications

References 54 publications

Hemşi̇releri̇n İlaç Hatalarinin Nedenleri̇ne İli̇şki̇n Algilari Ve Hata Nedenleri̇ni̇ Bi̇ldi̇rmeme Sebepleri̇ni̇n İncelenmesi̇

Hemşi̇releri̇n İlaç Hatalarinin Nedenleri̇ne İli̇şki̇n Algilari Ve Hata Nedenleri̇ni̇ Bi̇ldi̇rmeme Sebepleri̇ni̇n İncelenmesi̇

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel

Targeting zero medication administration errors in the pediatric intensive care unit: A Quality Improvement project

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