Medication administration errors and related deviations from safe practice: an observational study

Blignaut, Alwiena Johanna; Coetzee, Siedine K.; Klopper, Hester C.; Ellis, Suria

doi:10.1111/jocn.13732

Cited by 39 publications

(43 citation statements)

References 37 publications

(99 reference statements)

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“…The wrong time error finding was the most prevalent during observation of nurses administering medications in the current study. This finding compares closely with most MAEs studies done in similar settings including Alemu, Belachew & Yimam (2017), who reported that failure to administer medications at the right time was the second most commonly perpetrated incident [26], while a similar study in south Africa found that the most common types of errors were wrong-time errors at 43% and errors of omission at 41%, followed by wrong-dose errors 12% [10].…”

Section: Discussionsupporting

confidence: 85%

“…Tool 2: Nurses' medication administration errors observation checklist, was developed by the researchers after thorough review of related literature [5,10,[16][17][18][19][20][21]. The tool aimed to observe medication administration errors committed during the medication administration process by nurses in the medical and surgical units of the hospital.…”

Section: Methodsmentioning

confidence: 99%

“…Studies on MAE rates and safety have mostly been carried out in developed countries with varying reported incidences of 3.3%, 10%, 19.5% and 22.2% [5][6][7][8]. Recently, however, studies from developing countries have found very high MAE rates of 56.4% [9] and 94% [10]. Consequently, context-specific studies on the occurrence of MAEs and related factors like patient characteristics, bed occupancy, staffing levels, nurses' qualifications, dose calculation abilities, level of hospital, unit specialties, medication administration route and interruptions, within the continent of Africa is missing [10].…”

Section: Introductionmentioning

confidence: 99%

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Nurses’ Medication Administration Errors at Medical Surgical Units

Simiyu¹

2018

AJNS

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Medication administration errors (MAEs) are among the key concepts of patient safety in clinical care settings that have long been the focus of study and exploration because they contribute directly to patient injury, death and health care costs. Medication errors are recurrent and expected to be a prolonged problem in the health care system. The administration of medication is predominantly an important part of nursing practice that has a dimension of quality of care and organizational performance. The study sought to assess nurses' medication administration errors at the general medical and surgical units. A descriptive cross sectional study design was used where stratified random sampling using the medical and surgical units as strata was used to proportionately recruit 100 Nurses. Each nurse was further observed twice during medication administration process making a total of 200 observations included in the study. Two tools were used to collect data for the current study. The interviewer administered medication administration errors questionnaire and a concealed medication administration observation checklist. Data was collected for a period of four months and analyzed using descriptive and inferential statistics to check for relations between variables. The study findings imply that the wrong rate of administration, the wrong time of administration and medication being administered after the order to discontinue was written were the highly perceived MAEs reported respectively as occurring 'most of the time' by 27%, 23% and 15% of the studied nurses. For observed MAEs, the wrong time error type had the highest estimated error rate of 51%, followed by the documentation error at 29% and technique error at 27.5%. There was statistical significant difference between the pharmacy reasons subscale of causes of MAEs and the age (F= 5.465, p=0.006), clinical experience (F=3.922, p=0.011) and type of shift (F=2.507, p=0.035) the nurse works most. Further, there was statistically significant mean differences between the medical and surgical units with regard to the medication packaging subscale (t=4.160, p=0.044). The findings also revealed negative significant correlation between the observed MAEs scores and the nurses' reported scores on types of IV & non-IV MAEs (r s =-0.266, p=0.007) and the pharmacy reasons subscale (r s =-0.266, p=0.046). Updating, developing, disseminating and implementing medication administration guidelines and protocols in the hospital settings is required. Nurses have to embrace the occurrence of MAEs as a patient safety indicator that should be viewed as an opportunity to learn and prevent MAEs through rationalized medication management protocols and guidelines.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nurses’ Medication Administration Errors at Medical Surgical Units

Simiyu¹

2018

AJNS

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“…No studies were identified that specifically reported transcribing errors, dispensing errors and medication history errors. Most studies (12/36) were conducted in Nigeria and 8 studies [ 55 , 60 , 62 , 67 – 69 , 74 , 78 ] were conducted in a multicentre setting. Five studies [ 50 , 52 , 56 , 65 , 79 ] were solely conducted in a paediatric ward and one study [ 73 ] in an obstetric ward.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies [ 57 – 59 , 61 , 62 , 65 , 66 , 68 ] calculated medication administration error rate. A study by Amucheazi and Ajuzieogu [ 61 ] analysed only a single component of the medication administration procedure in an anaesthetic department, with incorrect drug administration reported in 0.5% of elective surgical procedures.…”

Section: Resultsmentioning

confidence: 99%

Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review

Mekonnen

Alhawassi

McLachlan

et al. 2017

Drugs - Real World Outcomes

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BackgroundMedication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear.ObjectiveThe objective of this study was to systematically investigate the literature on the extent of medication errors and adverse drug events, and the factors contributing to medication errors in African hospitals.MethodsWe searched PubMed, MEDLINE, EMBASE, Web of Science and Global Health databases from inception to 31 August, 2017 and hand searched the reference lists of included studies. Original research studies of any design published in English that investigated adverse drug events and/or medication errors in any patient population in the hospital setting in Africa were included. Descriptive statistics including median and interquartile range were presented.ResultsFifty-one studies were included; of these, 33 focused on medication errors, 15 on adverse drug events, and three studies focused on medication errors and adverse drug events. These studies were conducted in nine (of the 54) African countries. In any patient population, the median (interquartile range) percentage of patients reported to have experienced any suspected adverse drug event at hospital admission was 8.4% (4.5–20.1%), while adverse drug events causing admission were reported in 2.8% (0.7–6.4%) of patients but it was reported that a median of 43.5% (20.0–47.0%) of the adverse drug events were deemed preventable. Similarly, the median mortality rate attributed to adverse drug events was reported to be 0.1% (interquartile range 0.0–0.3%). The most commonly reported types of medication errors were prescribing errors, occurring in a median of 57.4% (interquartile range 22.8–72.8%) of all prescriptions and a median of 15.5% (interquartile range 7.5–50.6%) of the prescriptions evaluated had dosing problems. Major contributing factors for medication errors reported in these studies were individual practitioner factors (e.g. fatigue and inadequate knowledge/training) and environmental factors, such as workplace distraction and high workload.Conclusion Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors.Electronic supplementary materialThe online version of this article (10.1007/s40801-017-0125-6) contains supplementary material, which is available to authorized users.

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Medication‐related incidents at 19 hospitals: A retrospective register study using incident reports

2020

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Aim To examine (a) when medication incidents occur and which type is most frequent; (b) consequences for patients; (c) incident reporters’ perceptions of causes; and (d) professional categories reporting the incidents. Design A descriptive multicentre register study. Methods This study included 775 medication incident reports from 19 Swedish hospitals during 2016–2017. From the 775 reports, 128 were chosen to establish the third aim. Incidents were classified and analysed statistically. Perceived causes of incidents were analysed using content analysis. Results Incidents occurred as often in prescribing as in administering. Wrong dose was the most common error, followed by missed dose and lack of prescription. Most incidents did not harm the patients. Errors in administering reached the patients more often than errors in prescribing. The most frequently perceived causes were shortcomings in knowledge, skills and abilities, followed by workload. Most medication incidents were reported by nurses.

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Medication administration errors and related deviations from safe practice: an observational study

Abstract: Factors associated with wrong-time errors and omissions should be addressed. Patient identification and asepsis protocols should be adhered to. Dosage calculation training is indicated.

Cited by 39 publications

References 37 publications

Nurses’ Medication Administration Errors at Medical Surgical Units

Nurses’ Medication Administration Errors at Medical Surgical Units

Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review

Medication‐related incidents at 19 hospitals: A retrospective register study using incident reports

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