Medication administration – nursing workload and patient safety in clinical wards

Magalhães, Ana María Müller de; Kreling, Angélica; Chaves, Enaura Helena Brandão; Pasin, Simone Silveira; Castilho, Bárbara Motta

doi:10.1590/0034-7167-2018-0618

Cited by 19 publications

(19 citation statements)

References 18 publications

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“…In critical environments, the quality of nursing care and patient safety depend not only on professionals' qualifications, but also on the availability of appropriate amounts of human and material resources (Magalhães, Kreling, Chaves, Pasin, & Castilho, 2019). Nonetheless, Brazilian healthcare services, especially public facilities, have faced great shortages of resources, hindering work organisation to meet existing demand.…”

Section: Discussionmentioning

confidence: 99%

Adherence to hand hygiene in critical sectors: Can we go on like this?

Bezerra

Valim

Bortolini

et al. 2020

Journal of Clinical Nursing

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Aims and objectives The rates of healthcare‐associated infections are high around the world. Hand hygiene is considered the most effective measure to reduce the transmission of pathogens in the hospital environment. Our objective was to evaluate adherence to hand hygiene in critical units of a tertiary‐level hospital in Central‐West Brazil. Design Observational study employing cross‐sectional data. Reporting rigour was demonstrated using the STROBE checklist. Methods Observation of hand hygiene practices of 129 professionals from the health team, including nursing staff, physicians and physical therapists. Data collection was carried out using the World Health Organization form. Results A total of 3,025 hand hygiene opportunities were observed, and the overall rate of adherence was only 46.25%. There was a greater frequency of hand hygiene after risk of exposure to bodily fluids and after contact with patients, 60.80% and 53.45%, respectively. Nurses obtained a higher rate of adherence to hand hygiene (59.80%). The neonatal ICU had a higher rate of adherence to hand hygiene when compared to other sectors. Conclusions The physical structure for hand hygiene in the institution was poor, and no professionals reached the minimum time required for execution of hand hygiene techniques. There were low rates of adherence to hand hygiene by professionals at all five times and in all categories and sectors observed, which may have been influenced by poor infrastructure present in the institution. Relevance to clinical practice This study is of great relevance to patient safety, given the rates of healthcare‐associated infections worldwide, with emphasis on underdeveloped countries. It is hoped that the results of this research can guide organisations to validly and systematically evaluate adherence to hand hygiene and achieve higher rates of adherence to hand hygiene and consequently reduce the number of infections in health environments.

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Section: Discussionmentioning

confidence: 99%

Adherence to hand hygiene in critical sectors: Can we go on like this?

Bezerra

Valim

Bortolini

et al. 2020

Journal of Clinical Nursing

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“…they assess the existing risk factors as very signi cant. An analysis of individual elements of the risk matrix reveals that nurses from Slovakia most often, that is for 6 out of 9 risk factors (items: 1, 5, 6, 7, 8, 9) assessed them as "signi cant risk (3)", whereas Polish nurses most often, that is for as many as 8 out of 9 risk factors (items: 1, 2, 3, 4, 5,6,7,9) assessed risk factors as "very signi cant (5)". Signi cant differences (p<0.05) were demonstrated in 8 (out of 9) risk factors.…”

Section: Results Of the Nuriph Risk Matrixmentioning

confidence: 99%

Patient safety in the process of pharmacotherapy carried out by nurses – A Polish-Slovak prospective observational study

Witczak¹,

Rypicz²,

Šupínová

et al. 2021

Preprint

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Aim This study was aimed at the determination and comparison of safety levels at the nurse-managed stage of the pharmacotherapy process in Poland and Slovakia by identifying the key risk factors which directly affect patient safety. Background/Introduction: Pharmacotherapy, i.e. the use of medicines for combating a disease or its symptoms, is one of the crucial elements of patient care. Studies carried out with regard to nursing workloads in the pharmacotherapy process prove that nurses spend 40% of their work on the management of medications. Medicine administration is the most frequent task of all nursing activities, and there is a possibility of committing errors at this stage due to the complex and multifaceted nature of the pharmacotherapy process. Methods The study involved a group of 1774 nurses, of whom 1412 were from Poland and 362 from Slovakia. The original Nursing Risk in Pharmacotherapy (NURIPH) tool was used. The Cronbach alpha coefficient was 0.832. Results Nurses from Slovakia most often, i.e. for 6 out of 9 factors (items: 1, 5, 6, 7, 8, 9), assessed the risk factors as “significant risk (3)”, and Polish nurses most often, i.e. for as many as 8 out of 9 risk factors (items: 1, 2, 3, 4, 5, 6, 7, 9), assessed the risk factors as “very significant (5)”. Significant differences (p < 0.05) were demonstrated in 8 (out of 9) risk factors. Conclusions The pharmacotherapy process implemented by nurses, regardless of the country, is burdened with a considerable number of risk factors and it might negatively affect patient safety. It has been found that the safety of the pharmacotherapy process is assessed by Polish nurses as much lower than by Slovak ones. Training activities in the field of adverse events, adverse reactions to medications and appropriate and effective communication should be introduced for all members of the medical staff involved in the pharmacotherapy process.

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“…For example, we adapted participatory visual methods from the field of restoration science (Higgs, 2003) to conduct practitioner-led photo walkabouts and communal photo elicitation sessions that support researchers and study participants to jointly explore and exchange knowledge about safe practices and safety problems in healthcare environments (Marck, 2006;Magalhães et al, 2013;Backman et al, 2012;Parke et al, 2013;Magalhães et al, 2019).…”

Section: Study Theorymentioning

confidence: 99%

Safety culture in healthcare: mixed method study

Lorenzini

Oelke

Marck

2021

JHOM

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PurposeHealthcare providers’ perceptions of management's effectiveness in achieving safety culture improvements are low, and there is little information in the literature on the subject. Objective: The overall aim of this study was to examine the patient safety culture within an interprofessional team – physicians, nurses, nurse technicians, speech therapist, psychologist, social worker, administrative support – practicing in an advanced neurology and neurosurgery center in Southern Brazil.Design/methodology/approachThe authors applied the safety attitudes questionnaire (SAQ) in a mixed methods study, with a quan→QUAL sequential explanatory approach.FindingsIn the quantitative phase, the authors found a negative safety climate through the SAQ. In the qualitative phase, the approach enabled participants to identify specific safety problems. For that, participants proposed improvements that were directly and quickly implemented in the workplace during the study. The joint analysis of the quantitative and qualitative data inferred that the information and reflections of the focus group participants supported and validated the SAQ statistical analysis results. This integrated approach illustrated the importance of various safety culture aspects as a multifaceted phenomenon related to healthcare quality.Originality/valueThis study provides explanations for why management is associated negatively with safety climate in healthcare institutions. In addition, the study provides a novel contribution adding value to mixed methods research methodology.

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Medication administration – nursing workload and patient safety in clinical wards

Cited by 19 publications

References 18 publications

Adherence to hand hygiene in critical sectors: Can we go on like this?

Adherence to hand hygiene in critical sectors: Can we go on like this?

Patient safety in the process of pharmacotherapy carried out by nurses – A Polish-Slovak prospective observational study

Safety culture in healthcare: mixed method study

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