Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study

Abstract

Background Medication errors are a serious and complex problem in clinical practice, especially in intensive care units whose patients can suffer potentially very serious consequences because of the critical nature of their diseases and the pharmacotherapy programs implemented in these patients. The origins of these errors discussed in the literature are wide-ranging, although far-reaching variables are of particular special interest to those involved in training nurses. The main objective of this research was to study if the level of knowledge that critical-care nurses have about the use and administration of medications is related to the most common medication errors. Methods This was a mixed (multi-method) study with three phases that combined quantitative and qualitative techniques. In phase 1 patient medical records were reviewed; phase 2 consisted of an interview with a focus group; and an ad hoc questionnaire was carried out in phase 3. Results The global medication error index was 1.93%. The main risk areas were errors in the interval of administration of antibiotics (8.15% error rate); high-risk medication dilution, concentration, and infusion-rate errors (2.94% error rate); and errors in the administration of medications via nasogastric tubes (11.16% error rate). Conclusions Nurses have a low level of knowledge of the drugs they use the most and with which a greater number of medication errors are committed in the ICU. Electronic supplementary material The online version of this article (10.1186/s12913-019-4481-7) contains supplementary material, which is available to authorized users.

Medication errors and risk areas in a critical care unit

“…From the observation of the same sample during the same time space, two differentiated analyzes were carried out with different purposes that gave rise to two investigations. When studying medication errors in the same context, although from different perspectives, part of the results of this paper coincide with the paper entitled: "Medication errors and drug knowledge gaps among critical‐care nurses: a mixed multi‐method study", published in Escrivá Gracia et al (2019); especially the more general results and those referring to the socio‐demographic characteristics of the study population; being carried out indistinctly in this paper a greater pharmacological analysis of the medication errors, focused on the active principles, pharmaceutical forms, routes of administration, errors and causes of error, as well as the typology of error and drugs involved in the main areas of risk detected. [Correction added on 3 December 2020 after first online publication: This section was added with the accompanying reference (Escrivá Gracia et al, 2019) to explain the overlap between the two papers.…”

Evaluating the relationship between information literacy and evidence-based nursing and their impact on knowledge and attitude of nurses working in hospitals affiliated to Kerman University of Medical Sciences on medication errors

“…Accordingly, before they work in real situations of care, nursing students should have adequate competencies regarding medication safety. [ 5 ] However, research shows that nursing students are still at risk of taking medication. [ 6 ] The first step in preventing medication errors is identifying the factors that prevent increasing medication errors.…”

Nurses’ Compliance about Patient Safety in Improving Drug Safety as an Effort to Reduce Medication Error: A Literature Review

“…The main objective of this research was to study if the level of knowledge that critical-care nurses have about the use and administration of medications is related to the most common medication errors. (Gracia et al, 2019). Therefore, to improve the quality of patient safety services at the unit level, efforts must be made to change the nurse's compliance about patient safety in improving drug safety as an effort to reduce medication errors in all hospital units.…”

“…because of the critical nature of their diseases and the pharmacotherapy programs implemented in these patients (Gracia et al, 2019). Patient safety is also an attribute of healthcare systems.…”