Medication errors in intensive care units: nurses’ training needs

Simone, Emanuele Di; Tartaglini, Daniela; Fiorini, Simona; Petriglieri, Simona; Plocco, Carolina; Muzio, Marco Di

doi:10.7748/en.2016.11577

Cited by 25 publications

(25 citation statements)

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“…Environmental factors include noises, interruptions, and disorder. 29 Drug preparation in the adult ICU was performed on a dedicated bedside table on the ward, while the preparation in the NICU/PICU was performed in a separate room with an LAF. Both settings were affected by interruptions and the lack of preparation space.…”

Section: Discussionmentioning

confidence: 99%

<p>Evaluation to improve the quality of medication preparation and administration in pediatric and adult intensive care units</p>

Hermanspann¹,

Linden²,

Schoberer³

et al. 2019

DHPS

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Purpose: To determine the type, frequency, and factors associated with medication preparation and administration errors in adult intensive care units (ICUs) and neonatal ICUs (NICUs)/ pediatric ICUs (PICUs). Patients and methods: We conducted a prospective direct observation study in an adult ICU and NICU/PICU in a tertiary university hospital. Between June 2012 and June 2013, a clinical pharmacist and medical student observed the nursing care staff on weekdays during the preparation and administration of intravenous drugs. We analyzed the frequency and type of preparation and administration errors and factors associated with errors. Results: Six hundred and three preparations in the adult ICU and 281 in the NICU/PICU were observed. Three hundred and eighty-five errors occurred in the adult ICU and 38 in the NICU/ PICU. There were 5,040 and 2,514 error opportunities, with overall error rates of 7.6% and 1.5%, respectively. The total opportunities for error meant each single step of preparation and administration that was relevant for the drug. Most errors applied to the category "uniform mixing" (adult ICU: n=227, 59%; NICU/PICU: n=14, 37%). The multivariate logistic regression results showed a significantly different influence of the "preparation type" for the adult ICU compared with the NICU/PICU with regard to the occurrence of an error. Preparations for adult patients of the LCD type (liquid concentrate with diluent into syringe or infusion bag) were more often associated with errors than the P (powder in a glass vial that must be reconstituted and diluted if necessary), P=0.012, and LC (liquid concentrate into syringe), P=0.002 type. Conclusion: "Uniform mixing" was the most erroneous preparation step in intravenous drug preparations in two ICUs. Improvement of nurse training and the preparation of prefilled syringes in the pharmacy might reduce errors and improve the quality and safety of drug therapy.

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Section: Discussionmentioning

confidence: 99%

<p>Evaluation to improve the quality of medication preparation and administration in pediatric and adult intensive care units</p>

Hermanspann¹,

Linden²,

Schoberer³

et al. 2019

DHPS

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“…Yet this strategy is perceived as suitable with regard to patient safety and is also recommended by the AHRQ (AHRQ, 2018). The importance of this aspect was also shown in a survey by Di Simone et al (2016). Respondents perceived training of new colleagues as a high-risk area.…”

Section: Discussionmentioning

confidence: 84%

“…Di Simone et al (2016) reported elements of nurses' knowledge, training, behavior and attitude potentially preventing medication errors in ICUs during administration of intravenous drugs. They concluded that the prerequisite for proper administration of drugs and evaluation of their effects is pharmacological knowledge.…”

Section: Resultsmentioning

confidence: 99%

Measures to prevent medication errors in intensive care units

Plutínská

Plevová

2019

Cent Eur J Nurs Midw

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Aim: The aims were to summarize studies on the effectiveness of interventions to reduce adverse events of the medication error type and, based on the studies, to identify recommendations for preventing medication errors in intensive care units (ICUs). Design: A descriptive review. Methods: To find relevant resources, the SCOPUS and EBSCO electronic databases were searched using the following search words: prevention, medication errors, intensive care unit. Both primary and secondary studies on prevention of medication errors in ICUs were selected. Results: A total of eight primary studies and three systematic reviews were included. The studies showed considerable variability and differed in methods, numbers of monitored events or ways of data collection. The assessed interventions were pharmacist involvement, automated infusion devices, reporting medication errors, strategies to limit interruptions during drug administration, electronic health records together with support systems for clinical decision making, nurse education in drug administration and creating checklists. Conclusion: The assessment of selected studies suggests that to a certain extent, all of them showed certain medication error reduction. Due to numerous limitations, however, it is impossible to select and recommend a single approach.

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“…Other strategies have demonstrated to prevent ME based on implementing tools for guiding medication use and encouraging patient care by a multidisciplinary team. (Berdot et al, 2016;De Araújo et al, 2019;Di Simone et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Medication errors in prescription and administration in critically ill patients

Suclupe

Martinez-Zapata

Mancebo

et al. 2020

Journal of Advanced Nursing

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Aim To determine the prevalence and magnitude of medication errors and their association with patients' sociodemographic and clinical characteristics and nurses' work conditions. Design An observational, analytical, cross‐sectional and ambispective study was conducted in critically ill adult patients. Methods Data concerning prescription errors were collected retrospectively from medical records and administration errors were identified through direct observation of nurses during drug administration. Those data were collected between April and July 2015. Results A total of 650 prescription errors were identified for 961 drugs in 90 patients (mean error 7[SD 4.1] per patient) and prevalence of 47.1% (95% CI 44–50). The most frequent error was omission of the prescribed medication. Intensive care unit stay was a risk factor associated with omission error (OR 2.14; 1.46–3.14: p < .01). A total of 294 administration errors were identified for 249 drugs in 52 patients (mean error 6 [SD 6.7] per patient) and prevalence of 73.5% (95% CI 68–79). The most frequent error was interruption during drug administration. Admission to the intensive care unit (OR 0.37; 0.21–0.66: p < .01), nurses’ morning shift (OR 2.15; 1.10–4.18: p = .02) and workload perception (OR 3.64; 2.09–6.35: p < .01) were risk factors associated with interruption. Conclusions Medication errors in prescription and administration were frequent. Timely detection of errors and promotion of a medication safety culture are necessary to reduce them and ensure the quality of care in critically ill patients. Impact Medication errors occur frequently in the intensive care unit but are not always identified. Due to the vulnerability of seriously ill patients and the specialized care they require, an error can result in serious adverse events. The study shows that medication errors in prescription and administration are recurrent but preventable. These findings contribute to promote awareness in the proper use of medications and guarantee the quality of nursing care.

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Medication errors in intensive care units: nurses’ training needs

Cited by 25 publications

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<p>Evaluation to improve the quality of medication preparation and administration in pediatric and adult intensive care units</p>

<p>Evaluation to improve the quality of medication preparation and administration in pediatric and adult intensive care units</p>

Measures to prevent medication errors in intensive care units

Medication errors in prescription and administration in critically ill patients

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