A cross-sectional study of the knowledge, skills, and 6 rights on medication administration by nurses at emergency department
https://doi.org/10.4081/hls.2023.11177
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Introduction: Medication errors occur when a patient is given the wrong drug or receives incorrect pharmacological therapy. Incorrect drug administration can cause fatal errors resulting in the patient’s death. Approximately 44,000-98,000 patients die each year due to medication errors and this condition is found often in the Emergency Room (ER) due to the complexity. Therefore, this study aims to analyze the relationship between nurses’ knowledge, skills, and 6 rights on medication at Emergency Department.
Design and Methods: This is an analytical observational study involving 70 nurses randomly selected using consecutive sampling and working at the ER department of Saiful Anwar Hospital Malang. Data were collected through a questionnaire and analyzed descriptively to determine the knowledge and skills of nurses and the implementation of the correct principles of medication administration.
Results: The results showed that most of the emergency room nurses had good knowledge and skills in applying the correct principles of medicine. However, the majority could not calculate the drug dose accurately. The spearman rank results showed that there was a relationship between knowledge and the 6 correct drug principles (p<0.001, α= 0,05; r = 0.491) with a percentage of 44%. This indicates that a higher knowledge results in the correct implementation of the drug. Similarly, there was a significant positive correlation between skills and proper medicine (p<0.001, α= 0,05; r = 0.378).
Conclusions: It can be inferred that a higher nurse’s knowledge and skill results in a better administration of medicine.
Shitu Z, Aung MMT, Tuan Kamauzaman TH, et al. Prevalence and characteristics of medication errors at an emergency department of a teaching hospital in Malaysia. BMC Health Serv Res 2020;20:1–8. DOI: https://doi.org/10.1186/s12913-020-4921-4
Escrivá Gracia J, Brage Serrano R, Fernández Garrido J. Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Serv Res 2019;19:1–10. DOI: https://doi.org/10.1186/s12913-019-4481-7
Sutherland A, Canobbio M, Clarke J, et al. Incidence and prevalence of intravenous medication errors in the UK: A systematic review. Eur J Hosp Pharm 2020;27:3–8. DOI: https://doi.org/10.1136/ejhpharm-2018-001624
Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016;353:1–5. DOI: https://doi.org/10.1136/bmj.i2139
Bagheri Nesami M, Esmaeili R, Tajari M. Intravenous Medication Administration Errors and their Causes in Cardiac Critical Care Units in Iran. Mater Socio Medica 2015;27:442. DOI: https://doi.org/10.5455/msm.2015.27.442-446
Al worafi YM. Medication Errors [Internet]. Vol. 48, Nursing. New York: Elsevier B.V.; 2020. 59–71 p. DOI: https://doi.org/10.1016/B978-0-12-819837-7.00006-6
Basil JH, Wong JN, Zaihan AF, et al. Intravenous medication errors in Selangor, Malaysia: prevalence, contributing factors, and potential clinical outcomes. Drugs Ther Perspect 2019;35:381–90. DOI: https://doi.org/10.1007/s40267-019-00633-9
Salman M, Mustafa ZU, Rao AZ, et al. Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey. Front Pharmacol 2020;11:1–7. DOI: https://doi.org/10.3389/fphar.2020.01026
Mekonen EG, Gebrie MH, Jemberie SM. The magnitude and associated factors of medication administration error among nurses working in Amhara Region Referral Hospitals, Northwest Ethiopia. J Drug Assess 2020;9:151–8. DOI: https://doi.org/10.1080/21556660.2020.1841495
Bakhshi F, Mitchell R, Nikbakht Nasrabadi A, et al. Clinician attitude towards safety in medication management: a participatory action study in an emergency department. BMJ Open 2021;11:e047089. DOI: https://doi.org/10.1136/bmjopen-2020-047089
Rodziewicz TL, Houseman B, Hipskind JE. Medical Error Reduction and Prevention. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499956/
Westbrook JI, Raban MZ, Walter SR, et al. Task errors by emergency physicians are associated with interruptions, multitasking, fatigue, and working memory capacity: A prospective, direct observation study. BMJ Qual Saf. 2018;27(8):655–63. DOI: https://doi.org/10.1136/bmjqs-2017-007333
Cabilan C, Hughes J, Shannon C. The use of a contextual, modal, and psychological classification of medication errors in the emergency department: a retrospective descriptive study. Int J Lab Hematol 2016;38:42–9.
Hsieh MC, Chiang PY, Lee YC, et al. An Investigation of Human Errors in Medication Adverse Event Improvement Priority Using a Hybrid Approach. Healthcare (Basel) 2021;9:442. DOI: https://doi.org/10.3390/healthcare9040442
Lee SH, Phan PH, Dorman T, et al. Handoffs, safety culture, and practices: Evidence from the hospital survey on patient safety culture. BMC Health Serv Res 2016;16:1–8. DOI: https://doi.org/10.1186/s12913-016-1502-7
Wolf ZR, Hughes RG. Best Practices to Decrease Infusion-Associated Medication Errors. J Infus Nurs 2019;42:183–92. DOI: https://doi.org/10.1097/NAN.0000000000000329
Myroniak K, Elder S. Improving safe medication administration in new rns using simulation. J Contin Educ Nurs 2021;52:30–3. DOI: https://doi.org/10.3928/00220124-20201215-08
Sulosaari V, Huupponen R, Hupli M, et al. Factors associated with nursing students’ medication competence at the beginning and end of their education. BMC Med Educ 2015;15:1–12. DOI: https://doi.org/10.1186/s12909-015-0513-0
Di Simone E, Giannetta N, Auddino F, et al. Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian J Crit Care Med 2018;22:346–52. DOI: https://doi.org/10.4103/ijccm.IJCCM_63_18
Cottell M, Wätterbjörk I, Hälleberg Nyman M. Medication-related incidents at 19 hospitals: A retrospective register study using incident reports. Nurs Open 2020;7:1526–35. DOI: https://doi.org/10.1002/nop2.534
Di Simone E, Tartaglini D, Fiorini S, et al. Medication errors in intensive care units: Nurses’ training needs. Emerg Nurse 2016;24:24–9. DOI: https://doi.org/10.7748/en.2016.11577
Cleary-Holdforth J, Leufer T. Senior Nursing Students’ Perceptions of Their Readiness for Oral Medication Administration Prior to Final Year Internship: A Quantitative Descriptive Pilot Study. Dimens Crit Care Nurs 2020;39:23–32. DOI: https://doi.org/10.1097/DCC.0000000000000401
Björkstén KS, Bergqvist M, Andersén-Karlsson E, et al. Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden. BMC Health Serv Res 2016;16:1–9. DOI: https://doi.org/10.1186/s12913-016-1695-9
Høghaug G, Skår R, Tran TN, et al. Three-month follow-up effects of a medication management program on nurses’ knowledge. Nurse Educ Pract 2021;51:102979. DOI: https://doi.org/10.1016/j.nepr.2021.102979
Weant KA, Bailey A, Baker S. Strategies for reducing medication errors in the emergency department. Open Access Emerg Med 2014;6;45-55. DOI: https://doi.org/10.2147/OAEM.S64174
Guneş UY, Baran L, Yilmaz D (Kara). Mathematical and Drug Calculation Skills of Nursing Students in Turkey. Int J Caring Sci 2016;9:220–7.
Pazokian M, Zagheri Tafreshi M, Rassouli M. Iranian nurses’ perspectives on factors influencing medication errors. Int Nurs Rev 2014;61:246–54. DOI: https://doi.org/10.1111/inr.12086
Kim MS, Kim CH. Canonical correlations between individual self-efficacy/organizational bottom-up approach and perceived barriers to reporting medication errors: A multicenter study. BMC Health Serv Res 2019;19:1–10. DOI: https://doi.org/10.1186/s12913-019-4194-y
Ramadaniati HU, Hughes JD, Lee YP, et al. Simulated medication errors: A means of evaluating healthcare professionals’ knowledge and understanding of medication safety. Int J Risk Saf Med 2018;29:149–58. DOI: https://doi.org/10.3233/JRS-180001
Azami M, Sharifi H, Alvandpur S. 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. J Fam Med Prim Care 2020;9:4097–106. DOI: https://doi.org/10.4103/jfmpc.jfmpc_5_20
Özyazıcıoğlu N, Aydın Aİ, Sürenler S, et al. Evaluation of students’ knowledge about paediatric dosage calculations. Nurse Educ Pract 2018;28:34–9. DOI: https://doi.org/10.1016/j.nepr.2017.09.013
Smith JG, Plover CM, McChesney MC, et al. Rural Hospital Nursing Skill Mix and Work Environment Associated With Frequency of Adverse Events. SAGE Open Nurs 2019;5:1–13. DOI: https://doi.org/10.1177/2377960819848246
Devi A, Sembian N, Kaur S. Occurrence of medication errors and oral medication administration practices of staff nurses. Res J Pharm Technol 2016;9:1145–52. DOI: https://doi.org/10.5958/0974-360X.2016.00218.3
Sarfati L, Ranchon F, Vantard N, et al. Human-simulation-based learning to prevent medication error: A systematic review. J Eval Clin Pract 2019;25:11–20. DOI: https://doi.org/10.1111/jep.12883
Nurmeksela A, Mikkonen S, Kinnunen J, et al. Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. BMC Health Serv Res 2021;21:1–14. DOI: https://doi.org/10.1186/s12913-021-06288-5
Irajpour A, Farzi S, Saghaei M, et al. Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. J Educ Health Promot 2019;8:1–5.
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Downloads
Citations
