Incidence Of Medication Administration Errors Research Articles

Medication administration in aged care facilities: A mixed-methods systematic review.

To synthesize aged care provider, resident and residents' family members' perspectives and experiences of medication administration in aged care facilities; to determine the incidence of medication administration errors, and the impact of medication administration on quality of care and resident-centredness in aged care facilities. A mixed-methods systematic review. CRD42023426990. The AMED, CINAHL, MEDLINE, EMBASE, EMCARE, PsycINFO, Scopus and Web of Science core collection databases were searched in June 2023. Included studies were independently screened, selected and appraised by two researchers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed, with the Mixed Methods Appraisal Tool was used for critical appraisal. Convergent synthesis of data, thematic synthesis and meta-analysis were performed. One hundred and twenty-eight studies were included (33 qualitative, 85 quantitative and 10 mixed-methods). Five themes were formulated, including 1) Staffing concerns, 2) The uncertain role of residents, 3) Medication-related decision-making, 4) Use of electronic medication administration records and 5) Medication administration errors. Educational interventions for aged care workers significantly reduced medication administration errors, examined across five studies (OR = 0.37, 95%CI 0.28-0.50, p < .001). Medication administration in aged care facilities is challenging and complex on clinical and interpersonal levels. Clinical processes, medication errors and safety remain focal points for practice. However, more active consideration of residents' autonomy and input by aged care workers and providers is needed to address medication administration's interpersonal and psychosocial aspects. New directions for future research should examine the decision-making behind dose form modification, aged care workers' definitions of medication omission and practical methods to support residents' and their family members' engagement during medication administration. It is important that medication administration in aged care facilities be more clearly acknowledged as both a clinical and interpersonal task. More attention is warranted regarding aged care workers clinical decision-making, particularly concerning dose form modification, covert administration and medication omissions. Resident-centred care approaches that support resident and family engagement around medication administration may improve adherence, satisfaction and quality of care. What Problem Did the Study Address? Medication administration in aged care facilities is a complex clinical and interpersonal activity. Still, to date, no attempts have been made to synthesize qualitative and quantitative evidence around this practice. There is a need to establish what evidence exists around the perspectives and experiences of aged care workers, residents and resident's family members to understand the challenges, interpersonal opportunities and risks during medication administration. What Were the Main Findings? There is a lack of empirical evidence around resident-centred care approaches to medication administration, and how residents and their families could be enabled to have more input. Dose form modification occurred overtly and covertly as part of medication administration, not just as a method for older adults with swallowing difficulties, but to enforce adherence with prescribed medications. Medication administration errors typically included medication omission as a category of error, despite some omissions stemming from a clear rationale for medication omission and resident input. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The findings of this systematic review contribute to aged care policy and practice regarding medication administration and engagement with older adults. This review presents findings that provide a starting point for aged care workers in regards to professional development and reflection on practice, particularly around clinical decision-making on dose form modification, medication administration errors and the tension on enabling resident input into medication administration. For researchers, this review highlights the need to develop resident-centred care approaches and interventions, and to assess whether these can positively impact medication administration, resident engagement, adherence with prescribed medications and quality of care. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Page etal., 2021). No patient or public contribution to this systematic review.

Medication administration error prevention among nurses working in intensive care units: A secondary analysis.

The intensive care unit (ICU) brings together high-risk patients and interventions in a complex environment. Based on this consideration, medication administration error is the most common type of error that occurs in ICUs. Literature confirms that human factors (lack of knowledge, poor practices and negative attitudes) of nurses are the main contributors to the occurrence of medication administration errors in ICUs. To examine and compare the knowledge, attitudes and behaviour scores on medication administration error according to nurses' sociodemographic and professional variables. This is a secondary analysis of data from a cross-sectional international study based on a survey. Descriptive statistics were computed for all items of the questionnaire. Non-parametric tests (Kruskal Wallis and Mann Whitney U tests) were used to carry out the comparison between groups. The international sample consisted of 1383 nurses in 12 different countries. Statistically significant changes were seen in knowledge, attitudes and behaviour scores among several subgroups of the international population. Eastern nurses were more likely to show adequate knowledge about medication administration error prevention than Western nurses; concurrently, Western nurses were significantly more likely to show positive attitudes than Eastern nurses. No statistically significant differences in the behaviour scale were found in this study. The findings show a difference between knowledge and attitudes in relation to cultural background. Decision makers in ICUs should consider cultural background when planning and implementing prevention strategies for medication administration errors. Further research is needed to investigate the effectiveness of educational systems on the decrease of the incidence of medication administration errors in ICU.

Meta-Analysis of Medication Administration Errors in African Hospitals.

The incidence of medication administration errors (MAEs) and associated patient harm continue to plague hospitals worldwide. Moreover, there is a lack of evidence to address this problem, especially in Africa. This research synthesis was intended to provide current evidence to decrease the incidence of MAEs in Africa. Standardized search criteria were used to identify primary studies that reported the incidence and/or predictors of MAEs in Africa. Included studies met specifications and were validated with a quality-appraisal tool. The pooled incidence of MAEs in African hospitals was estimated to be 0.56 (CI: 0.4324-0.6770) with a 0.13-0.93 prediction interval. The primary estimates were highly heterogeneous. Most MAEs are explained by system failure and patient factors. The contribution of system factors can be minimized through adequate and ongoing training of nurses on the aspects of safe medication administration. In addition, ensuring the availability of drug use guidelines in hospitals, and minimizing disruptions during the medication process can decrease the incidence of MAEs in Africa.

Self-reported medication administration errors in clinical practice of nurses: a descriptive correlation study

Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic.A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA).The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE.The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.

Medical generalism. Past, present and future

The study assessed perception and contributing factors to medication administration errors among nurses.A quantitative descriptive design was adopted. Three hundred nurses participated in the study during the month of July 2015. A self-administered questionnaire was used to obtain information on registered nurses characteristics, knowledge and perceived causes of medication admiration errors. Descriptive analysis and inferential statistics were done using Statistical Package for Social Sciences.The findings of the study revealed that Nurses have good knowledge and perception of medication administration errors. Confusion of drugs with different names and increase patient to nurse staffing ratio constitute the major contributing factors for the occurrence of medication administration error among them. Furthermore, majority of the nurses are aware of guidelines and methods to follow to prevent the occurrence of medication administration errors.In this regards, identification of the main factors contributing to medication administration errors allows nurses and system to eliminate situations such as nurse staffing, medication transcribing issues, poor physician communication, problem with medication packaging and poor reporting system as well as incorporating changes that minimize them. Also, nursing supervisors should create an enabling environment which allows incidence of medication administration errors to be reported not on the basis of being punished but to initiate actions to prevent future occurrences. This will improve and enhance patient safety environment in the hospital.

Is The Incidence of Medication Administration Errors in A Tertiary Care Hospital a Secret Factor in our Health-Care System?

Medication Error (ME) are one of the biggest problems in healthcare that occur often Hospitalized. MEs can aid in examining major morbidity or mortality as well as significantly lowering the expenses of medical care for patients and the healthcare system.The goal of the current study was to determine the prevalence and risk factors of such drug administration mistakes as well as to identify and evaluate the MAEs that occurred in patients admitted to the tertiary care hospital.The current cross-sectional study was carried out in the tertiary care hospital over the period of 4 months, from 1st May 2022 to 31st August 2022. Data was collected by Clinical Pharmacist, who are highly trained to spot all categories of medication related errors. Each and every patient’s medication chart as well as admission chart was thoroughly analyzed, evaluated and reviewed to figure out any kind of suspected administration error as well as medication error. In this study it has been observed that Delay in administration, Wrong drug administration and failure to intercept drug interaction and contradiction has been observed in tertiary care hospital which need to be improvised and proper guidelines should be followed so that in future further such incident may not repeat and provide safety and efficacy to the patient.

Biometric palm vein authentication of psychiatric patients for reducing in-hospital medication errors: a pre–post observational study

ObjectivesThis study aimed to evaluate a biometric palm vein authentication system to prevent medication administration errors in psychiatric hospitals.DesignThis is a pre–post observational study.SettingConventionally, the medication was distributed after a...

Relationship between nursing supervision and the incidence of medication administration errors

Background Nursing supervision has an essential role in staff development and quality improvement through development of professional practice, safeguarding the standards of patient care, ensuring that registered nurses have the necessary skills and knowledge to reduce patient harm as well as the incidence of medication errors, and providing safe administration of medication by nurses. Aim The current study aimed to assess the relationship between nursing supervision and the incidence of medication administration errors. Design A descriptive correlational design was utilized. Setting The current study was conducted at Al-Mattar Psychiatric and Addiction Health Hospital. The study sample was composed of all staff nurses (70 nurses) who were working in inpatient departments and accepted to participate in the study. Tools Data were collected using two tools: the first tool was a nursing supervision questionnaire developed by researchers. It was designed to assess nursing supervision efficacy. It contained 77 items. The second tool was the medication administration error observational checklist developed by Kim and Bates (2012). Result Regarding nursing supervision, the highest mean percentage for staff nurses about nursing supervision was personal issues (84.63%) and the lowest mean percentage was finding time (69.20%). Regarding the incidence of medication administration errors, the highest mean percent age for staff nurses’ medication administration errors was for adherence to basic infection regulation and safety regulation: external and oral administration (78.3), whereas the lowest mean percentage was for adherence to the five rights of medication safety (65.5%). Conclusion There was no statistically significant correlation between perceived nursing supervision and observed medication administration errors. There was a significant correlation between adherence to the five rights of medication safety and finding time. Recommendation A supportive and establishing healthy work environment that helps nurses to reflect on their personal and professional-work related issues should be provided. Periodic formal and informal evaluation of nurses’ performance should be conducted, and guidelines should be developed on how to prevent medication administration errors.

The Influence of Nurses’ Characteristics on Medication Administration Errors: An Integrative Review

BackgroundMedication administration errors (MAEs) are a frequent cause of morbidity and mortality in acute care settings and can result in a prolonged hospital stay. The WHO estimated that medication errors cost up to $42 billion globally per a year. Therefore, MAEs was among the most common medical errors to occur in acute care settings. Studies of medication error usually focus on system factors, thus creating a gap between what researchers know about the causes of MAEs, and what frontline nurses actually do in the clinical setting. The purpose of this review is to fill a gap in the existing literature by focusing on the relationship between nurses’ characteristics and MAEs.MethodsOnline databases were accessed, including CINAHL, PsycINFO, PubMed, Scopus, and Google Scholar from 2007–2020 period. This review was guided by the methods described by Whittemore and Knafl. Studies that addressed the occurrence of medication errors based on RN demographics were included in this review. The included studies were reviewed and analyzed by the two authors.ResultsOf the 1141 publications retrieved, 19 studies met inclusion criteria. The result provided strong evidence that nurses’ level of education, length of experience, and attendance at training courses, are directly associated with the occurrence of MAEs. There is weak evidence of MAEs being influenced by the age and gender of nurses. Other nurse characteristics, such as cognitive load, frustration with technology, negligence, lack of attentiveness, and nurse ethnicity, are not adequately examined across the reviewed studies necessitates further research.ConclusionFocusing on nurses’ characteristics might facilitate other researchers to suggest appropriate interventions that may reduce the incidence of MAEs. Interventional studies may provide convincing evidence as to whether one variable has a causal effect on another variable, and control the influence of confounding variables to enhance the generalizability of the findings.

Incidence of medication administration errors in Ethiopia: A systematic review and meta-analysis of observational studies

Abstract Introduction: In Ethiopia, the overall incidence of medication administration errors (MAEs) has been variously estimated within the range of 16% to 99%; a wide range and difficult to conclude. Thus, this study aimed to assess the pooled incidence of MAEs in Ethiopia. Materials and methods: A systematic literature search in the databases of Pub-Med, Cochrane, and Google Scholar were performed. The quality of study was assessed using criteria adopted from similar studies. Heterogeneity test and evidence of publication bias were assessed. Sensitivity test and trim and fill analysis was also performed. Pooled incidence of MAE was calculated using random effects model. Results: A total of nine studies, including a total of 46,426 medication administrations interventions, were included in this systematic review and meta-analysis. The frequently reported MAEs were wrong dose, wrong time, and wrong route. The reported error was ranged from 0.1% for wrong medication to 95.8% for omitted drug error. Overall the pooled incidence of MAE was found to be 37.9% (95% CI, 34%-41.9%). It has no evidence of significant heterogeneity (I2 = 0%, p <0.820) and publication bias from the visual inspection of funnel plot and Egger’s test (P =0.481). Conclusion: The incidence of MAE was high. Wrong dose, wrong time, and wrong route were the frequently reported errors. Omission error was the most incident errors. Authors suggested to give more attentions to the rights of medication administration guide, particularly to prevent omission error.

Perception and contributing factors to medication administration errors among nurses in Nigeria

PurposeThe study assessed perception and contributing factors to medication administration errors among nurses. DesignA quantitative descriptive design was adopted. Three hundred nurses participated in the study during the month of July 2015. A self-administered questionnaire was used to obtain information on registered nurses characteristics, knowledge and perceived causes of medication admiration errors. Descriptive analysis and inferential statistics were done using Statistical Package for Social Sciences. ResultsThe findings of the study revealed that Nurses have good knowledge and perception of medication administration errors. Confusion of drugs with different names and increase patient to nurse staffing ratio constitute the major contributing factors for the occurrence of medication administration error among them. Furthermore, majority of the nurses are aware of guidelines and methods to follow to prevent the occurrence of medication administration errors. ConclusionIn this regards, identification of the main factors contributing to medication administration errors allows nurses and system to eliminate situations such as nurse staffing, medication transcribing issues, poor physician communication, problem with medication packaging and poor reporting system as well as incorporating changes that minimize them. Also, nursing supervisors should create an enabling environment which allows incidence of medication administration errors to be reported not on the basis of being punished but to initiate actions to prevent future occurrences. This will improve and enhance patient safety environment in the hospital.

The Risk Factors Of Nurses' Non-Compliance To The Principles Of Five Rights in Drug Administration in Patient Wards in One Of The Private Hospitals in West Indonesia

&lt;p&gt;Medication administration errors (MAEs) are one of the risks in nursing practice and occur because the drugs received by patients with prescription drugs are not appropriate. Nurses play an important role in patient safety, especially in drug delivery. The principle of five correct is needed to prevent the incidence of MAE. The causes of MAE are interruptions, workload, knowledge, and communication. The purpose of this study was to analyze the most influential factors on the incidence of MAE in a hospital West Indonesia. The research design used cross sectional. The sampling technique is simple random sampling and 99 people are taken as sample. The research instrument used is questionnaire. Data analysis used multivariate with logistic regression method. The results showed that the knowledge variable is the most dominant variable associated with medication error with OR = 7.262 means that the risk of knowledge raises medication error 7.262 larger than the workload after controlled by interrupt and communication variables. Recommendations for future researchers to make the results of this study as a baseline for doing a research about MEA and patient.&lt;/p&gt;

Impact of a Barcode Medication Administration System on Patient Safety

To determine the impact of barcode medication administration (BCMA) on the incidence of medication administration errors among patients in an onco-hematology day hospital and to identify the characteristics of medication errors in that setting. . 715 patients treated in the onco-hematology day unit at the Príncipe de Asturias University Hospital in Madrid, Spain. . A between-groups, pre-/postintervention study was conducted. Administration errors observed in patients with solid tumors (intervention group) were compared with those in patients with hematologic cancer (control group) before and after the introduction of BCMA. Error incidence, type, and severity were assessed, as was length of stay for treatment. . Use of a BCMA system reduced the incidence and severity of errors in medication administration in the onco-hematology day hospital. . BCMA is a useful technology to check the five rights of medication administration in the onco-hematology day hospital and could help nurses increase the time spent on direct patient care activities. .

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

To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice. Context-specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators' qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking. A cross-sectional, observational design. Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February-August 2015 in medical and surgical units from eight public hospitals. Twenty-five medication administrators completed dose calculations. In total, 296 medication errors were identified, of which most were wrong-time errors and omissions. Interruptions and patient acuity were significantly associated with wrong-dose and wrong-route errors, respectively. Most medication administration-related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages. Medication administration errors, especially wrong-time errors and omissions, are prevalent in public hospitals in the Gauteng Province. Interruptions lower the risk of wrong-dose errors, while patient acuity exacerbates this risk. 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.

Evaluating clinical decision support tools for medication administration safety in a simulated environment

ObjectivesThe specific aims of this study were to develop a methodology and tools for the design of clinical decision support systems to decrease the incidence of medication administration errors. MethodsA mixed-methods design was utilized in this study. First, observations of medication administration practice were used to inform the design of a simulated information system with a variety of decision support tools. Then, nurses were observed administering medications in a simulated environment using the simulated system. Finally, the nurses participated in focus groups to provide input into system tools design. Observations of nurses’ use of the decision support tools as well as semi-structured focus groups were used to evaluate nurses’ use and perceptions of the utility of the system decision support tools. ResultsNurses’ evaluation of the medication administration decision support tools as well as their actual performance revealed a tendency to underestimate their need for support. Their preferences were for decision support that was short, color coded, and easily accessed. Observations of medication administration showed that nurses exhibit a variety of work processes to prepare and administer medications to patients and access system decision support tools at a variety of points in this process. System design should allow flexibility of multiple points and types of information delivery to accommodate variations in workflow to minimize the tendency for system workarounds. ConclusionsThis study was performed in one hospital and results may not generalize beyond this setting. However, this method used to design and test decision support could be transferred to other settings. Using simulation in this study provided a method for testing new information system design, related to a potentially dangerous procedure, in a manner that eliminated the hazards of potential unintended consequences for patients.

Factores del entorno de trabajo que influyen en la ocurrencia de errores de administración de medicación

The incidence of medication administration errors (MAE) is high and costly for patients and health institutions. Human factors and factors relating to the work context intervene in their occurrence. The aim of this article is to identify the role of factors in the work setting related to occurrence of MAEs in the hospital field.A narrative review of the literature. Eight articles were included following a review of MEDLINE, CINAHL and COCHRANE LIBRARY databases for the 2002-2012 period.Distractions and interruptions, work overload, design of units and characteristics of the material stood out amongst the work context factors intervening in the occurrence of medication administration errors.The creation of organizational artefacts to reduce interruptions; patient involvement in medication administration; the introduction of new technologies and improving the labelling of medications can help reduce the incidence of medication administration errors. To advance in identifying and managing factors that are precursors of medication administration errors, we recommend the carrying out of studies or reviews of prospective cohorts.

Medication administration errors for older people in long-term residential care

BackgroundOlder people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system.MethodsA prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs) and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors.ResultsA total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors) was attempting to give medication at the wrong time. Over the 3-month observation period, half (52%) of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p < 0.001) in nursing homes as in residential homes. The level of non-compliance with system alerts was very low in both settings (0.075% of administrations). The pre-study survey revealed that only 12/41 staff administering drugs reported they were aware of potential administration errors in their care home.ConclusionsThe incidence of medication administration errors is high in long-term residential care. A barcode medication administration system can capture medication administration errors and prevent these from occurring.