Medication Administration Skills Research Articles

The effects of screen-based simulation on nursing students’ acquisition of medication administration and dosage calculation skills: a randomized controlled trial

BackgroundScreen-based simulation is a cost-effective educational modality that allows nursing students to comfortably acquire new skills as they become accustomed to digital environments. The aim of this study is to evaluate the effectiveness of a screen-based simulation tool in enhancing knowledge and skills related to medication administration and dosage calculation in nursing students.MethodsThis multicenter, single-blind, stratified, randomized controlled trial initially enrolled 480 nursing students. The 351 students eligibles were randomly allocated to two groups. Using a screen-based simulation tool (SIMDOSE®), the intervention group was trained in drug administration and dosage calculation through four perfusion clinical cases. The control group underwent the same training content using the paper-and-pencil method. knowledge and skills acquisition, Students’ satisfaction, self-confidence and anxiety were analyzed using Jamovi software (version 2.3.18).Results4 out of 5 main variables examined were significantly different, specifically in dosage calculation, where the simulation group excelled both in the knowledge post-test (post – pre = 1.00 (20%); p = 0.004) and in the objective structured clinical examination (p = 0.013). The intervention group reported higher levels of satisfaction and self-confidence than the control group (p < 0.001). Their moderate anxiety levels didn’t differ significantly (0.161).ConclusionThe SIMDOSE® platform can be used as a supplementary teaching method of dosage calculation for nursing students. Screen-based simulation has benefits that nurse educators should be aware of, such as being a key to more satisfied and confident students.Trial registrationThis Moroccan clinical trial was prospectively registered (16/05/2023) in the Pan African Clinical Trial Registry (pactr.samrc.ac.za) with trial registration number PACTR202305505743210.

Assessing patient work system factors for medication management during transition of care among older adults: an observational study

ObjectiveTo develop and evaluate measures of patient work system factors in medication management that may be modifiable for improvement during the care transition from hospital to home among older adults.Design,...

Effectiveness of Jigsaw Learning Strategy on Administration of Pediatric Medications among 3rd Year BSc Nursing Students Posted in Pediatric Wards at Selected Hospital, Mysuru

Background: Patient safety and quality care are issues of major concern worldwide and are significant challenges facing healthcare systems, clinical practice and Nursing education. Administering medications to children is a unique challenge requiring specialized knowledge and skills. Each child’s age, background and level of physical and psychosocial development must be considered. Children are at increased risk of medication errors. This is due to a combination of factors including the need for calculation to be performed at all stages of the process. Reducing medication errors and increasing patient safety has recently become a really critical issue in nursing. Improving medication administration skills of nursing students takes an important place in nursing education systems too. Objectives: To evaluate the effectiveness of Jigsaw Learning strategy on knowledge regarding administration of pediatric medications among 3rd year BSc Nursing students posted in pediatric wards at selected hospital, Mysuru, Karnataka. Methodology: A pre-experimental design and evaluative approach was used in the study. The data was collected from 50 subjects through simple random sampling technique. Data was collected using structured questionnaire. Results: Findings of the study concluded that majority 31 (62%) of the subjects had moderately adequate knowledge and 19 (38%) of the subjects had inadequate knowledge regarding administration of pediatric medications in the pre-test. Where as in post-test, majority 45 (90%) of them had adequate knowledge and 5 (10%) of them had moderately adequate knowledge. Hence the study concluded that, the Jigsaw learning strategy was effective in enhancing knowledge regarding medication administration among 3rd year BSc Nursing students. Therefore, the study reinforces the need to organize health campaigns and teaching programs which sensitize the 3rd year BSc Nursing students to enhance the knowledge regarding administration of pediatric medications among 3rd year BSc Nursing students. Conclusion: Findings of the study show that there was a significant difference in pre-test and post-test level of knowledge of 3rd year BSc Nursing students posted in pediatric wards. Hence it is concluded that the Jigsaw Learning strategy is effective in improving the level of knowledge of 3rd year BSc Nursing students posted in pediatric wards. There was no significant association between level of knowledge of 3rd year BSc Nursing students posted in pediatric wards and selected demographic variables such as Age, gender, type of family, source of information and religion.

Identifying Risk Areas of Medication Administration Process for Developing an Interactive Three-Dimensional Game Intervention.

The aim of this study was to describe identified risk areas related to the medication administration process in acute care in order to develop a three-dimensional-game intervention. A secondary analysis was conducted using (1) observed medication administrations (n = 1058) and identified medication errors in 2012 (n = 235), (2) a systematic review including a meta-analysis of previous medication administration educational interventions (n = 14) from 2000 to 2015, (3) incident reports of medication administration errors (n = 1012) from 2013 to 2014, and (4) focus group interviews with RNs' (n = 20) views in 2015. A qualitative content analysis was used to identify risk areas, and the data were organized according to the following main themes: (1) factors related to patients (patient identification, patients' characteristics or symptoms, and patients' allergies and interactions); (2) factors related to medications (medication information, changes in medications, generic substitutes, new drugs, look-alike/sound-alike drugs, demanding drug treatments, medication preparation, and administration techniques); (3) factors related to staffing (workload, skills, interruptions and distractions, division of work, responsibility, attitudes, and guidelines); and (4) factors related to communication (flow of information, communication with the patients, and marking of medication information). Identified risk areas could be used to develop interventions with the aim of increasing the safety of medication administration and nurses' skills.

Registered Nurses' medication administration skills: a systematic review.

The aim of this review was to identify methods for measuring Registered Nurses' medication administration skills and to describe these skills. A systematic literature review. The CINAHL, PubMed, Scopus, Cochrane, PsycInfo and Medic databases were searched for articles from the period 2007-2018. Two researchers independently selected the articles and evaluated their quality using the National Heart, Lung and Blood Institute study quality assessment tools. The data were analysed using content analysis. A total of 727 studies were identified of which 22 studies were included in this review. A total of six different measurement methods were identified: questionnaire or survey, observation, knowledge test or exam, focus group interviews, chart reviews and voluntarily reported errors. Different methods provided different information on medication administration skills. Medication administration skills were classified under nine areas: (1) safe ordering, handling, storing and discarding of medications, (2) preparing of medications, (3) the administration of medications to patients, (4) documentation, (5) evaluation and assessment of medication-related issues, (6) drug calculation skills, (7) cooperation with other professionals and (8) with the patients and (9) reporting of medication information. The results demonstrated that there are many areas that need to be improved to increase medication safety. Medication administration includes many different phases, as a result of which nurses need to have many various skills to cope with medication administration as required by their profession. This review shows that nurses' medication administration skills need to be developed, and special attention should be paid to the preparation and administration phases. It is important to regularly utilise different teaching strategies and verify nurses' medication competence. As each research method has different limitations, it is vital that further studies combine different methods to form a comprehensive picture of nurses' medication administration skills.

Nursing Practice towards Pediatric Medication Process in Yogyakarta’s Private Hospital Indonesia

Background: Pediatric medication safety is a greater challenge in patient safety practice. Patient safety is a quality indicator of health care. Nurses have an important role to achieve safety medication&#x0D; Objective: To describe the nursing practice based on safety medication process.&#x0D; Methods: An observational study in 90 medication administration was conducted in May until August 2016 in one of private hospital in Yogyakarta, Indonesia. Fifty data from medical record used as a secondary data. Observation and document study was performed by two research assistants. Healthy Futures Medication Administration Skills Checklist used to collect the data of ordering, dispensing, administration and monitoring of medication process. Descriptive analytic used to analyse the data.&#x0D; Results: Regarding of the four-step of implementation medication safety process during ordering phase, twenty five medication documentation in medical record were not complete. In dispensing phase, more than a half nurses observed (63,3%) were not give explanation about the medication.All of nurses have done five right principle butalmos to nurses were not do the right documentation.Most of the medical record(88,9%)were not documentedthe side effect of drug and more than ahalf medical record(66,7%)were not have complete documentaion of medication effect.&#x0D; Conclusion: Poordocumentationpracticecangive negative impact in medication safety that contribute medication error. Nurses could utilize the electronic medical record to increase quality medication safety.

Calm to chaos: Engaging undergraduate nursing students with the complex nature of interruptions during medication administration.

To describe undergraduate student nurse responses to a simulated role-play experience focussing on managing interruptions during medication administration. Improving patient safety requires that we find creative and innovative methods of teaching medication administration to undergraduate nurses in real-world conditions. Nurses are responsible for the majority of medication administrations in health care. Incidents and errors associated with medications are a significant patient safety issue and often occur as a result of interruptions. Undergraduate nursing students are generally taught medication administration skills in a calm and uninterrupted simulated environment. However, in the clinical environment medication administration is challenged by multiple interruptions. A qualitative study using convenience sampling was used to examine student perceptions of a simulated role-play experience. Data were collected from 451 of a possible 528 student written reflective responses and subject to thematic analysis. Students reported an increased understanding of the impacts of interruptions while administering medications and an improved awareness of how to manage disruptions. This study reports on one of three emergent themes: "Calm to chaos: engaging with the complex nature of clinical practice." Interrupting medication administration in realistic and safe settings facilitates awareness, allows for students to begin to develop management strategies in relation to interruption and increases their confidence. Students were given the opportunity to consolidate and integrate prior and new knowledge and skills through this role-play simulation.

Seeing Through Google Glass: Using an Innovative Technology to Improve Medication Safety Behaviors in Undergraduate Nursing Students.

Addressing safe medication administration skills and behaviors is integrated throughout many nursing curricula using high-fidelity simulation. Simulation allows students to practice on electronic manikins in a safe environment, allowing for independent, critical thinking as medications are administered. However, the restricted physical environment, often behind a one-way mirror, inhibits faculty from observing the processes students use to calculate or reference medication dosages. This article describes the errors in medication administration identified through use of Google Glass, an innovative technology that allows video recording from the student's perspective.

Evaluation of an interactive web-based nursing course with streaming videos for medication administration skills

PurposeNursing students should exhibit competence in nursing skills in order to provide safe and quality patient care. This study describes the design and students’ response to an interactive web-based course using streaming video technology tailored to students’ needs and the course objectives of the fundamentals of nursing skills clinical course. MethodA mixed-methodology design was used to describe the experience of 102 first-year undergraduate nursing students at a school of nursing in Jordan who were enrolled in the course. A virtual course with streaming videos was designed to demonstrate medication administration fundamental skills. The videos recorded the ideal lab demonstration of the skills, and real-world practice performed by registered nurses for patients in a hospital setting. After course completion, students completed a 30-item satisfaction questionnaire, 8 self-efficacy scales, and a 4-item scale solicited their preferences of using the virtual course as a substitute or a replacement of the lab demonstration. Students’ grades in the skill examination of the procedures were measured. Relationships between the main variables and predictors of satisfaction and self-efficacy were examined. ResultsStudents were satisfied with the virtual course (3.9±0.56, out of a 5-point scale) with a high-perceived overall self-efficacy (4.38±0.42, out of a 5-point scale). Data showed a significant correlation between student satisfaction, self-efficacy and achievement in the virtual course (r=0.45–0.49, p<0.01). The majority of students accessed the course from home and some faced technical difficulties. Significant predictors of satisfaction were ease of access the course and gender (B=0.35, 0.25, CI=0.12–0.57, 0.02–0.48 respectively). The mean achievement score of students in the virtual class (7.5±0.34) was significantly higher than that of a previous comparable cohort who was taught in the traditional method (6.0±0.23) (p<0.05). Nearly 40% of the students believed that the virtual course is a sufficient replacement of the lab demonstration. ConclusionsThe use of multimedia within an interactive online learning environment is a valuable teaching strategy that yields a high level of nursing student satisfaction, self-efficacy, and achievement. The creation and delivery of a virtual learning environment with streaming videos for clinical courses is a complex process that should be carefully designed to positively influence the learning experience. However, the learning benefits gained from such pedagogical approach are worth faculty, institution and students’ efforts.

Multimedia applications in nursing curriculum: The process of producing streaming videos for medication administration skills

PurposeStreaming videos (SVs) are commonly used multimedia applications in clinical health education. However, there are several negative aspects related to the production and delivery of SVs. Only a few published studies have included sufficient descriptions of the videos and the production process and design innovations. This paper describes the production of innovative SVs for medication administration skills for undergraduate nursing students at a public university in Jordan and focuses on the ethical and cultural issues in producing this type of learning resource. MethodThe curriculum development committee approved the modification of educational techniques for medication administration procedures to include SVs within an interactive web-based learning environment. The production process of the videos adhered to established principles for “protecting patients’ rights when filming and recording” and included: preproduction, production and postproduction phases. Medication administration skills were videotaped in a skills laboratory where they are usually taught to students and also in a hospital setting with real patients. The lab videos included critical points and Do's and Don’ts and the hospital videos fostered real-world practices. The range of time of the videos was reasonable to eliminate technical difficulty in access. ResultsEight SVs were produced that covered different types of the medication administration skills. The production of SVs required the collaborative efforts of experts in IT, multimedia, nursing and informatics educators, and nursing care providers. Results showed that the videos were well-perceived by students, and the instructors who taught the course. ConclusionsThe process of producing the videos in this project can be used as a valuable framework for schools considering utilizing multimedia applications in teaching.

Evaluation of student nurses' perception of preparedness for oral medication administration in clinical practice: A collaborative study

Attainment of oral medication administration skills and competency for student nurses is challenging and medication errors are common. The ability of nurses to master a clinical skill is dependent upon educational instruction and practice. The aim of this study was to evaluate nursing students' perception of preparedness for oral medication administration in two practice environments and determine possible relationship between student demographics and their perceived preparedness for oral medication administration. This was a cross sectional, exploratory study. Eighty-eight second year students from a baccalaureate nursing course from two metropolitan Australian tertiary institutions participated. Student nurses' perception of preparedness for oral medication administration was measured via a self-administered, adapted, and validated questionnaire. The overall mean Total Preparedness Score was 86.2 (range 71-102). There was no significant difference for perceived total preparedness to administer oral medications between the two facilities. Whilst there was no significant relationship established between student demographics and their perceived preparedness to administer oral medications, four single questions related to clinical practice were shown to be significant. Low fidelity simulated teaching environments that incorporate time management and post medication situations, may improve student nurses' perceived preparedness for oral medication administration.

Using Simulation to Improve the Medication Administration Skills of Undergraduate Nursing Students

This quasi-experimental pilot study examined simulation methods to improve nursing students' medication calculation and administration abilities. Approximately 25 percent of junior-level students in the nursing program who took a medication administration exam (MAE) failed in their first attempt. It was theorized that simulation could facilitate their success. Students in the control group (n = 79) attended a didactic medication administration review session; students in the intervention group (n = 79) participated in a medication administration simulation review session. All students took the MAE within a week of their review. The intervention group scored significantly higher (M = 95 percent, SD = 6.8) on the MAE than the control group (M = 90 percent, SD = 12.9) at the p = .004 level. The simulation facilitated student success by giving students a state-of-the-art contextual reference to apply when taking the MAE.

Using Integrated Simulation in a Nursing Program to Improve Medication Administration Skills in the Pediatric Population

The purpose of this evaluative study was to determine the overall influence of a mixed educational approach on student knowledge and self-confidence with pediatric intravenous medication administration. There are diminishing opportunities for students to practice IV medication administration in pediatric patients. Nurse educators must find ways to effectively train students that ready them for the real world of patient care while reducing risk. After lecture and pretesting, junior-level students spent approximately 50 hours in a pediatric unit and 40 hours in a high-fidelity pediatric simulation completing scenarios with medical prescribing and system-based pharmaceutical error, unpredictable medication administration dilemmas, and acute drug reactions.After the clinical rotation, students completed a posttest and self-confidence survey. . Results revealed a rise in knowledge and student self-reporting of confidence of essential medication administration skills for the pediatric population. A clinical rotation enhanced with simulation provides a rich learning environment without endangering patients. It allows students to experience risk-free problem-solving while giving faculty a more predictable process to assess acquisition of skills.

Using Integrated Simulation in a Nursing Program to Improve Medication Administration Skills in the Pediatric Population

Aim. The purpose of this evaluative study was to determine the overall influence of a mixed educational approach on student knowledge and self-confidence with pediatric intravenous medication administration. Background. There are diminishing opportunities for students to practice IV medication administration in pediatric patients. Nurse educators must find ways to effectively train students that ready them for the real world of patient care while reducing risk. Method. After lecture and pretesting, junior-level students spent approximately 50 hours in a pediatric unit and 40 hours in a high-fidelity pediatric simulation completing scenarios with medical prescribing and system-based pharmaceutical error, unpredictable medication administration dilemmas, and acute drug reactions. After the clinical rotation, students completed a posttest and self-confidence survey. Results. Results revealed a rise in knowledge and student self-reporting of confidence of essential medication administration skills for the pediatric population. Conclusions. A clinical rotation enhanced with simulation provides a rich learning environment without endangering patients. It allows students to experience risk-free problem-solving while giving faculty a more predictable process to assess acquisition of skills.

InnovationCENTER: Evaluation of the Effectiveness of “The Village ”: A Pharmacology Education Teaching Strategy

MEDICATION ADMINISTRATION IS ONE OF THE RISKIEST TASKS A NURSE EXECUTES (Maricle, Whitehead, & Rhodes, 2007). The Institute of Medicine (IOM) estimates that there are 1.5 million preventable adverse drug events each year in the United States and that patients can expect to be subjected to one medication error each day while hospitalized (2006). The most common and costly errors made by nurses include administering the wrong drug, an incorrect dose, using the wrong technique or route, omitting the medication altogether, or administering medication to the wrong patient (Maricle et al.). Teaching pharmacotherapeutics to nursing students is paramount for safe medication administration. Traditionally, pharmacotherapeutics education has revolved around lectures and memorization. Lectures are an economical and efficient way to introduce new material and to relate material to what is already known (DeYoung, 2008). An enthusiastic teacher can encourage students to learn more, provide auditory learners concise information, and clarify details from the text (Bradshaw & Lowenstein, 2007). However, lectures may fail to engage students or involve them in active learning or critical thinking (DeYoung), and new strategies are needed. This article reports on evaluation of the Village as a teaching strategy in an undergraduate course in pharmacotherapeutic nursing interventions. This teacher-developed strategy incorporates case studies, open discussion, and problem-based learning. It is designed to help nursing students comprehend pharmacology and apply knowledge of medications in practice. Literature Review The National League for Nursing (NLN) recommends basing teaching practices on current research findings (2005). However, few research studies address how to improve the quality of pharmacology education preparation of baccalaureate students, how to determine effectiveness of pharmacology preparation, and how to improve teaching methods. Studies have shown that RNs have felt unprepared to administer medications upon graduation. Smith and Crawford's (2003) stratified random study of 1,000 RNs found that only 19 percent of BSN graduates felt prepared to administer medications to groups of 10 or more patients; only 48 percent reported understanding the pharmacological implications of medications. A descriptive study of 352 RNs conveniently selected in the state of Nevada (Candela & Bowles, 2008) revealed that 51 percent did not believe enough time for the practice of pharmacology was provided in the BSN curriculum. An evaluative study using a convenient representative sample of Finnish nurses and nursing students (Grandell- Niemi, Hupli, Leino-Kilpi, & Puukka, 2005) found that nurses and nursing students considered their pharmacology skills insufficient. Using a nonexperimental causal comparative and correlational research design, Ndosi and Newell (2009) found that nurses had poor knowledge of drug mechanisms of action and interactions. In Australia, Bullock and Manias (2002) conducted a qualitative study of 23 nursing lecturers and found that 35 percent felt nursing education provided insufficient pharmacology preparation for practice, and 34 percent thought nursing students were unprepared for pharmacology practice. Smith and Crawford (2003) recommend more comprehensive educational preparation in the areas of psychomotor skills, pharmacology, pathophysiology, clinical decision- making, and client education. Candela and Bowles (2008) recommend using active teaching methods such as case studies, discussion and narratives, and collaborative exercises to teach pharmacology concepts. Ndosi and Newell (2009) suggest increasing pharmacology education and clinical exposure to drug administration in undergraduate nursing courses. Being unprepared for medication administration is cause for anxiety for nurses. Dickens (2008) noted that nursing education should emphasize medication administration skills, including dosage calculations, adaptations to varied medication forms, and accurate documentation. …

Promoting Positive Student Clinical Experiences with Older Adults Through Use of Group Reminiscence Therapy

Interest in psychiatric nursing as a practice area is associated with positive undergraduate clinical experiences that include staff acceptance, diverse learning opportunities, direct involvement with patients, and community placements. Essential student preparedness includes attitudes affirmative of patient recovery; assessment, communication, teaching, and medication administration and monitoring skills; and a toolkit of nursing interventions such as group facilitation and reminiscence therapy. In an innovative intervention, students in a geriatric psychiatric community setting developed and facilitated a support group with reminiscence-based activities to reduce social isolation. Patients increased social interactions, and students gained awareness of older adults' interests and self-identities, as well as confidence in providing care.

Assessing the Capability of School-Age Children With Asthma to Safely Self-Carry an Inhaler

The purpose of this descriptive study was to pilot test an Asthma Assessment Interview (AAI) and to determine the approximate age a child with asthma is capable to self-carry an inhaler. A random sample of 34 students with asthma (Grades K through 10) from a midwestern school district were interviewed by the school nurse using the AAI, which assesses knowledge of asthma, symptoms, coping strategies, medication administration skills, triggers, and judgment about when to use an inhaler including the ability to tell time. Only 38% passed the AAI. No students ages 5 to 7 passed, fewer than 50% of students ages 8 to 10 passed, and half or more of students age 11 or older passed the AAI. Results suggest a school nurse should supervise elementary students when using an inhaler; most should not self-carry. The AAI can be a useful part of the school nurse's assessment.

Assessing the Capability of School-Age Children With Asthma to Safely Self-Carry an Inhaler

The purpose of this descriptive study was to pilot test an Asthma Assessment Interview (AAI) and to determine the approximate age a child with asthma is capable to self-carry an inhaler. A random sample of 34 students with asthma (Grades K through 10) from a midwestern school district were interviewed by the school nurse using the AAI, which assesses knowledge of asthma, symptoms, coping strategies, medication administration skills, triggers, and judgment about when to use an inhaler including the ability to tell time. Only 38% passed the AAI. No students ages 5 to 7 passed, fewer than 50% of students ages 8 to 10 passed, and half or more of students age 11 or older passed the AAI. Results suggest a school nurse should supervise elementary students when using an inhaler; most should not self-carry. The AAI can be a useful part of the school nurse’s assessment.