Medication Administration Practices Research Articles

OSCE to assess competency in IV medication administration

BackgroundCompetency-based education (CBE) supports nursing student learning and safe practices by adopting repeated practice and feedback. AimThe project aimed to examine processes to increase student competencies in intravenous (IV) medication administration and Objective Structured Clinical Evaluation (OSCE) methods using best practices in simulation. MethodsThis pilot project examined CBE and OSCE processes in building student confidence and competency in IV medication administration skills.Using a quasi-experimental design, the effects of CBE on confidence were examined by differences in student (n = 19) confidence levels pre and post IV medication administration practice sessions with senior nursing students using IV Therapy Self-Confidence Scale. End of program confidence levels were compared with OSCE scores to examine the correlations between confidence and competence. ResultsConfidence levels increased significantly (<.05), while the relationship between confidence and competence in IV medication administration was mixed. ConclusionsConfidence in nursing skills does not equate to competency. Implementing CBE and OSCE using simulation best practices is a challenge.

Resilience in nursing medication administration practice: a systematic review with narrative synthesis.

Little is known about how nurses adapt medication administration practices to preserve safety. The capacity to adapt and respond before harm occurs has been labelled 'resilience'. Current evidence examining medication safety largely focuses on errors and what goes wrong. This review aimed to synthesise evidence for the application of resilience principles and practices in nursing medication administration. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review, which was registered with PROSPERO. MEDLINE, EMBASE, PsychINFO and CINAHL databases were searched from 14 August 2020 to 1 January 2021 for English-language studies. A systematic review of empirical studies of any design relating to resilience and safety in nursing medication administration in the inpatient setting was conducted. Methodological quality was appraised using the Mixed Methods Appraisal Tool. Data were synthesised thematically. Thirty-two studies with a range of methodologies of mostly good quality met the inclusion criteria. Eleven interventional studies included two that evaluated the effectiveness of education interventions and nine exploratory studies with outcomes showing the impact of an intervention designed or examined to build resilience. Twenty-one non-interventional studies showed how resilience principles are put into practice. Only three studies explicitly named the concept of resilience. Resilient medication administration strategies result from five triggers. Nurses' resilience practices were found to be responses to identified trigers that threaten safety and productivity. These were often short term, real-time proactive adaptations to preserve safety, compensating for and responding to complexities in the modern healthcare setting. CRD42018087928.

Simulated medication administration for vulnerable populations using scanning technology: a quasi-experimental pilot study

BackgroundMedication errors may occur due to shortcuts and pressures on time and resources on nurses. Nursing students are enculturated into these environments where their perceptions of norms around reporting and responding to medication errors are formative, yet simulated medication administration experiences are rarely reflective of the real-world environment. such as the standard use of medication scanning technology. The purpose of the present study is to test a pilot intervention, Medication Quick Response (QR) code scanning, and evaluate its effect on medication errors during simulation when compared to traditional simulation medication administration practices and to assess the students’ perceptions of the intervention.MethodsWe conducted a quasi-experimental, observational study involving Junior and Senior (3rd and 4th year) undergraduate, pre-licensure nursing students from Spring 2022 until Fall 2023. Seven simulations were conducted in pediatric and obstetric courses. The intervention group used non-patented, low cost QR scanning during medication administration. The control group used standard manual administration. Medication errors were measured based on the quantity, type of error, and degree of patient risk. A Qualtrics survey was used to assess the students’ perceptions of the intervention following simulation participation.ResultsA total of 166 students participated in the study. In each course, 7 groups were assigned to the intervention and 8 were assigned to the control. More than half of the groups made at least one medication error (n = 17), one-third of groups (n = 10) made a high-risk medication error. There was no statistically meaningful difference in the rate, type, or potential patient risk of medication errors between the intervention and control groups. The majority of participants (n = 53) felt that QR scanning more closely mimicked medication administration in clinical settings. Half of the participants responded that it improved their safety practices (n = 37).ConclusionsThe results of this pilot study indicate that while there is a high risk for error among pre-licensure nursing students, the use of QR scanning did not increase the risk of medication errors. The next study iteration will build upon these pilot findings to integrate the use of embedded medication errors, time management tasks, and a multi-site implementation.

Medicine management: legal and ethical principles

This article explores the legal and ethical issues that impact the safe administration of medicines. A discussion is provided on understanding the role of the healthcare assistant (HCA), assistant practitioner (AP) and informed consent, which is key to ethical and legal care provision. Mental capacity and the practice of covert medication administration is also outlined. By upholding ethical and legal principles, the HCA and AP can ensure that patient-centred care, which respects individuals' rights and promotes their wellbeing, is consistently practiced.

Improving the quality of medication administration practices in a tertiary Australian hospital: a best practice implementation project.

Medication safety is an important health priority that focuses on preventing harm from medication-related events. Unsafe medication administration practices can lead to errors, which can cause avoidable injury (or harm) to patients. This paper reports on an evidence implementation project conducted in a large tertiary hospital in Australia to improve nursing compliance with best practice recommendations for medication administration. The project was guided by JBI's seven-phase approach to evidence implementation, using audit and feedback and a structured framework to identify barriers, enablers, and implementation strategies. The project resulted in improved compliance with best practice recommendations. This was achieved through multimodal strategies, including education, improved access to resources, and targeted feedback and discussion sessions to encourage culture and behavior change. The project improved nurses' medication administration practices, specifically in performing independent second checks. Collaborative efforts of the project leads facilitated the review of medication administration policy and the development of staff education resources. Patient engagement remains an area for improvement, along with the potential need for further ongoing medication education. http://links.lww.com/IJEBH/A237.

The Association of Transformational Leadership on Safety Practices Among Nurses: The Mediating Role of Patient Safety Culture.

To ensure best possible patient outcomes, patient safety is a major component of healthcare delivery system that needs to be prioritized. Safety practices among nurses are essential to maintain patient safety, especially the practices of medication administration, handover, patient falls and unplanned extubations prevention. To investigate the mediating effect of patient safety culture between the relationship of transformational leadership and safety practices among nurses. The data in this cross-sectional study were gathered from a survey targeted clinical nurses using a random sampling technique. The study was conducted in a medical city in Saudi Arabia, and two hundred nurses were surveyed. The Multifactor Leadership, Hospital Survey on Patient Safety Culture, and Nursing Safety Practice questionnaires were used in the study. The results revealed significant positive associations between transformational leadership, patient safety culture, and nursing safety practices. Moreover, patient safety culture mediates the association between transformational leadership and safety practices among nurses. Enhancing transformational leadership capabilities among nurse managers should be considered in order to improve nursing safety practices. Additionally, patient safety culture should be measured and improved periodically to ensure better nursing safety practices.

Causes of medication administration errors and barriers to reporting as perceived by nurses in Saudi Arabia: A qualitative study.

Medication administration errors significantly impact patient safety, potentially leading to severe harm or fatality. Reporting such errors through active systems improves medication administration, thereby enhancing patient safety and the quality of care. However, in the context of Saudi Arabia, little is understood about the causes of medication administration errors and the obstacles hindering their reporting. This study aimed to explore nurses' perceptions of the causes of medication administration errors and the barriers to reporting them. The study employed a qualitative descriptive design, conducting face-to-face semi-structured interviews with 43 nurses from three hospitals in Taif Governorate, Saudi Arabia, between October and November 2023. Purposive sampling was used to recruit participants, and thematic analysis was utilized for data analysis. The following themes emerged regarding the causes of medication administration errors: order deficiencies, high workloads and staff shortages, and malpractice. Regarding the barriers to reporting errors, the emerging themes were fear of punishment and lack of support, lack of knowledge and awareness about reporting, and lack of feedback. This study reveals nurses' perceptions of the causes of medication administration errors and the barriers to reporting them. Recognizing and addressing these causes and barriers are essential for patient safety and the improvement of the healthcare environment. Efforts should be directed toward implementing interventions that address high workloads, enhance staff education and awareness, and promote a workplace culture conducive to reporting errors without fear of repercussions. Additionally, supportive mechanisms, such as feedback systems and resources for professional development, should be implemented to empower nurses to actively participate in error reporting and contribute to continuous improvement in medication administration practices.

Central and Peripheral Medication Administration Practices in Pediatric Patients.

Central and Peripheral Medication Administration Practices in Pediatric Patients.

Registered nurses' knowledge and practice of preoperative fasting and medication administration.

Knowledge of fasting or Nil Per Os (NPO) guidelines is an essential component of nursing care in the preoperative period. To describe registered nurses' (RNs) knowledge and management of the preoperative NPO period. Selected surgical wards in a tertiary hospital in the Western Cape, South Africa. Quantitative descriptive, cross-sectional study utilising a structured questionnaire. The population consisted of RNs working in selected surgical wards. Convenience sampling was used and adequate knowledge was determined as ≥ 90%. The response rate was 100%. Of the 68 participants, 48 (70.6%) held a diploma and 20 (29.4%) held a degree as the highest academic qualification achieved. Sixty-one (89.7%) participants knew the correct reason for keeping patients NPO. Sixty-five (95.6%) knew the correct answer for the NPO time for solids while only 27 (39.7%) knew the correct answer for clear fluids. Only 30 (44.1%), 26 (38.2%) and 33 (48.5%) participants, respectively, answered the questions about oral analgesia, oral antibiotics and chronic medication administration during the NPO period correctly. Significantly more degree participants knew the correct answer for the fasting time for non-human milk (p = 0.005) and more diploma participants would administer chronic medication during the NPO period (p = 0.037). Inadequate knowledge of NPO times for various fluids and unsatisfactory practice of medication administration for oral and chronic medication require attention. This study highlights the importance that ongoing education is needed to ensure that patients receive the most up-to-date evidence-based care during the NPO period.

Medication errors by caregivers in the homes of children discharged from a pediatric department in Ghana.

Medication errors (MEs) by caregivers at home are a cause of morbidity and mortality, shortly after discharge from the hospital. The objective of this study was to determine the rate and types of MEs at the homes of children discharged from a hospital in Ghana and to explore the factors associated with these errors. This was a cross-sectional study of infants and children discharged from the hospital to review medication administration practices. Caregivers of children discharged from the hospital after at least 24 hours of admission were interviewed at their homes about medication administration practices. The study assessed potential harm associated with MEs made by caregivers using the Harm Associated with Medication Error Classification tool. The Least Absolute Shrinkage and Selection Operator regression were used to identify the variables associated with MEs. A total of 95 children (mean age: 28.6 months, 52.6% female) and their caregivers were included. Overall, 65 (68.4%) children experienced one or more MEs. Out of a total of 232 medications reviewed, 102 (44.0%) (95% CI: 37.6-50.4) were associated with a ME. The top two errors, wrong time errors and errors in the frequency of dosing were, 45.1% and 21.6%, respectively. Understanding the information on the disease condition being treated and the medicines dispensed was associated with committing fewer MEs. The number of medicines prescribed was associated with a higher likelihood of MEs. Out of 102 MEs, 48 (47.1%) were assessed as posing potentially no harm, 26 (25.5%) minor harm, 15 (14.7%) moderate harm, and 13 (12.8%) serious harm to the patients. Importantly, none of the MEs were assessed as posing potentially severe or life-threatening harm to the patients. MEs in children following discharge are high, and systems should be developed to prevent these errors.

The lived experiences of mother's caring for children with uncontrolled asthma: A qualitative study.

Childhood-onset asthma is a chronic respiratory disease that profoundly impacts patients, their families, and healthcare systems. This study explores the lived experiences, challenges, and perceptions of mothers in managing asthma, controlling symptoms, and maintaining the quality of life for their children with asthma in Palestine. A qualitative descriptive design through semi-structured interviews was used in this study. Purposive sampling was used to identify mothers who have children with severe uncontrolled asthma in the four public hospitals with pediatric units in the West Bank, Palestine. Mothers of children with scored below 15 on the asthma control test were included in the study. The data were analyzed using an analytical framework following a thematic analysis through the NVivo 11. A total of 20 mothers participated in interviews wherein they delineated the most important challenges negatively affecting asthma management from mothers' perspectives. These challenges encompassed frequent emergency room visits, improper medication administration practices, and limitations in physical activity. The mothers expressed concerns regarding asthma control, including anxieties concerning the chronicity of the illness, adverse effects of medications, and susceptibility to weather fluctuations. The main themes that emerged from the data included reduced quality of life for the child, parental responsibility for monitoring triggers, symptoms, and medications, challenges in asthma management, apprehensions regarding asthma control, and strategies for enhancing asthma management. This study emphasizes the pressing need for targeted interventions to address asthma management, environmental triggers, and psychosocial disruptions related to asthma in children with asthma to enhance the quality of life and asthma control. This study highlights the importance of developing strategies that provide mothers with the appropriate information and tools to navigate the complexities of caring for a child with asthma.

Life cycle assessment of pharmaceutical and clinical packaging required for medication administration practices

PurposeDigital closed-loop medication administration (CLMA) is a prime example of how digitalization in healthcare can reduce time and costs while simultaneously increasing patient safety. However, in contrast to its social and economic benefits, associated environmental impacts have never been investigated. Since the required amount of packaging material is seen as a major subject of criticism, we assess associated environmental burdens using life cycle assessment (LCA) methodology to identify hotspots and provide adaptation recommendations.MethodsDigital, as well as conventional paper-based medication management (PBMM), involve two types of packaging: pharmaceutical packaging (blisters or bottles), containing purchased medication, and clinical packaging (unit doses or medical dispensers) for medication dispensation. Therefore, a cradle-to-grave life cycle model was established comparing impacts at pharmaceutical packaging level, clinical packaging level, and a combined level. While PBMM requires small, blistered boxes, CLMA requires large, bottled packages. Therefore, the functional unit allows to compare different box sizes but inhibits comparing medication from different manufacturers. Primary data is obtained from University Medical Centre Hamburg-Eppendorf which practices state-of-the-art CLMA. PBMM data is obtained in three dispenser scenarios, varying the reusability of medical dispensers. The life cycle impact assessment was performed for five impact categories using CML 2001(2016) method.Results and discussionAll compared blistered pharmaceutical packaging options yield higher impacts than their bottled counterparts. Cardboard and package inserts result in up to 40 times higher impacts for blisters than for bottles, which, however, is attributed to the methodology of comparing different box sizes. Yet, this does not influence the required amount of blister laminate. All blister materials were found to result in higher environmental burdens, peaking in nearly 240 times higher ozone depletion impacts for polyvinylchloride/polychlorotrifluoroethylene blisters. In terms of clinical packaging, two of three dispenser scenarios result in higher environmental burdens than the respective unit dose scenario. Only if reused, 7.2 times this trend is reversed. When combining selected impacts from both pharmaceutical and clinical impacts, all three dispenser scenarios perform worse than the unit dose scenario.ConclusionsPackaging impacts are lowest if unit dose dispensation is combined with bottled pharmaceutical packaging. Given a specific pharmaceutical packaging, dispensation via medical dispensers may perform better, if they are comprehensively reused. With this study, the authors disproved that packaging impacts are generally higher for CLMA than for PBMM. However, both systems certainly comprise other processes and materials like consumed paper or energy to run required digital infrastructure, which should be subject to future studies.

Implementing a medication lubricant for pill dysphagia on an acute care ward using Plan-Do-Study-Act cycles

BackgroundPill dysphagia, the difficulty in swallowing solid oral medications, is a common problem that can affect medication adherence and increase pill modifications. Current practices of crushing medications or using food...

Knowledge, attitudes, and practices toward over-the-counter antipyretics among fever patients: a cross-sectional study in the context of a policy change KAP of OTC antipyretics.

On January 8, 2023, a change in the control policy for COVID-19 was implemented in China, whereby patient self-management of fever typically entails the utilization of over-the-counter fever-reducing medications. This study aimed to investigate the knowledge, attitudes, and practices (KAP) toward over-the-counter (OTC) antipyretics among fever patients. This cross-sectional study was conducted between October 2022 and February 2023 at author's hospital in Wuhan, China, among fever patients on OTC antipyretics, using a self-administered questionnaire. A total of 481 valid questionnaires were collected, with the age of 36.05 ± 12.10 years, including 240 (49.90%) males, and 209 (43.45%) collected before policy change. The knowledge, attitudes, precautions for medication administration and decision-making practices scores were 6.86 ± 3.30 (possible range: 0-12), 16.67 ± 2.46 (possible range: 7-35), 29.98 ± 5.41 (possible range: 7-35) and 27.87 ± 1.28 (possible range: 8-40), respectively. The multivariable logistic regression analysis showed that knowledge (OR = 0.83, 95%CI: 0.81-0.92, p < 0.001) was independently associated with positive attitude. Knowledge (OR = 1.41, 95%CI: 1.28-1.56, p < 0.001), attitude (OR = 0.87, 95%CI: 0.79-0.95, p = 0.004), suburban (OR = 0.45, 95%CI: 0.23-0.88, p = 0.019) were independently associated with proactive precautions for medication administration practices. Knowledge (OR = 1.14, 95%CI: 1.07-1.22, p < 0.001), attitude (OR = 0.90, 95%CI: 0.82-0.98, p = 0.018), responding after policy change, 2023 (OR = 1.70, 95%CI: 1.10-2.63, p = 0.016) were independently associated with proactive decision making practices. Fever patients had moderate knowledge, negative attitude, proactive precautions for medication administration practices, moderate decision-making practices. After the policy change, there was a significant increase in knowledge regarding medication administration precautions and decision-making.

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel.

Intensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the '5 rights'). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety. To identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel). A dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56-bedded adult intensive care unit and a 6-bedded neonatal intensive care unit in Sydney, Australia. Incident monitoring data were examined. Direct semi-covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel. No medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the '5 rights' and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling. This study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses. This novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling.

Medication Administration Practices Among Nurses: An Observational Study from Oman

Safe medication administration is vital in ensuring patients’ safety and enhancing their quality of life. This study aimed to observe nurses' practice in medication administration in Hospitals and primary healthcare institutions to identify and examine the different steps of the medication administration process for quality assurance and safe drug administration. The methodology of the study employed a cross-sectional design using quantitative descriptive data within health institutions at South Sharqiyah Governorate. Data from the direct observation of 99 nurses (once at a time) were observed while they were preparing and administering medications using the disguised observation method (DDM). The data was recorded via Microsoft Access using a descriptive approach (frequencies and percentages) for analysis. The areas of concern in the study were: the five rights of medication administration, documentation, the use of patient’s identifiers, double checking and drug labeling. The trained observer completed the checklist after observing the nurses’ medication administration. Data were collected from 99 observations for analysis. Data analysis was conducted using descriptive and inferential statistics in the SPSS software version 26. The quantitative data illustrates that only 34.3% of nurses performed an independent double check by another nurse, only 56.6% performed appropriate labeling, and 62.6% confirmed the patient’s identity using at least two patient identifiers. Most medication administrations meet the “Five Rights” criteria (right patient =92.9%; right medication=98%; right dose=97%; right route=98%; and right time=97%). A statistically significant association was found between the participant's age and right time (p=0.013); and between years of experience and right medication (p=0.005), right dose (p=0.019) and right route (p=0.004). In this study, the nurses' poor areas of practice in medication administration were identified as double-checking of medication, labeling, and use of patient identifiers. Checking the right of medication administration and documentation post the procedure was the most followed by nurses in the medication administration process. The relevance of the study to clinical practice is the continuing education and clinical audits for nurses regarding basic pharmacology, medication administration policy, factors contributing to medication errors, and strategies preventing medication errors should be a priority.

Competence and Stress of Medication Administration Practices for School Nurses in K-12 Taiwan Schools.

We investigated school nurses' experiences, perceived government support, school nurses' acceptance of responsibility for medication administration, perceived stress, and perceived competence of medication administration and analyzed factors associated with perceived competence. In this cross-sectional study, from February to April 2023, we conducted an online survey of 269 school nurses serving at K-12 schools in Taiwan. The results revealed that although 71% of the participants had prior experience with medication administration, they reported low competence and high stress in areas such as drug interactions, adverse drug effects, and referrals. The school nurses' disagreement with responsibilities for medication administration emerged as the only factor to be significantly associated with perceived medication administration competence, accounting for 22.8% of the variance. We recommend implementing continuing training programs to provide school nurses with up-to-date medication information. Additionally, the development of practice guidelines is suggested as a means of enhancing nurses' competence and reducing their stress levels for the administration of medications.

Nighttime medication administration and patient perception of sleep in the intensive care unit

AbstractIntroductionEnvironmental, patient, disease, and care‐related factors can lead to sleep disruption in the intensive care unit (ICU). Medication administration is a potentially modifiable factor in this setting that has not been well described as a target for sleep improvement.ObjectivesTo determine characteristics of nighttime medication administration practices in the ICU, evaluate the effect on patient perceived sleep, and assess the opportunity for pharmacist‐led nighttime medication administration stewardship.MethodsThis was a multicenter, retrospective, observational cohort study. Patients included for chart review had perceived sleep measured using the Richards‐Campbell Sleep Questionnaire (RCSQ). Data were collected on patient characteristics, ICU exposures, and nighttime medications administered. Four RCSQ groups defined for comparison were RCSQ 0–25 indicating “very poor” sleep, 26–50 “poor” sleep, 51–75 “good” sleep, and 76–100 “very good” sleep.ResultsOverall, 115 patients with RCSQ assessments and 435 nighttime medication administrations were included. Nighttime medications were most commonly cardiovascular (28.9%) and central nervous system (21.4%) agents, administered via intravenous (54.5%) and oral (22.7%) routes. Patient characteristics were comparable between the four groups except for history of head trauma. Patients reporting very poor sleep had a significantly higher median number of nighttime medications administered as compared to patients reporting very good sleep (4.0 [interquartile range (IQR) (2, 6)] vs. 2.5 [IQR 1, 4], adjusted p = 0.048). Approximately three‐quarters of nighttime medications occurred between the hours of 22:00–0:59 and 5:00–5:59. Nearly 40% of nighttime medications could have been retimed for daytime administration.ConclusionsUnnecessary nighttime medication administration is common and associated with poor patient perceived sleep in the ICU. Pharmacists are well‐positioned to evaluate timing of medication administration and cluster medication‐related care for daytime hours, when appropriate. Nighttime medication stewardship optimization by pharmacists is an opportunity to improve patient perceived sleep in the ICU.

Medication administration evaluation and feedback tool: Longitudinal cohort observational intervention

Background Medication administration by nurses is a complex task requiring multiple steps to ensure patient safety. A medication administration evaluation and feedback tool (MAEFT) incorporating self-assessment, direct observation, and feedback has been developed and tested previously for reliability. Aim To describe nurses’ medication administration practice when followed up with self and peer evaluation and feedback using the MAEFT. Methods Four nurse evaluators were trained to use the MAEFT. Twenty-eight nurses participated in the study to be observed administering medications in the clinical setting. The initial observations were conducted over four weeks, with follow-up four months later. The MAEFT contains 22 criteria, against which the nurses were evaluated. For each criterion, an evaluation of whether it was performed (“yes” or “no”) was made. The overall score was calculated as a percentage of the number of criteria performed. Findings There was a high standard of criteria performed, with median overall observer scores of 95% at time 1 and 94% at time 2. Criteria not performed demonstrated 71 potential medication errors at time point 1, with only 33 at time point 2. Discussion There was no difference in nurses’ practice using the MAEFT when followed up, but there was no baseline control to determine the current practice before using the MAEFT. However, there was a reduction in the number of medication errors. Conclusion Nurses’ medication administration practice standards remained high when followed up with self and peer evaluation and feedback using the MAEFT. More criteria were checked during the follow-up evaluation.

Critical Care Nurse’s Practice Regarding Medication Administration Safety in Intensive Care Units at Governmental Hospitals in Gaza Strip

Background: Administration of medications is primarily the nurse’s responsibility. This study aimed to assess intensive care nurses’ practice of safe medication administration in governmental hospitals in the Gaza Strip. Methods: This study utilized descriptive, cross-sectional, analytical design. The sample of the study consisted of 116 ICU nurses from five governmental hospitals (Al Shifa Hospital, Indonesy Hospital, Shohada Al Aqsa hospital, European Gaza Hospital, and Nasser Hospital). For data collection, the researcher used Patient Safety Assessment in Medication Administration Questionnaire and Observation Checklist. A pilot study was conducted on 20 nurses, and reliability of the Patient Safety Assessment in the Medication Administration Questionnaire was 0.908. Results: The results showed that 66.4% of study participants were male nurses and 33.6% were female nurses, mean age was 28.97 years, 85.4% have bachelor degree, mean experience was 4.18 years, mean income was 1431.64 New Shekel, and 67.2% are working mixed shifts (morning, evening, and night). The practice of safety medication administration indicated that the highest score was in right route (93.8%), the right time (91.8%), right patient (90.7%), right way (89.5%), right recording of administered medication (88.9%), right answer (86.7%), right guidance (86.5%), right dose (86%), right medication (85.3%), and the overall score was 88.6%. Also, observation of nurses indicated high practice of safe medication administration with an average score of 83.6%. There were statistically insignificant differences in the practice of safe medication administration related to the hospital, gender, qualification, age, experience, and income. Conclusion: The study concluded that intensive care nurses handling medication safely at a moderate level and more. The authors demonstrated the need to provide adequate number of qualified nurses in Intensive Care Units, and encouraged nurses to participate in training programs about safe medication preparation and administration.