Assessment of Nurses Perception towards Medication Errors in Palestinian Hospitals

Background: Medication errors are one of the most common causes of accidental errors affecting patients’ safety and can cause serious consequences for patients. Medication errors are underreported worldwide, particularly in developing countries. Which lead to the lack of information regarding the problems of medication errors. Aim: To assess the input from nurses’ regarding several issues in medication error, exploring their perception towards medication error causes, types, rate, and reporting. which might help in pinpointing some areas in medication safety issues where there is potential for making improvement to be reflected in the nurses practices regarding medication managements at hospitals. Methods: A cross-sectional design was used. Data was collected using a self-administered questionnaire. The study was conducted in three hospitals; public, private, and NGO. A total of 267 nurses participated in the study Findings: The overall response rate was (57.17%). Female were 59.8%, and males 40.2%. The most perceived causes of MEs were lack of pharmacological knowledge and skills (82%), and heavy workload and shortage of staff (77.7%). As for the most common types of MEs, wrong medication dose (57.5%) and wrong time (53.2%) were the most prevalent. The mean number ofcommitted MEs in the past 12 months was 1.94, and the mean number of reporting medication errors in the past 12 months was 1.6. With regard to the most common type of medications involved in MEs, antibiotics was given the highest frequency in MEs. Regarding the level of harm resulted from medication error that occurs in the past 12 months, the higher frequency was for MEs causing temporary harm to patients (28.2%). Moreover, participants from the NGO and public hospitals scored higher than private hospital participants inregard to shortage of nursing staff and heavy work overload cause (P<0.001). Also 57.9% of participants with bachelor’s degree indicated the effect of lacking pharmacological knowledge and skills more than diploma and graduate studies participants (P<0.001). Finally a statistically significant relationship was found in the frequency of committing MEs (P=0.001) and frequency of reporting MEs (P<0.001) in relation to the hospital ownership. Conclusions: the results of the study indicate that there are areas of potential improvements in Palestinian hospitals. Medication safety interventions should be formulated to address strategies to reduce and eliminate medication errors

The Relationship between Perceived Safety Culture, Nursing Leadership and Medication Errors Reporting (by nurses) in a Saudi Arabian Context: A Sequential Explanatory Mixed Method Design

Abstract Background: Medication errors have significant implications for patient safety and can cause serious harm and even death. Error discovery through an effective leadership and active reporting system uncovers medication errors and encourages safe practices. A positive safety culture and effective leadership likely plays an essential role in improving medication error reporting systems. A review of literature highlighted that no study had previously investigated the effect of safety culture and nursing leadership styles on medication error reporting. Aim: The aim of this study was to explore the relationship between perceived safety culture, nursing leadership and medication errors reporting (by nurses) in adult medical-surgical wards in the Qassim region of Saudi Arabia. Methods: The methodological design adopted for this study was an explanatory sequential mixed methods design; quantitative followed by qualitative in two phases. The first phase began with the collection and examination of quantitative data from four hospitals in the Qassim region using the Hospital Survey on Patient Safety Culture (HSOPSC) (n=218) and the Multifactor Leadership Questionnaire (MLQ 5X) (n=186), along with a prospective audit of type and rates of reported medication errors on these wards. The second, qualitative phase involved face-to-face semi-structured interviews with nurses (n=8) and nurse managers (n=8). Results: The literature review highlighted a lack of studies exploring the relationship between perceived safety culture and nursing leadership styles and medication errors reporting. The findings from surveys showed that 50% of nurses in this study have not made an incident report in the last 12 months. Moreover, less than 10% of nurses report errors in two participant hospitals in the last two years. The qualitative findings revealed that fear was a key causal factor for underreporting of medication errors. Nurses feared punishment and legal action or losing their jobs. In addition, lack of feedback from quality or patient safety offices when nurses did make reports discouraged them from reporting future errors. Further barriers to reporting were personal characteristics, workload or shortage of staff, nursing leadership problems, blame, lack of knowledge or skills, unclear, or noncompliance with policy and safety culture. Conclusion: This is the first study to explore the relationship between perceived safety cultures and nursing leadership styles on medication errors reporting in Saudi Arabia. The findings of the research presented in this thesis contribute new knowledge to the Yorkshire Contributory Factors Framework by evidencing the relationship between nursing leadership and safety culture through statistical methods. Also, the main methodological contribution of the research field has been the first mixed methods study to investigate these relationships. The results of this study offer guidance and present understanding of both the multicultural nurses’ and their managers’ opinions of improving the medication errors reporting system in Saudi Arabia. In addition, provide valuable local evidence that can be built into appropriate professional education and procedures for encouraging both Saudi and international nurses employed in Saudi Arabian hospitals to report errors. Finally the findings will assist policy makers and hospital managements to develop suitable medication safety education and procedures for encouraging nurses to report errors

Patient safety in Europe: medication errors and hospital-acquired infections

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required

Medical errors : Healthcare professionals’ perspective at a tertiary hospital in Kuwait

Medical errors are of economic importance and can contribute to serious adverse events for patients. Medical errors refer to preventable events resulting from healthcare interactions, whether these events harm the patient or not. In Kuwait, there is a paucity literature detailing the causes, forms, and risks of medical errors in their state-funded healthcare facilities. This study aimed to explore medical errors, their causes and preventive strategies in a Kuwait tertiary hospital based on the perceptions and experience of a cross-section of healthcare professionals using a questionnaire with 27 open (n = 10) and closed (n = 17) questions. The recruited healthcare professionals in this study included pharmacists, nurses, physicians, dentists, radiographers, hospital administrators, surgeons, nutritionists, and physiotherapists. The collected data were analysed quantitatively using descriptive statistics. A total of 203 participants filled and completed the survey questionnaire. The frequency of medical errors in Kuwait was found to be high at 60.3% ranging from incidences of prolonged hospital stays (32.9%), adverse events and life-threatening complications (32.3%), and fatalities (20.9%). The common medical errors result from incomplete instructions, incorrect dosage, and incorrect route of administration, diagnosis errors, and labelling errors. The perceived causes of these medical errors include high workload, lack of support systems, stress, medical negligence, inadequate training, miscommunication, poor collaboration, and non-adherence to safety guidelines among the healthcare professionals.Peer reviewe

Navigating Independent Double Checks for Safer Care: A Nursing Perspective

Abstract The purpose of this study was to explore registered nurses’ understanding and practice of “independent double-checks” prior to administration of high-alert medications. The study used a qualitative descriptive design for data collection and data analysis. It included thirteen participants from a hospital located in southern New Hampshire. Results of the study revealed a core theme of navigating independent double checks (IDC) for safer care. Two major themes stemming from the core theme were also uncovered. Navigating IDC through knowing and navigating IDC through nurse partnership both focused on the perception and practice on IDC prior to administration of high alert medications. IDC was accepted and promoted as best practice, but the definition and process is still unclear. Having a universal definition will assist in clarity of the process and in turn, promote ensuring safe administration of high alert medications to patients. Keywords: independent double check, safer care, knowing, nurse partnershi

Investigating the prevalence and causes of prescribing errors in general practice : the PRACtICe Study

Report prepared by the University of Nottingham, University of Reading and University of Hertfordshir

Errors and discrepancies in the administration of intravenous infusions: a mixed methods multihospital observational study

Introduction Intravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error. Objectives To determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, and to explore sources of variation, including the contribution of smart pumps. Methods We conducted an observational point prevalence study of intravenous infusions in 16 National Health Service hospital trusts. Observers compared each infusion against the medication order and local policy. Deviations were classified as errors or discrepancies based on their potential for patient harm. Contextual issues and reasons for deviations were explored qualitatively during observer debriefs. Results Data were collected from 1326 patients and 2008 infusions. Errors were observed in 231 infusions (11.5%, 95% CI 10.2% to 13.0%). Discrepancies were observed in 1065 infusions (53.0%, 95% CI 50.8% to 55.2%). Twenty-three errors (1.1% of all infusions) were considered potentially harmful; none were judged likely to prolong hospital stay or result in long-term harm. Types and prevalence of errors and discrepancies varied widely among trusts, as did local policies. Deviations from medication orders and local policies were sometimes made for efficiency or patient need. Smart pumps, as currently implemented, had little effect, with similar error rates observed in infusions delivered with and without a smart pump (10.3% vs 10.8%, p=0.8). Conclusion Errors and discrepancies are relatively common in everyday infusion administrations but most have low potential for patient harm. Better understanding of performance variability to strategically manage risk may be a more helpful tactic than striving to eliminate all deviations

A systematic review of the nature of dispensing errors in hospital pharmacies

Background: Dispensing errors are common in hospital pharmacies. Investigating dispensing errors is important for identifying the factors involved and developing strategies to reduce their occurrence. Objectives: To review published studies exploring the incidence and types of dispensing errors in hospital pharmacies and factors contributing to these errors. Methods: Electronic databases including PubMed, Scopus, Ovid, and Web of Science were searched for articles published between January 2000 and January 2015. Inclusion criteria were: studies published in English, and studies investigating type, incidence and factors contributing to dispensing errors in hospital pharmacies. One researcher searched for all relevant published articles, screened all titles and abstracts, and obtained complete articles. A second researcher assessed the titles, abstracts, and complete articles to verify the reliability of the selected articles. Key findings: Fifteen studies met the inclusion criteria all of which were conducted in just four countries. Reviewing incident reports and direct observation were the main methods used to investigate dispensing errors. Dispensing error rates varied between countries (0.015%–33.5%) depending on the dispensing system, research method, and classification of dispensing error types. The most frequent dispensing errors reported were dispensing the wrong medicine, dispensing the wrong drug strength, and dispensing the wrong dosage form. The most common factors associated with dispensing errors were: high workload, low staffing, mix-up of look-alike/sound-alike drugs, lack of knowledge/experience, distractions/interruptions, and communication problems within the dispensary team. Conclusion: Studies relating to dispensing errors in hospital pharmacies are few in number and have been conducted in just four countries. The majority of these studies focused on the investigation of dispensing error types with no mention of contributing factors or strategies for reducing dispensing errors. Others studies are thus needed to investigate dispensing errors in hospital pharmacies, and a combined approach is recommended to investigate contributing factors associated with dispensing errors and explore strategies for reducing these errors.Peer reviewe