scholarly journals Literature review of medication administration problems in paediatrics by parent/caregiver and the role of health literacy

2020 ◽  
Vol 4 (1) ◽  
pp. e000841
Author(s):  
Dania Talaat Dahmash ◽  
Zakia B Shariff ◽  
Daniel J Kirby ◽  
David Terry ◽  
Chi Huynh
Keyword(s):  
Health Literacy ◽  
Young People ◽  
Medication Administration ◽  
Dosing Error ◽  
Medication Administration Errors ◽  
Parents And Children ◽  
Measurement Tools ◽  
Key Factor ◽  
Administration Error ◽  
At Home

ObjectiveTo identify studies that highlighted medication administration problems experienced by parents and children, which also looked at health literacy aspect using a validated tool to assess for literacy.Study designTen electronic databases were systematically searched and supplemented by hand searching through reference lists using the following search terms: (1) paediatric, (2) medication error including dosing error, medication administration error, medication safety and medication optimisation and (3) health literacy.ResultsOf the (1230) records screened, 14 studies were eligible for inclusion. Three analytical themes emerged from the synthesis. The review highlighted that frequencies and magnitudes of dosing errors vary by the measurement tools used, the dose prescribed and by the administration instruction provided. Parent’s sociodemographic, such as health literacy and language, is a key factor to be considered when designing an intervention aimed at averting medication administration errors at home. The review summarised some potential strategies that could help in reducing medication administration errors among children at home. Among these recommendations is to show the prescribed dose to the parents or young people along with the verbal instructions, as well as to match the prescribed dose with the measuring tool dispensed, to provide an explicit dose intervals and pictographic dosing instructions.ConclusionThe findings suggest that in order to optimise medication use by parents, further work is needed to address the nature of these issues at home. Counselling, medication administration instructions and measurement tools are some of the areas in addition to the sociodemographic characteristics of parents and young people that need to be considered when designing any future potential intervention aimed at reducing medication errors among children and young people at home.

scholarly journals Use of Pediatric Injectable Medicines Guidelines and Associated Medication Administration Errors: A Human Reliability Analysis

2021 ◽  
pp. 106002802199964
Author(s):  
Matthew D. Jones ◽  
Jonathan Clarke ◽  
Calandra Feather ◽  
Bryony Dean Franklin ◽  
Ruchi Sinha ◽  
...  
Keyword(s):  
Reliability Analysis ◽  
Medication Administration ◽  
Original Study ◽  
Human Reliability ◽  
Large Magnitude ◽  
Human Reliability Analysis ◽  
Video Recordings ◽  
Medication Administration Errors ◽  
Key Factor ◽  
Clinically Significant

Background: In a recent human reliability analysis (HRA) of simulated pediatric resuscitations, ineffective retrieval of preparation and administration instructions from online injectable medicines guidelines was a key factor contributing to medication administration errors (MAEs). Objective: The aim of the present study was to use a specific HRA to understand where intravenous medicines guidelines are vulnerable to misinterpretation, focusing on deviations from expected practice ( discrepancies) that contributed to large-magnitude and/or clinically significant MAEs. Methods: Video recordings from the original study were reanalyzed to identify discrepancies in the steps required to find and extract information from the NHS Injectable Medicines Guide (IMG) website. These data were combined with MAE data from the same original study. Results: In total, 44 discrepancies during use of the IMG were observed across 180 medication administrations. Of these discrepancies, 21 (48%) were associated with an MAE, 16 of which (36% of 44 discrepancies) made a major contribution to that error. There were more discrepancies (31 in total, 70%) during the steps required to access the correct drug webpage than there were in the steps required to read this information (13 in total, 30%). Discrepancies when using injectable medicines guidelines made a major contribution to 6 (27%) of 22 clinically significant and 4 (15%) of 27 large-magnitude MAEs. Conclusion and Relevance: Discrepancies during the use of an online injectable medicines guideline were often associated with subsequent MAEs, including those with potentially significant consequences. This highlights the need to test the usability of guidelines before clinical use.

scholarly journals The Effectiveness of Interventions to Reduce the Nurses’ Distractions during Medication Administration: A Systematic Review

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 132
Author(s):  
Chandra Apriadi Panduwal ◽  
E. C. Bilaut
Keyword(s):  
Systematic Review ◽  
Relevant Literature ◽  
Hospital Setting ◽  
Medication Administration ◽  
Error Rates ◽  
Limited Evidence ◽  
Post Intervention ◽  
Medication Administration Error ◽  
Medication Administration Errors ◽  
Administration Error

Introduction: Nurses constitute the largest group of health professionals who work in the hospital setting and most of the medications in the setting are administered by nurses. Errors related to medication conducted by a nurse frequently occur during medication administration. Interruptions or distractions during medication administration have been identified as significant contributory factors to medication administration errors (MAEs).Methods: This systematic review critically reviewed the evidence of the effectiveness of the interventions that aim to reduce nurse interruptions or distractions during medication administration. The search for the relevant literature was conducted in August 2018 using three databases; Medline, Cinahl and Embase.Results: Nineteen full text articles were retrieved and reviewed, and 7 articles were included in this review. Five of these studies showed evidence of a reduction in the interruption or distraction rates in post-intervention measurements, while 4 studies reported a statistically significant reduction in the interruption or distraction rates, with p values between 0.0005 and 0.002.Conclusion: There was limited evidence available to support the effectiveness of the interventions in terms of either reducing the interruptions or distractions of the nurses during the medication administration or in terms of reducing the medication administration error rates.

scholarly journals P002 Medicine use and optimisation for children and young adults aged 0–18 years old – medication administration and adherence of parent/caregiver and child

2019 ◽  
Vol 104 (7) ◽  
pp. e2.4-e2
Author(s):  
Dania Dahmash ◽  
Zakia Ramjee ◽  
Daniel Kirby ◽  
David Terry ◽  
Chi Huynh
Keyword(s):  
Health Literacy ◽  
Healthcare Professionals ◽  
Data Extraction ◽  
Paediatric Population ◽  
Medication Administration ◽  
Search Terms ◽  
Medication Administration Errors ◽  
Children And Young Adults ◽  
Extraction Stage ◽  
The Uk

AimTo systematically review all published evidence related to medication administration accuracy and its relation to improving medication adherence among paediatric population. The objectives are to identify, the main issues and challenges that the patients or their parents, caregivers or healthcare professionals face when administering or taking a medication any published methods or tools that improves medication administration accuracy and adherence among the paediatric population; and the health literacy and knowledge of parents/caregivers/healthcare professionals concerning medication administration.MethodsA systematic search of the literature to identify any related studies to medication administration among paediatrics was performed using the following bibliographic databases: PubMed, Scopus and Cochrane Library. The list of various synonyms of the keywords was defined following the PICOC model and a discussion between the authors. An information specialist was contacted to ensure the accuracy of the developed search terms. Search terms included a list of synonyms relating to i) paediatric ii) medication administration accuracy iii) medication adherence and iv) medication error. The search was limited to studies published in English. Only studies that report paediatric patients aged from 0 up to 18 years of age who are prescribed medication that requires administration by the parent, caregiver or themselves were included. Studies including mixed paediatric and adults were further investigated and data related to paediatric were extracted. Quality assessment will be integrated into the review process using ‘CASP’ checklist at the data extraction stage.1 The study protocol was registered on PROSPERO.ResultsAll databases were systematically searched (in April 2018). Overall, 1,018 citations were found; of which 994 remained after removal of duplicates. After screening of titles and abstracts, 46 studies were considered eligible for inclusion in this review. At data extraction stage, 12 studies were excluded, owing to the lack of paediatric specific information or medication-related errors. 34 studies were further investigated, among which, 30 (30/34, 88.2%) studies reported that dosing errors are the most common type of medication errors and are associated with parents or caregivers with inadequate health literacy. Over-the-counter liquid medications and antibiotics are commonly associated with dosing errors among parents and caregivers. Two (2/26, 7.7%) experimental studies indicated that both droppers and cups are the prime causes of dosing errors that occur via parents. Two (2/34, 5.9%) review studies indicated that medication administration errors are common among children with prescribed inhalers. Finally, two (2/34, 5.9%) observational studies identified that labels and information sheets of the medication contribute to medication administration errors.ConclusionThe preliminary findings of this review suggest that further integrated education strategies between healthcare-professionals and parents or caregivers is a priority to reduce medication administration and dosing errors among children and young adults. To our knowledge, limited studies were conducted in the UK about this topic, hence, further work is required to highlight the issue of medication errors among children and its association with parents or caregivers health literacy in the UK.ReferencesCASP Appraisal Checklists, [Internet]. 2017 [cited 1st of December]. Available from: https://casp-uk.net/casp-tools-checklists/

scholarly journals Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Agani Afaya ◽  
Kennedy Diema Konlan ◽  
Hyunok Kim Do
Keyword(s):  
Medication Error ◽  
Hospital Setting ◽  
Medication Administration ◽  
Integrative Review ◽  
Medication Administration Error ◽  
Medication Administration Errors ◽  
Inadequate Knowledge ◽  
Administration Error ◽  
Uniform Definition ◽  
Definition Of

Abstract Background The aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative. Objective This review systematically identified and examined the barriers hindering nurses from reporting medication administration errors in the hospital setting. Design An integrative review. Review methods PubMed, Web of Science, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication administration error reporting from January 2016 to December 2020. Two reviewers (AA, and KDK) independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018. Results Of the 10, 929 articles retrieved, 14 studies were included in this study. The main themes and subthemes identified as barriers to reporting medication administration errors after the integration of results from qualitative and quantitative studies were: organisational barriers (inadequate reporting systems, management behaviour, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons, and inadequate knowledge of errors). Conclusion Providing an enabling environment void of punitive measures and blame culture is imperious for nurses to report medication administration errors. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses’ ability to report medication administration errors.

Medication Administration Error and Associated Factors among Nurses in Referral Hospitals, Amhara region, Ethiopia, 2019

2020 ◽  
Author(s):  
Wubet Alebachew ◽  
Dejene Tsegaye ◽  
Girma Alem ◽  
Zenaw Tesema
Keyword(s):  
Statistical Significance ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Medication Administration ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Medication Administration Error ◽  
Medication Administration Errors ◽  
Referral Hospitals ◽  
Administration Error

Abstract Background: Medication administration error is a failure in the treatment process resulting in potential harm to the patient. Medication errors are the leading causes of mistrust in the healthcare system, inducing corrective therapy and prolonged hospitalization thereby producing extra costs and even death. These errors are most common and can occur through failures in any of the ten rights of medication administration. About 10% of the overall preventable harm to hospitalized patients is attributed to the wrong use of medications. However, there is limited data regarding the magnitude and determinants of medication administration errors both nationally and in the study area in particular. Methods: A multicenter hospital based, cross-sectional study design was employed on a sample of 422 nurses selected by simple random sampling technique. Pre-tested structured questionnaire and observational checklist were used for data collection from March 1-30/2019. The collected data were cleaned, coded and entered into Epi-data version 4.2 and exported to STATA version 14. Binary logistic regression model was considered and those variables with P<0.25 in the bivariable analysis were included in to final model after which statistical significance was declared at P< 0.05 using adjusted odds ratio at 95% confidence interval. The study findings were presented using tables and figures. Multicollinerity was diagnosed using standard error and correlation matrix. Result: From the overall nurses, 239 (57.7%) of them made medication administration error in the last 12 months. Lack of training [AOR=2.20; 95% CI (1.09, 4.46)], unavailability of guideline [AOR=1.65; 95% CI (1.03, 2.79)], poor communication while facing problems [AOR=3.31; 95% CI (2.04, 5.37)], interruption [AOR = 3.37, 95 % CI (2.15, 5.28)] and failure to follow medication administration rights [AOR=1.647; 95% CI (1.00, 2.49)] were significantly associated with medication administration errors. Conclusion and recommendation: Medication administration error was high in Amhara referral hospitals. Therefore, interventions like developing guideline, providing training and developing strategies to minimize distracters should be given much emphasis by different stakeholders to decrease the burden of medication error.

Analisis Faktor Perawat Dalam Pelaksanakan Keselamatan Pasien Terhadap Kejadian Medication Administration Error di Rumah Sakit

2020 ◽  
Author(s):  
Bintang Marsondang Rambe
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Medication Error ◽  
Medication Errors ◽  
Medication Administration ◽  
Prescribing Error ◽  
Medication Administration Error ◽  
Administration Error

Latar Belakang Keselamatan pasien (patient safety) rumah sakit adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman yang meliputi assessment risiko, identifikasi dan pengelolaan hal yang berhubungan dengan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya serta implementasi solusi untuk meminimalkan timbulnya risiko dan mencegah terjadinya cedera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil yang dilakukan oleh perawat (Kemenkes, 2011).Salah satu kesalahan yang dapat merugikan pasien adalah medication error. Menurut WHO (2016) medication error adalah setiap kejadian yang dapat dicegah yang menyebabkan penggunaan obat yang tidak tepat yang menyebabkan bahaya kepasien, dimana obat berada dalam kendali profesional perawatan kesehatan. proses terjadi medication error dimulai dari tahap prescribing, transcribing, dispensing,dan administration. Kesalahan peresepan (prescribing error), kesalahan penerjemahan resep (transcribing erorr), kesalahan menyiapkan dan meracik obat (dispensing erorr), dan kesalahan penyerahan obat kepada pasien (administration error). Medication error yang paling sering terjadi adalah pada fase administration / pemberian obat yang dilakukan oleh perawat.Administration error terjadi ketika pemberian obat kepada pasien tidak sesuai dengan prinsip enam benar yaitu benar obat, benar pasien, benar dosis, benar rute pemberian, benar waktu pemberian dan benar pendokumentasian. Secara global, kesalahan pemberian obat (medication errors) sampai saat ini masih menjadi isu keselamatan pasien dan kualitas pelayanan di beberapa rumah sakit (Depkes RI, 2015; AHRQ, 2015). Perawat sebagai bagian terbesar dari tenaga kesehatan di rumah sakit, mempunyai peranan dalam kejadian medication error. Perawat berkontribusi karena perawat banyak berperan dalam proses pemberian obat. Pemberian obat/ Medication Administration adalah salah satu intervensi keperawatan yang paling banyak dilakukan, dengan sekitar 5- 20% waktu perawat dialokasikan untuk kegiatan ini (Härkänen et al.,, 2019). Pemberian obat juga mencakup tugas-tugas lain, seperti menyiapkan dan memeriksa obat obatan, memantau efek obat-obatan, mengedukasi pasien tentang pengobatan, dan memperdalam pengetahuan perawat tentang obat – obatan sendiri (DrachZahavy et al., 2014 dalam Yulianti et al., 2019)Berdasarkan isu tersebut, penulis tertarik untuk melakukan literature review terkait faktor perawat dalam pelaksanakan keselamatan pasien terhadap kejadian medication administration error di Rumah Sakit.

scholarly journals A Scoping Review of Health Literacy Measurement Tools in the Context of Cardiovascular Health

2019 ◽  
Vol 46 (4) ◽  
pp. 677-688 ◽  
Author(s):  
Rita Wai Yu Chan ◽  
Adnan Kisa
Keyword(s):  
Health Literacy ◽  
Scoping Review ◽  
Cardiovascular Health ◽  
Measurement Tool ◽  
Care Providers ◽  
Valid Measurement ◽  
Broad Concept ◽  
Measurement Tools ◽  
Health Literacy Measurement ◽  
Print Literacy

Background. Despite the strong link between health literacy and cardiovascular health outcomes, health literacy measurements remain flawed and fragmented. There exists a gap in the knowledge when formulating a valid measurement to capture the broad concept of health literacy. The existence of various tools for health literacy measurement also hampers the availability of health literacy data. Additionally, little research is available on a valid measurement tool for cardiovascular health literacy. Objective. This study aims to provide an overview of the health literacy measurement tools used in the context of cardiovascular health. Method. A scoping review was conducted. Two electronic databases, Medline and Embase, were searched to identify studies that described a tool for the measurement of health literacy in the context of cardiovascular health. Results. After reviewing the available studies, 53 studies met the inclusion criteria. A total of 26 health literacy measurement tools were identified in the studies. Among the 26 tools, 16 used an objective measurement approach, 9 adopted a subjective approach, and 1 employed a mixed approach. Additionally, 28 studies used tools to measure print literacy, 15 studies measured print literacy and numeracy, and 5 studies measured print literacy, oral literacy, and numeracy. Conclusions. STOFHLA, TOFHLA, and REALM were the mostly commonly used tools in the selected studies. The majority of tools were based heavily on reading skills and word recognition. Researchers should focus on the development of more comprehensive and reliable health literacy measurement tool(s) specific to cardiovascular health to assist health care providers to more efficiently and accurately identify people with cardiovascular problems who have inadequate health literacy.

scholarly journals Development and validity testing of the Adolescent Health Literacy Questionnaire (AHLQ): Protocol for a mixed methods study within the Irish school setting

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039920
Author(s):  
Ailbhe Spillane ◽  
Sarahjane Belton ◽  
Clare McDermott ◽  
Johann Issartel ◽  
Richard H Osborne ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Young People ◽  
Adolescent Health ◽  
Pearson Correlation ◽  
Adult Population ◽  
School Setting ◽  
Mixed Methods Study ◽  
Advisory Panel ◽  
Validity Testing

IntroductionHealth literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young people because of the developmental characteristics that impact on adolescents’ behaviour, including impulse control and judgement skills. This protocol describes the intended development and validity testing of a questionnaire to measure health literacy in adolescents.Methods and analysisThis protocol describes this mixed methods study that has three phases: the first phase will involve grounded research with adolescents using qualitative group interviews, co-design and concept mapping workshops to understand what health and healthy behaviours mean to adolescents and to explore their health literacy needs and the potential domains for the questionnaire. The draft health literacy domains identified will be presented to the youth advisory panel, and the questionnaire will be altered based on their feedback. Cognitive pretesting of the questionnaire items will also be conducted. Phase 2 will involve piloting the questionnaire to a two-stage random sample of young people in five urban and rural schools in Ireland. Test–retest reliability will be conducted using Pearson correlation coefficient. Confirmatory factor analysis will also be conducted to analyse the psychometric properties of the questionnaire. Phase 3 will involve the questionnaire being rolled out to a nationally representative sample of adolescents (n=6052) in Ireland to assess their levels of health literacy.Ethics and disseminationEthical approval to conduct this study has been granted from the University College Dublin Human Research Ethics Committee – Sciences (LS-20–08). Informed assent from adolescents and informed consent from parents/guardians will be sought. The findings of this research will be disseminated at national and international conferences, as well as through publication in peer-reviewed journals.

scholarly journals Understanding disadvantaged adolescents’ perception of health literacy through a systematic development of peer vignettes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah R. Goss ◽  
Clare McDermott ◽  
Laura Hickey ◽  
Johann Issartel ◽  
Sarah Meegan ◽  
...  
Keyword(s):  
Health Literacy ◽  
Young People ◽  
Research Methods ◽  
Health Behaviours ◽  
Potential Health ◽  
Socially Disadvantaged ◽  
Unhealthy Behaviour ◽  
Health Related ◽  
Literacy Profiles ◽  
Improve Health

Abstract Background Adolescence represents a crucial phase of life where health behaviours, attitudes and social determinants can have lasting impacts on health quality across the life course. Unhealthy behaviour in young people is generally more common in low socioeconomic groups. Nevertheless, all adolescents should have a fair opportunity to attain their full health potential. Health literacy is positioned as a potential mediating factor to improve health, but research regarding health literacy in adolescents and socially disadvantaged populations is limited. As part of Phase one of the Ophelia (OPtimising HEalth LIterAcy) framework, The purpose of this study was to explore the perceptions of socially disadvantaged Irish adolescents in relation to health literacy and related behaviours, and utilise this data to develop relevant vignettes. Methods A convergent mixed method design was used to co-create the vignettes. Questionnaires were completed by 962 adolescents (males n = 553, females n = 409, Mean age = 13.97 ± 0.96 years) from five participating disadvantaged schools in Leinster, Ireland. Focus groups were also conducted in each school (n = 31). Results were synthesised using cluster and thematic analysis, to develop nine vignettes that represented typical male and female subgroups across the schools with varying health literacy profiles. These vignettes were then validated through triangular consensus with students, teachers, and researchers. Discussion The co-creation process was a participatory methodology which promoted the engagement and autonomy of the young people involved in the project. The vignettes themselves provide an authentic and tangible description of the health issues and health literacy profiles of adolescents in this context. Application of these vignettes in workshops involving students and teachers, will enable meaningful engagement in the discussion of health literacy and health-related behaviours in Irish young people, and the potential co-designing of strategies to address health literacy in youth. Conclusion As guided by the Ophelia framework, the use of authentic, interactive and participatory research methods, such as the co-creation of vignettes, is particularly important in groups that are underserved by traditional research methods. The approach used in this study could be adapted to other contexts to represent and understand stakeholders’ perceptions of health, with a view to explore, and ultimately improve, health literacy.

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