Family Perceptions of Medication Administration at School: Errors, Risk Factors, and Consequences

2008 ◽  
Vol 24 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Daniel Clay ◽  
Karen Farris ◽  
Ann Marie McCarthy ◽  
Michael W. Kelly ◽  
Robyn Howarth

Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses’ and educators’ experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems children experience with medicines at school, (b) clarify risk factors for medication errors, and (c) examine the perceived impact of medication errors on school performance and social relationships. Participants included children ages 8 to 18 years ( n = 157) being treated at a large Midwestern Children’s Hospital in diabetes, asthma, and Attention Deficit Hyperactivity Disorder (ADHD) clinics. Findings suggest that forgetting a dose and running out of medication were the most common problems. Missing a dose was more frequent in students with ADHD than in students with diabetes or asthma. Medication nonadherence at school, which includes medication administration errors such as missing a dose, may potentially lead to a variety of educational, social/emotional, and physical consequences. These results indicate that the impact of missing medication on children with ADHD appeared to have a greater effect on schoolwork and friendships, while the physical consequences appeared to vary widely based on health condition. Interestingly, children with more self-responsibility for medications were less likely to report medication errors. School nurses will want to include students when planning for medication management at school.

Author(s):  
Seham Sahal Aloufi

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety. Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure. This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies. The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration. Keyword: Patient Safety, Impact, BCMA, eMAR


2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Saeid Jafarzadeh Ghoushchi ◽  
Shadi Dorosti ◽  
Mohd Nizam Ab Rahman ◽  
Marzieh Khakifirooz ◽  
Mahdi Fathi

Medication Errors (MEs) are still significant challenges, especially in nonautomated health systems. Qualitative studies are mostly used to identify the parameters involved in MEs. Failing to provide accurate information in expert-based decisions can provoke unrealistic results and inappropriate corrective actions eventually. However, mostly, some levels of uncertainty accompany the decisions in real practice. This study tries to present a hybrid decision-making approach to assigning different weights to risk factors and considering the uncertainty in the ranking process in the Failure Modes and Effect Analysis (FMEA) technique. Initially, significant MEs are identified by three groups of qualified experts (doctors, nurses, and pharmacists). Afterward, for assigning weights to the risk factors, Z-number couples with the Stepwise Weight Assessment Ratio Analysis (SWARA) method, named Z-SWARA, to add reliability concept in the decision-making process. Finally, the identified MEs are ranked through the developed Weighted Aggregated Sum Product Assessment (WASPAS) method, namely, Z-WASPAS. To demonstrate the applicability of the proposed approach, the ranking results compare with typical methods, such as fuzzy-WASPAS and FMEA. The findings of the present study highlight improper medication administration as the main failure mode, which can result in a fatality or patient injury. Moreover, the utilization of multiple-criteria decision-making methods in combination with Z-number can be a useful tool in the healthcare management field since it can address the problems by considering reliability and uncertainty simultaneously.


2010 ◽  
Vol 13 (2) ◽  
pp. 105-111
Author(s):  
Agustin Indracahyani

AbstrakKesalahan medikasi merupakan masalah yang sangat serius di pelayanan kesehatan di seluruh dunia. Masalah tersebut mengakibatkan cedera dan kematian bagi pasien, serta meningkatkan biaya yang harus dikeluarkan oleh rumah sakit. Kesalahan medikasi dapat terjadi di setiap tahapan proses manajemen dan penggunaan medikasi dan berakibat pada keselamatan pasien. Kesalahan medikasi dapat terjadi akibat kondisi laten, kondisi yang menyebabkan kesalahan, dan kegagalan aktif. Perawat sebagai pihak yang paling banyak terlibat dalam proses pemberian medikasi memiliki peran penting dalam mencegah, mengenali, dan mengatasi terjadinya kesalahan untuk meningkatkan keselamatan pemberian medikasi. Upaya meningkatkan keselamatan pemberian medikasi dilakukan melalui pendekatan proses keperawatan sejak pengkajian hingga evaluasi dan dokumentasi. AbstractMedication errors are a very serious problem in health care services around the world. These problems lead to morbidity and mortality for patients, as well as increase the costs to be incurred by the hospital. Medication errors may occur at any stages of medication management and use process and result in patient safety. These may occur due to latent conditions, error producing conditions, and active failures. Nurses who are primarily involved in the process of medication administration have important role in preventing, recognizing, and addressing errors in order to enhance safety medication administration. Efforts to enhance safety medication administration may be done through nursing process approach from assessment to evaluation and documentation.


2019 ◽  
Vol 5 (4) ◽  
pp. 137-143
Author(s):  
N. Kudaibergenov

The comprehensive assessment of medical and social risk factors and their impact on the health of children working at industrial waste landfills of the Kyrgyz Chemical Metallurgical Plant has presented. Various industrial and environmental factors were covered. To identify signs of environmental pollution by radioactive substances of natural and artificial origin the average values of gamma-radiation power levels have been examined. The hygienic, sociological, medical and statistical research methods are used. During the study, the social-hygienic and living conditions of life and work of children were studied. The selection of respondents conducted by random sampling. The health condition of children living in the region but not working at industrial waste landfills has studied to compare the data of a control group. An assessment of the physical and biological development of children in the experimental and control groups was carried out by measuring somatometric indicators (length and body weight, head circumference), as well as indicators of dynamometry and their external respiration function. The intensive morbidity rates of children have been studied. The article analyzes the impact of medical and social risk factors that adversely affect the health conditions of working children. It describes the various factors of the working environment and the labor process, which form the occupational risk of morbidity. An important part of the study was to assess the situation and identify possible causes that force families to involve children to work at industrial waste landfills.


2021 ◽  
Vol 30 ◽  
Author(s):  
Raíssa Guimarães Fonseca Camargos ◽  
Cissa Azevedo ◽  
Caroline de Castro Moura ◽  
Bruna Figueiredo Manzo ◽  
Patrícia de Oliveira Salgado ◽  
...  

ABSTRACT Objective: to analyze the correspondence between actions contemplated in the safety protocol on medication prescription, use and administration of the Ministry of Health with interventions of the Nursing Interventions Classification, by means of cross-mapping. Method: a descriptive study developed in four stages: extraction of the protocol’s Nursing actions; identification of the interventions of the Nursing Interventions Classification; cross-mapping; and cross-mapping validation by experts. Results: 61 actions of the protocol and 32 interventions of the Nursing Interventions Classification were identified. After two rounds of mapping analysis by the experts, correspondence was identified between 53 actions and seven interventions. The interventions that presented the highest correspondence were the following: Medication Administration, Medication Management and Medication Prescription. Of the 53 mapped actions of the protocol, 56,6% were considered more detailed and specific than the activities of the interventions, 20,8% were classified as similar in meaning, 17,0% as broader and general, and 5,7% were only mapped with the title and definition of the intervention. Conclusion: the mapped actions of the protocol were considered more detailed and specific in relation to the activities of the interventions of the Nursing Interventions Classification. The unmapped interventions can contribute to elaborating operational protocols that expand the Nursing actions related to the mitigation of medication errors.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Berdot ◽  
Aurélie Vilfaillot ◽  
Yvonnick Bezie ◽  
Germain Perrin ◽  
Marion Berge ◽  
...  

Abstract Background The use of a ‘do not interrupt’ vest during medication administration rounds is recommended but there have been no controlled randomized studies to evaluate its impact on reducing administration errors. We aimed to evaluate the impact of wearing such a vest on reducing such errors. The secondary objectives were to evaluate the types and potential clinical impact of errors, the association between errors and several risk factors (such as interruptions), and nurses’ experiences. Methods This was a multicenter, cluster, controlled, randomized study (March–July 2017) in 29 adult units (4 hospitals). Data were collected by direct observation by trained observers. All nurses from selected units were informed. A ‘Do not interrupt’ vest was implemented in all units of the experimental group. A poster was placed at the entrance of these units to inform patients and relatives. The main outcome was the administration error rate (number of Opportunities for Error (OE), calculated as one or more errors divided by the Total Opportunities for Error (TOE) and multiplied by 100). Results We enrolled 178 nurses and 1346 patients during 383 medication rounds in 14 units in the experimental group and 15 units in the control group. During the intervention period, the administration error rates were 7.09% (188 OE with at least one error/2653 TOE) for the experimental group and 6.23% (210 OE with at least one error/3373 TOE) for the control group (p = 0.192). Identified risk factors (patient age, nurses’ experience, nurses’ workload, unit exposition, and interruption) were not associated with the error rate. The main error type observed for both groups was wrong dosage-form. Most errors had no clinical impact for the patient and the interruption rates were 15.04% for the experimental group and 20.75% for the control group. Conclusions The intervention vest had no impact on medication administration error or interruption rates. Further studies need to be performed taking into consideration the limitations of our study and other risk factors associated with other interventions, such as nurse’s training and/or a barcode system. Trial registration The PERMIS study protocol (V2–1, 11/04/2017) was approved by institutional review boards and ethics committees (CPP Ile de France number 2016-A00211–50, CNIL 21/03/2017, CCTIRS 11/04/2016). It is registered at ClinicalTrials.gov (registration number: NCT03062852, date of first registration: 23/02/2017).


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lucie Isoline Pisella ◽  
Sara Fernandes ◽  
Guilhem Solé ◽  
Tanya Stojkovic ◽  
Céline Tard ◽  
...  

Abstract Background Due to their health condition, patients with neuromuscular diseases (NMD) are at greater risk of developing serious complications with COVID-19. The objective of this study was to analyze the prevalence of COVID-19 among NMD patients and the risk factors for its impact and severity during the first wave of the pandemic. Clinical data were collected from NMD-COVID-19 patients, between March 25, 2020 and May 11, 2020 in an anonymous survey carried out by expert physicians from the French Health Care Network Filnemus. Results Physicians reported 84 patients, including: 34 with myasthenia gravis, 27 with myopathy and 23 with neuropathy. COVID-19 had no effect on NMD for 48 (58%) patients and 48 (58%) patients developed low COVID-19 severity. COVID-19 caused the death of 9 (11%) NMD patients. Diabetic patients were at greater risk of dying. Patients with diabetes, hypertension or severe forms of NMD had a higher risk of developing a moderate or severe form of COVID-19. In our cohort, corticosteroids and other immunosuppressants were not significantly associated with higher COVID-19 severity for acquired NMD. Conclusion During this period, a small percentage of French NMD patients was affected by COVID-19 compared to the general French population and COVID-19 had a limited short-term effect on them. Diabetes, hypertension and a severe degree of NMD were identified as risk factors of unfavorable outcome following COVID-19. Conversely, in our cohort of patients with acquired NMD, corticosteroids or other immunosuppressants did not appear to be risk factors for more severe COVID-19.


2017 ◽  
Vol 34 (6) ◽  
pp. 468-479 ◽  
Author(s):  
Erin D. Maughan ◽  
Ann Marie McCarthy ◽  
Maria Hein ◽  
Yelena Perkhounkova ◽  
Michael W. Kelly

The increasing prevalence of chronic conditions in children, for both common and rare conditions, over the past 30 years, and the increase in the number and range of medications used to manage these conditions, has contributed to the need to address medication management in schools. The purpose of this article is to present the key findings from a national survey on medication administration in schools. A nonexperimental cross-sectional design was used in this descriptive study. An online survey was sent to school nurses across the country. Responses from a total of 6,298 school nurses were used in the analysis. Results of the survey related to prescription and nonprescription medications, medication storage, student’s carrying their medications, delegation of medication administration, documentation, and medication errors are discussed. The article concludes that many different medications are administered during the school day. School nurses must advocate for proper policies and procedures to guard the safety of students.


2009 ◽  
Vol 17 (5) ◽  
pp. 721-729 ◽  
Author(s):  
Paulo Celso Prado Telles Filho ◽  
Marcus Fernando da Silva Praxedes

This study aimed to identify and categorize publications about themes related to medication administration in Brazilian nursing journals between 1987 and 2008. From a survey in the main health databases, we reviewed literature about the theme in six Brazilian journals, classifying the articles into care, teaching, research, technique, medication errors, communication and specific drugs. One hundred eight articles were identified, particularly in the Revista Latino-Americana de Enfermagem and the Revista Brasileira de Enfermagem. The author Cassiani and the category specific drugs stand out as responsible for the largest number of articles published. Efforts need to be added up with a view to a more expressive production of articles on medication administration.


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