scholarly journals Medication Errors and Reducing Interventions: A Mixed Study in a Teaching Hospital

2021 ◽  
Author(s):  
Serajaddin Gray ◽  
Mohammad Effatpanah ◽  
Sara Salehi ◽  
Siamand Anvari Savojbalaghi ◽  
Leila Momeni ◽  
...  
Keyword(s):  
Medication Errors ◽  
Teaching Hospital ◽  
Medication Administration ◽  
Cross Sectional Study ◽  
Special Importance ◽  
Academic Education ◽  
Personal Network ◽  
Cross Sectional ◽  
Psychological Pressure ◽  
The Right

Background: Given the special importance of preventing from medication, the present study aimed to investigate the determining Causes of Medication Errors (CMEs) and their Priorities for reducing interventions in a hospital.  Methods: The present mixed, sequential and cross-sectional study was conducted in a teaching hospital (2016). For data collection, Fishbone Diagrams, interviews, note taking and checklists were used, and qualitative data were analyzed though the thematic approach. Moreover, the Maxqda Software v.14.0, Excel, Edraw Max v.9.0 were employed for data analysis and reporting. Results: Seventy-five CMEs were classified under two main themes (human and non-human) and four sub-themes (personal, network, organizational, and meta-organizational). Weakness of professionalism and low experience as the personal causes; Actions of pharmacy colleagues, physicians and other nurses as the network causes; Management of nurses and unit specialty as the organizational causes and the quality of academic education, drug features and macro policies of medication as meta-organizational causes were classified. Six causes were given priority for reducing interventions. Conclusion: In the short term, human factors should be considered with the aim of reducing medication errors. It is also recommended that teaching how to deal with nurses’ stress and psychological pressure (especially beginner nurse), resulting from critically ill patients and high workload, be paid special attention. Besides, it is suggested that professionalism be given priority to reduce personal neglects and to create safe environments for reporting personal neglects. In addition, more emphasis should be placed on the right route in the process of medication administration.

scholarly journals Root Cause Analysis of Medication Administration Error by Nursing Staff at a Number of Medical Institutes in Riyadh

2021 ◽  
pp. 152-161
Author(s):  
Tahani Alrahbeni ◽  
Muteeb Eid Alenezi
Keyword(s):  
Medication Errors ◽  
Clinical Pharmacist ◽  
Medication Administration ◽  
Cross Sectional Study ◽  
Ministry Of Health ◽  
Target Number ◽  
Cross Sectional ◽  
Medication Administration Error ◽  
Administration Error ◽  
The Times

Background: Medication errors genuinely influence patient safety, staying cost in hospital and integrity of nursing job, because the nurses play a specific part in managing the medication for the patients. The present study was done with the aim to investigate factors associated with nurses’ medication errors in a number of medical institutes (Ministry of Health) and the role of clinical pharmacist in these errors. Methodology: The present study was a cross-sectional study based on standardized questionnaire which was designed and distributed to the target nurses in a number of medical institutes (Ministry of Health). The target number was (171) which was achieved depending on the calculation of sample size after the questionnaires was gathered; data was subjected to descriptive and inferential statistics. Results: The highest mean score of error was obtained in the factor related to medication packaging reason, which includes that different medications look alike, and the names of at least 60 medications were similar by 82.7%.  The second group of reasons was system associated, which included: abbreviations were used instead of writing the orders out completely, overall 60.5% of the times nurses were pulled between teams. Third reason, overall 45.3% of the times the errors were associated with pharmacy when they did not prepare\label the medication correctly, and clinical pharmacist did not give education workshops to the nurses. Documentation issues were the fourth reason, 39.5% of the times nurses were interrupted while administering medication to perform other duties and nurses on the same unit did not adhere to the approved medication administration procedure. Conclusion: The data of the current study suggested the ranking of five reasons or root causes of why medication errors happened. These are medication package, system related, pharmacy related, documentation-transcription reason and physician-nurse related respectively. Furthermore, clinical pharmacists must thrive to improve the nurses' knowledge of how these factors will lead to critical errors and help them discover strategies to prevent these errors from happening.

scholarly journals COSTS AND ROOT CAUSES OF MEDICATION ERRORS AND FALLS IN A TEACHING HOSPITAL: CROSS-SECTIONAL STUDY

2021 ◽  
Vol 30 ◽  
Author(s):  
Gabriela Machado Ezaias Paulino ◽  
Laura Misue Matsuda ◽  
Alessandra Cristina Gobbi Matta ◽  
Andressa Martins Dias Ferreira ◽  
Alexsandro de Oliveira Dias ◽  
...  
Keyword(s):  
Medication Errors ◽  
Teaching Hospital ◽  
Low Frequency ◽  
Cross Sectional Study ◽  
Care Process ◽  
Direct Patient Care ◽  
Sectional Study ◽  
Contributing Factors ◽  
Night Time ◽  
Cross Sectional

ABSTRACT Objectives to characterize accidents/falls and medication errors in the care process in a teaching hospital and to determine their root causes and variable direct costs. Method cross-sectional study implemented in two stages: the first, was based on the analysis of secondary sources (notifications, medical records and cost reports) and the second, on the application of root-cause analysis for incidents with moderate/severe harm. The study was carried out in a teaching hospital in Paraná, which exclusively serves the Brazilian Unified Health System and composes the Network of Sentinel Hospitals. Thirty reports of accidents/falls and 37 reports of medication errors were investigated. Descriptive statistical analysis and the methodology proposed by The Joint Commission International were applied. Results among the accidents/falls, 33.3% occurred in the emergency room; 40.0% were related to the bed, in similar proportions in the morning and night periods; 51.4% of medication errors occurred in the hospitalization unit, the majority in the night time (32.4%), with an emphasis on dose omissions (27.0%) and dispensing errors (21.6%). Most incidents did not cause additional harm or cost. The average cost was R$ 158.55 for the management of falls. Additional costs for medication errors ranged from R$ 31.16 to R$ 21,534.61. The contributing factors and root causes of the incidents were mainly related to the team, the professional and the execution of care. Conclusion accidents/falls and medication errors presented a low frequency of harm to the patient, but impacted costs to the hospital. Regarding root causes, aspects of the health work process related to direct patient care were highlighted.

scholarly journals Medication Errors Caused by Nurses and Physicians in a Swiss Acute Care Community Hospital: Frequency and Correlation to Nurses’ Reported Workload / Von Pflegefachpersonen und Ärzten/-innen verursachte Medikamentenfehler in einem Schweizer Akutspital: Häufigkeit und Korrelation zur Arbeitsbelastung von Pflegefachpersonen

2018 ◽  
Vol 5 (1) ◽  
pp. 15-24
Author(s):  
Benjamin David Rapphold ◽  
Petra Metzenthin ◽  
Marc Oertle ◽  
Kaspar Küng
Keyword(s):  
Acute Care ◽  
Medication Errors ◽  
Community Hospital ◽  
Medication Administration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Community ◽  
Medication Process ◽  
Clinical Consequences ◽  
Nurses And Physicians

Abstract Objectives This study was carried out in a Swiss acute care community hospital to investigate the frequency, type, causes and potential clinical consequences of medication errors (MEs) caused by nurses and physicians in all stages of a technology-supported medication process, the relationship between the nurses’ workload and the medication administration errors (MAEs) and their reason for workload. Methods In this descriptive cross-sectional study, a questionnaire, the adapted Medication Error Self Reporting Tool (A-MESRT), was used to identify MEs in all stages of the medication process and record nurses’ self-perceived workload during medication administration. Results A total of 1936 completed A-MESRTs were returned. A total of 751 (38.8%) respondents reported different MEs. The highest number of errors occurred during medication administration (43%), followed by errors during dispensing (34%) and physician ordering errors using a computerised physician order entry (CPOE) system (23%). Of the 768 (100%) handwritten orders, 232 (30.2%) were erroneous. Moreover, the greater the individual nurse’s workload during a shift, the higher was the relative probability of committing an MAE (χ2 = 85.479, df = 1, OR = 2.129, p < 0.001). Furthermore, the three main causes of high or very high workload were revealed: (1) many newly operated patients to monitor; (2) complex multimorbid patients, for example, those with delirium; and (3) patients with complications after surgery. Conclusion The A-MESRT showed that the highest rate of MEs caused by nurses and physicians is in the non-technologically supported steps, demonstrating the potential benefits of a technology-supported medication process. Moreover, this study revealed a statistically significant correlation between nurses’ workload and MAEs.

scholarly journals Medication Errors and Their Relationship with Care Complexity and Work Dynamics

2019 ◽  
Vol 7 (21) ◽  
pp. 3579-3583
Author(s):  
Zahra Sabzi ◽  
Reza Mohammadi ◽  
Razieh Talebi ◽  
Gholam Reza Roshandel
Keyword(s):  
Medication Errors ◽  
Working Conditions ◽  
Nursing Care ◽  
Medication Administration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Drug Incompatibility ◽  
Organisation Management ◽  
Medication Calculation

BACKGROUND: Medication errors are currently known as the most common medical errors. Research shows that work environment and organisation management, in addition to the role of nurses, contribute to the occurrence of an error. AIM: Therefore, the present study was conducted to determine the rate of nurses’ medication errors and its relation to the care complexity and work dynamics in the Taleghani Pediatric Hospital of Gorgan in 2017. MATERIAL AND METHODS: This was a descriptive-correlational and cross-sectional study. Sampling was done through census method (N = 100). The data collection tools consisted of four questionnaires of demographic information, Salyer work dynamics, Medication Administration Errors, and Velasquez Nursing Care Complexity. Data were analysed in SPSS V.16 software using descriptive and inferential statistical methods including independent t-test and Pearson’s correlation. RESULTS: Medication calculation errors, wrong dose and wrong medication were the most common non-injectable medication errors, respectively. Drug incompatibility, wrong infusion rate and medication calculation errors were the most common injectable medication errors, respectively. There was a positive correlation between medication calculation errors (P = 0.02, r = 0.23), wrong solvent (P = 0.04, r = 0.21), and drug incompatibility (P = 0.01, r = 0.25) with amount of work dynamics. Also, there was a positive correlation between medication calculation errors (P = 0.03, r = 0.22) and wrong medication (P = 0.00, r = 0.31) with the nursing care complexity. CONCLUSION: Regarding the irrefutable impact of working conditions on the occurrence of errors, it appears that the study and complete recognition of nurses’ working conditions and their adjustment would lead to a reduction in medication errors.

Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam
Keyword(s):  
Drug Use ◽  
World Health Organization ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

Distribution and Characteristics of Intrathoracic Lymphadenopathy in TB/HIV Co-Infection

2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh
Keyword(s):  
Lymph Nodes ◽  
Cross Sectional Study ◽  
Short Axis ◽  
Mediastinal Lymph Nodes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Hilar Adenopathy ◽  
The Right ◽  
Pulmonary Abnormalities

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.

scholarly journals Medication Errors in Adolescents Using Asthma Controller Medications

2020 ◽  
Vol 7 ◽  
pp. 2333794X2098134
Author(s):  
Henry Clark ◽  
Delesha Carpenter ◽  
Kathleen Walsh ◽  
Scott A. Davis ◽  
Nacire Garcia ◽  
...  
Keyword(s):  
Medical Record ◽  
Medication Errors ◽  
Medication Use ◽  
Persistent Asthma ◽  
Cross Sectional Study ◽  
Asthma Medication ◽  
Sectional Study ◽  
Cross Sectional ◽  
Controller Medication ◽  
Controller Medications

The purpose of this study was to describe the number and types of errors that adolescents and caregivers report making when using asthma controller medications. A total of 319 adolescents ages 11 to 17 with persistent asthma and their caregivers participated in this cross-sectional study. Adolescent and caregiver reports of asthma medication use were compared to the prescribed directions in the medical record. An error was defined as discrepancies between reported use and the prescribed directions. About 38% of adolescents reported 1 error in using asthma controller medications, 16% reported 2 errors, and 5% reported 3 or more errors. About 42% of caregivers reported 1 error in adolescents using asthma controller medications, 14% reported 2 errors, while 6% reported 3 or more errors. The type of error most frequently reported by both was not taking the medication at all. Providers should ask open-ended questions of adolescents with asthma during visits so they can detect and educate families on how to overcome errors in taking controller medication use.

Disaster Risk Assessment Among Iranian Exceptional Schools

2021 ◽  
pp. 1-5
Author(s):  
Seyedeh Samaneh Miresmaeeli ◽  
Nafiseh Esmaeili ◽  
Sepideh Sadeghi Ashlaghi ◽  
Zahra Abbasi Dolatabadi
Keyword(s):  
Risk Assessment ◽  
Cross Sectional Study ◽  
Disaster Risk ◽  
Disaster Mitigation ◽  
Vulnerable Groups ◽  
Risk Level ◽  
Cross Sectional ◽  
Fire Extinguishing ◽  
Disaster Risk Assessment ◽  
The Right

Abstract Background: Exceptional children, like other children, have the right to be educated in a safe environment. Disasters are considered as serious issues regarding safety and security of educational environments. Following disasters, vulnerable groups, especially children with handicaps and disabilities are more likely to be seriously injured. Thus, the present study aimed to evaluate the safety and disaster risk assessment of exceptional schools in Tehran, Iran. Method: The cross-sectional study was conducted in exceptional schools in Tehran, 2018. First, 55 exceptional schools in all grades were selected based on census sampling method and evaluated by using a checklist designed by Tehran Disaster Mitigation and Management Organization (TDMMO) and Ministry of Education in 2015. The data were analyzed using Excel software and statistical descriptive tests. Result: Based on the results, school facilities are worn and have unsafe elevators (least safety: 7.69%), yards (least safety: 9.52%), laboratories (least safety: 16.67%), libraries (least safety: 24.24%), fire extinguishing systems (least safety: 28.99%), and storage rooms and kitchens (least safety: 33.33%) which require immediate considerations. In total, the safety of exceptional schools in this study was 70.13%, which suggests medium-risk level. Conclusion: The educational settings must be reconsidered, along with identifying the risk and safety at school. In addition, a standard should be established for evaluating safety, especially in exceptional schools.

scholarly journals Clinico-hematological study of pancytopenia

1970 ◽  
Vol 2 (3) ◽  
pp. 207-210 ◽  
Author(s):  
A Lakhey ◽  
OP Talwar ◽  
VK Singh ◽  
Shiva Raj KC
Keyword(s):  
Bone Marrow ◽  
Teaching Hospital ◽  
Myeloid Leukemia ◽  
Hematological Malignancies ◽  
Hematological Malignancy ◽  
Complete Blood Count ◽  
Megaloblastic Anemia ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Erythroid Hyperplasia

Background: Pancytopenia refers to a reduction in all the three cellular elements of blood. The aim of this study was to identify the various causes of pancytopenia in patients attending to Manipal teaching hospital in Pokhara. Materials and Methods: This was a cross-sectional study, carried out in Manipal teaching hospital from August 2008 to August 2010. Fifty-four patients with pancytopenia were included in the study. Complete blood count, bone marrow aspirations and trephine biopsies were performed. Data were analyzed using SPSS 11.0 version. Results: Out of 54 cases, there were 16 cases (29.60%) of hypoplastic bone marrow, 15 cases (27.78%) of hematological malignancies, 13 cases (24.10%) of megaloblastic anemia, 4 cases (11.11%) of erythroid hyperplasia and 6 cases (7.41%) of normcellular bone marrow. Acute myeloid leukemia was the commonest hematological malignancy. Conclusion: The commonest cause of pancytopenia in our study was hypoplastic bone marrow followed by hematological malignancies and megaloblastic anemia. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6023 JPN 2012; 2(3): 207-210

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