scholarly journals Critical Care Nurses Competency Level on the Administration of Microinfusion Medication at Critical Care Unit Kenyatta National Hospital

2020 ◽  
Vol 8 (04) ◽  
pp. 312-329
Author(s):  
Isaac Nyabuto Onwongá ◽  
Hannah Inyama ◽  
Eve Risper Rajula

Background of the study: Most drugs given as Microinfusion require infusion pumps to administer. They are very potent with very narrow therapeutic index and any small changes on the process results in enormous effects to patients. The nursing profession has a duty to advocate for patients rights as well as do no harm. One of the core goals of nurses is medication administration; this puts nurses in the last line of defence against medication administration errors (MAEs). This study aimed to look into the roles played by nurse that hamper the efforts to reduce the Microinfusion MAEs on which minimal studies have been done. Objective: This study determined the competency level influencing the administration of Microinfusion medication by critical care nurses at Kenyatta National Hospital’s (KNH) Intensive Care Unit (ICU). Significance of study: Local data in the area of Microinfusion MAEs is not available, specifically KNH’s ICU. This study therefore sought to breech this gap and hopes to influence policy on management of critical patients, patient safety, environment, and curriculum development so as to reduce Microinfusion MAEs. Methodology: This study used a descriptive cross-sectional study design, simple random sampling was used to pick 64 participants. Quantitative data was analyzed by both descriptive and inferential statistics, which included regression analysis. Descriptive statistics were presented by use of the mean, percentages and standard deviation. Chi-square was used to determine statistical significance of the differences in proportions and logistic regression was used to identify factors that lead to Medication administration errors. Necessary ethical approval was sought. Results: The prevalence of MAEs was at 64.1% in the last six months, 65.6% 0f the respondents reported lack of supportive supervision, 37.5% of the respondents reported not to know mechanisms in place for reporting Microinfusion medication errors. This prevalence was of statistical significance when cross tabulated with critical care nurses competency level (p<0.05) on aspects such as; having prescription checks [95%CI= 0.000-17.9; p=0.008], working experience, type of medication error, checking weight of patients [p=0.019], reporting of the errors [95%CI = 0.1-0.8; p=0.019], documenting drug errors and monitoring patients after drug administration. Conclusion and recommendation: The prevalence of Microinfusion administration errors in KNH-ICU is high. There is need to ensure that nurses are always equipped with adequate knowledge and experience in drug administration through trainings and mentorship programs as this will reduce  medication errors and increase  safety of patient  in health facilities.


Author(s):  
Dalal Salem Al- Dossari ◽  
Mohammed Ibrahim Alnami ◽  
Naseem Akhtar Qureshi

Background: Drug prescription error is a medication error that most frequently happens in healthcare organizations and adversely affects the healthcare consumers. Most medication errors (MEs) but not all are captured and corrected before reaching the patient by designed system controls. Medication administration errors (MAEs) mostly are made by nurses but frequently reported by clinical pharmacists in hospitals in Saudi Arabia. Objective: This study aimed to analyze exclusively the voluntarily reported drug administration errors in a tertiary care hospital in Riyadh city. Methods: This cross-sectional, retrospective study evaluated consecutively collected medication administration report forms over a period of one year from January 1, 2015 to December 31, 2015. Results: The number of MAEs occurring during stage of drug administration constituted 7.1% (n=971) of total medication errors (n=13677). The maximum number of MEs (n=6838, 50%) and MAEs (n=455, 46.9%) occurred during the 4th quarter of the year 2015. The most common MAE happened to be category C (n=888, 91.5%) which means error occurred, reached the patient but without causing any harm. Concerning MAE types, the most common error included wrong frequency (40%) followed by wrong drug (17%), wrong time of administration (16%) and wrong rate of infusion (10%). Nurses made the most of the errors (92.2%) while the clinical pharmacists reported the most MAEs (75.5%). High alert medications (HAM) errors constituted 32.3% (n=314) of MAEs (n=971) and most common HAM errors included the wrong route of administration of Lanus Insulin (15%) followed by Insulin Aspart (15%), Enoxaparin (13%) and Insulin Protamine-Nvomix (12%). Look-alike and sound-alike (LASA) errors constituted 55.2% of MAEs (971/536) and most common LASA drugs identified were Gentamycin (13%), Insulin Mixtard (11%), NPH Insulin (8%) Intralipid vial (8%) and Insulin regular (6%). Conclusion: This retrospective study provides some important tentative pharmacovigilance insights into MAEs, which are partially comparable with current international trends in drug administration errors. Further studies on MAEs are warranted not only in the Kingdom of Saudi Arabia but also other Gulf countries.



2020 ◽  
Author(s):  
Wubet Alebachew ◽  
Dejene Tsegaye ◽  
Girma Alem ◽  
Zenaw Tesema

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.



2017 ◽  
Vol Volume 6 ◽  
pp. 47-51 ◽  
Author(s):  
Tezeta Fekadu ◽  
Mebrahtu Teweldemedhin ◽  
Eyerusalem Esrael ◽  
Solomon Weldegebreal Asgedom


2017 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Amal Abd El-Hafez1 ◽  
Asmaa Mahjoub ◽  
Eman Ahmad

Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy and postpartum period that facing critical care nurses in Intensive Care Unit (ICU). Having a uniform standard for identifying and classifying AKI would enhance critical care nurses’ ability to recognize these patients and leading to better outcomes.Objective: This work aimed to explore the risk factors and outcome of early identified acute kidney injury of critically obstetric patients in Obstetric ICU. Design. A descriptive cross sectional research design was used in this study. Participants: A total sample of 338 women admitted to Obstetric ICU at Woman Health Hospital, Assiut City, Egypt. Method: Three tools were used.Tool I was developed by the researcher and included demographic and obstetric history, lab parameters, complications and outcomes arising from AKI. The Sequential Organ Failure Assessment (SOFA) score as tool II to determine the extent of a patient's organ function or rate of failure. Measurement of serum creatinine and urine output were used to early identify AKI stages according to Acute Kidney Injury Network (AKIN) Criteria (tool III). Results: The prevalence of AKI among obstetric patients admitted to obstetric ICU was 10.1%; of them 52.9% needed renal replacement therapy and the mortality rate was 29.4%. Postpartum hemorrhage was the most common cause of AKI and its prevalence was 41.2%. It was also found that 74.5% of AKI patients developed complications. Conclusion: AKI complicated 10.1% of total admitted women to the OICU in the studied period. Postpartum hemorrhage represents the most prevalent risk factors with a highly significant SOFA score compared to other risk factors as sever preeclampsia, eclampsia, HEELP & APH with acute fatty liver.



2020 ◽  
Vol 33 (5) ◽  
pp. 426-435
Author(s):  
Gemma Via-Clavero ◽  
Joan Guàrdia-Olmos ◽  
Anna Falcó-Pegueroles ◽  
Diana Gil-Castillejos ◽  
Anna Lobo-Cívico ◽  
...  


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Juan Escrivá Gracia ◽  
Ricardo Brage Serrano ◽  
Julio Fernández Garrido


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