2021, Number 2
An intervention to improve safe administration of medication in the night shift
Language: Spanish
References: 31
Page: 1-21
PDF size: 525.56 Kb.
ABSTRACT
Introduction: One in seven hospitalized patients experiences an adverse event related to administration of medication. Medication errors are one of the most important causes of preventable mortality and morbidity.Objective: To assess the efficacy of a training intervention with the population of night shift nurses in an acute care hospital, in order to improve compliance with the protocol for the safe administration of medication.
Methods: Experimental trial, pre-post training intervention, carried out at Hospital Clínic of Barcelona, during 2015-2016. The population consisted of 268 nurses in two night shifts. The sample consisted of 177 participants (88 from the control group and 89 from the experimental group). The intervention consisted in information sessions and access to a written procedure. The measurement instrument was the Institution's Standard Work Procedure by means of a compliance check-list. Uni-bivariate study was performed, using chi-square and Fisher's test with a significance of P<0.05.
Results: 219 observations were carried out in the control group and 207, in the experimental group. Of seventeen variables analyzed, only three showed significant differences: in the experimental group, knowledge of the procedure improved, increase in the use of soap and water over hydroalcoholic solution, and worsening of standardized identification of drugs pending from being administered. None of the fourteen remaining variables showed significant differences. Of 426 observations, only three medication errors occurred in the control group, corrected before its administration, and zero occurred in the experimental group.
Conclusions: Classic training interventions with passive receptors may not be effective to improve nursing practice in safe administration of medication.
REFERENCES
Magalhães de AMM, Moura de GMSS , Pasin SS, Funcke LB, Pardal BM, Kreling A. Processos de medicação, carga de trabalho e a segurança do paciente em unidades de internação. Rev Esc Enferm USP. 2016 [acceso: 10/06/2019];49(Esp):43-50. Disponible en: Disponible en: https://www.scielo.br/scielo.php?pid=S0080-62342015000700043&script=sci_arttext
Arakawa C, Kanoya Y, Sato C. Factors cntributing to medical errors and incidents among hospital nurses --nurses' health, quality of life, and workplace predict medical errors and incidents--. Ind Health. 2011 [acceso: 10/06/2019];49(3):381-8. Disponible en: Disponible en: https://www.jstage.jst.go.jp/article/indhealth/49/3/49_MS968/_article/-char/ja/.
Donaldson LJ, Kelley ET, Dhingra-Kumar N, Kieny M-P, Sheikh A. Medication Without Harm: WHO's Third Global Patient Safety Challenge. Lancet. [Internet]. 2017 [acceso: 11/06/2019];389(10080):1680-1. Disponible en: Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31047-4/fulltext.
Sheikh A, Dhingra-Kumar N, Kelley E, Kieny MP, Donaldson LJ. The third global patient safety challenge: tackling medication-related harm. Bulletin of the World Health Organization. 2017 [acceso: 13/06/2019];95(8):546-A. Disponible en: Disponible en: https://www.who.int/bulletin/volumes/95/8/17-198002.pdf.
Keers RN, Williams SD, Cooke J, Ashcroft DM. Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study. BMJ Open. 2015 [acceso: 10/06/2019];5(3):e005948. Disponible en: Disponible en: https://bmjopen.bmj.com/content/5/3/e005948.short.
Huckels-Baumgart S, Niederberger M, Manser T, Meier CR, Meyer-Massetti C. A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests J Nurs Manag. [2017 [acceso: 10/06/2019];25(7):539-48. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.12491.
Lim S, Han K, Cho H, Baek H. Shift-work nurses' work environments and health-promoting behaviours in relation to sleep disturbance: A cross-sectional secondary data analysis J Clin Nurs. 2019 [acceso: 10/06/2020];28(9-10):1538-45. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14769.
Berdot S, Roudot M, Schramm C, Katsahian S, Durieux P, Sabatier B. Interventions to reduce nurses' medication administration errors in inpatient settings: A systematic review and meta-analysis. Int Nurs Stud. 2016 [acceso: 10/06/2019];53:342-50. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S002074891500262X.
Wimpenny P, Kirkpatrick P. Roles and systems for routine medication administration to prevent medication errors in hospital-based, acute care settings: a systematic review. JBI Libr Syst Rev. 2010 [cited 20 Nov 2019 ];8(10):405-46. Disponible en: Disponible en: http://insights.ovid.com/crossref?an=01583928-201008100-00001.
Li XJ, Moola S. Strategies to reduce medication omissions in an acute medical unit of an acute tertiary hospital. JBI Database System Rev Implement Rep. 2016 [acceso: 10/06/2019];14(6):347-61. Disponible en: Disponible en: https://journals.lww.com/jbisrir/Abstract/2016/06000/Strategies_to_reduce_medication_omissions_in_an.19.aspx.
Härkänen M, Ahonen J, Kervinen M, Turunen H, Vehviläinen-Julkunen K. The factors associated with medication errors in adult medical and surgical inpatients: a direct observation approach with medication record reviews. Scan J Caring Sci. 2015 [acceso: 10/06/2019];29(2):297-306. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12163.
World Health Organization. WHO guidelines on hand hygiene in health care (advanced draft): a summary: clean hands are safer hands (No. WHO/EIP/SPO/QPS/05.2). Geneve: World Health Organization; 2005 [acceso: 10/06/2019]. Disponible en: Disponible en: https://www.who.int/patientsafety/information_centre/Spanish_HH_Guidelines.pdf?ua=1.
Peters A, Tartari E, Mai SHC, Allegranzi B, Pittet D. 2019 WHO hand hygiene campaign and global survey: clean care for all-it's in your hands. Lancet Infect Dis. 2019 [acceso: 10/06/2020];19(5):463-4. Disponible en: Disponible en: https://www.researchgate.net/profile/Alexandra_Peters4/publication/332794342_2019_WHO_hand_hygiene_campaign_and_global_survey_clean_care_for_all-it's_in_your_hands/links/5cff5f99a6fdccd13091dae1/2019-WHO-hand-hygiene-campaign-and-global-survey-clean-care-.
Drach-Zahavy A, Somech A, Admi H, Peterfreund I, Peker H, Priente O. (How) do we learn from errors? A prospective study of the link between the ward's learning practices and medication administration errors Int J Nurs Stud. 2014 [acceso: 10/06/2020];51(3):448-57. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0020748913001922.
Waltz TJ, Powell BJ, Fernández ME, Abadie B, Damschroder LJ. Choosing implementation strategies to address contextual barriers: Diversity in recommendations and future directions. Implement Sci. 2019 [acceso: 10/06/2020];14(1):1-15. Disponible en: Disponible en: https://implementationscience.biomedcentral.com/articles/10.1186/s13012-019-0892-4.
Baek EH, Kim SE, Kim DH, Cho OH, Hong SI, Kim S. The difference in hand hygiene compliance rate between unit-based observers and trained observers for World Health Organization checklist and optimal hand hygiene. Int J Infect Dis. 2020 [acceso: 10/06/2020];90:197-200. Disponible en: https://www.sciencedirect.com/science/article/pii/S1201971219303960.
Hor SY, Hooker C, Iedema R, Wyer M, Gilbert GL, Jorm C, et al. Beyond hand hygiene: A qualitative study of the everyday work of preventing cross-contamination on Hospital wards. BMJ Qual Saf. 2017 [acceso: 10/06/2020];26(7):552-8. Disponible en: Disponible en: https://qualitysafety.bmj.com/content/26/7/552.short.
Hope J, Recio-Saucedo A, Fogg C, Griffiths P, Smith GB, Westwood G, et al. A fundamental conflict of care: Nurses' accounts of balancing patients' sleep with taking vital sign observations at night. J Clin Nurs. 2018 [acceso: 10/06/2020];27(9-10):1860-71. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/29266489/.
Llapa-Rodriguez EO, Silva L de SL, Menezes MO, De Oliveira JKA, Currie LM. Assistência segura ao paciente no preparo e administração de medicamentos. Rev Gaucha Enferm. 2018 [acceso: 10/06/2020];38(4):e2017-29. Disponible en: Disponible en: https://www.scielo.br/scielo.php?pid = S1983-14472017000400408&script = sci_arttext.
Wilson M, Sleutel M, Newcomb P, Behan D, Walsh J, Wells JN, et al. Empowering Nurses With Evidence-Based Practice Environments: Surveying Magnet(r), Pathway to Excellence(r), and Non-Magnet Facilities in One Healthcare System. Worldviews Evid Based Nurs. 2015 [acceso: 10/06/2020];12(1):12-21. Disponible en: https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/wvn.12077.
Delgado Hito P, Sola Prado A, Mirabete Rodríguez I, Torrents Ros R, Blasco Afonso M, Barrero Pedraza R, et al. Modificación de la práctica enfermera a través de la reflexión: una investigación-acción participativa. Enferm Intensiva. 2001 [acceso: 10/06/2020];12(3):110-26. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1130239901780297.
Abad Corpa E, Delgado Hito P, Cabrero García J. The Participatory-Action-Research: A way to research in the nursing practice. Invest Educ Enferm. 2010 [acceso: 10/06/2020];28(3):464-74. Disponible en: Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-53072010000300017&lng=en&nrm=iso&tlng=.