Wondmieneh Adam, Alemu Wudma, Tadele Niguse, Demis Asmamaw
Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia.
2School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Nurs. 2020 Jan 13;19:4. doi: 10.1186/s12912-020-0397-0. eCollection 2020.
Unsafe medication practices are the leading causes of avoidable patient harm in healthcare systems across the world. The largest proportion of which occurs during medication administration. Nurses play a significant role in the occurrence as well as preventions of medication administration errors. However, only a few relevant studies explored the problem in Ethiopia. Therefore, this study aimed to assess the magnitude and contributing factors of medication administration error among nurses in tertiary care hospitals, Addis Ababa, Ethiopia, 2018.
We conducted a hospital-based, cross-sectional study in Addis Ababa, Ethiopia. The study involved 298 randomly selected nurses. We used adopted, self-administered survey questionnaire and checklist to collect data via self-reporting and direct observation of nurses while administering medications. The tools were expert reviewed and tested on 5% of the study participants. We analyzed the data descriptively and analytically using SPSS version 24. We included those factors with significant -values ( ≤ 0.25) in the multivariate logistic regression model. We considered those factors, in the final multivariate model, with < 0.05 at 95%Cl as significant predictors of medication administration errors as defined by nurse self-report.
Two hundred and ninety eight (98.3%) nurses completed the survey questionnaire. Of these, 203 (68.1%) reported committing medication administration errors in the previous 12 months. Factors such as the lack of adequate training [AOR = 3.16; 95% CI (1.67,6)], unavailability of a guideline for medication administration [AOR = 2.07; 95% CI (1.06,4.06)], inadequate work experience [AOR = 6.48; 95% CI (1.32,31.78)], interruption during medication administration [AOR = 2.42, 95% CI (1.3,4.49)] and night duty shift [AOR = 5, 95% CI (1.82, 13.78)] were significant predictors of medication administration errors at -value < 0.05.
Medication administration error prevention is complex but critical to ensure the safety of patients. Based on our study, providing a continuous training on safe administration of medications, making a medication administration guideline available for nurses to apply, creating an enabling environment for nurses to safely administer medications, and retaining more experienced nurses may be critical steps to improve the quality and safety of medication administration.
不安全的用药行为是全球医疗系统中可避免的患者伤害的主要原因。其中最大比例发生在用药过程中。护士在用药错误的发生和预防中起着重要作用。然而,在埃塞俄比亚,只有少数相关研究探讨了这个问题。因此,本研究旨在评估2018年埃塞俄比亚亚的斯亚贝巴三级护理医院护士用药错误的严重程度及其影响因素。
我们在埃塞俄比亚亚的斯亚贝巴进行了一项基于医院的横断面研究。该研究涉及298名随机选择的护士。我们使用采用的自填式调查问卷和清单,通过护士在给药时的自我报告和直接观察来收集数据。这些工具经过专家评审,并在5%的研究参与者中进行了测试。我们使用SPSS 24版对数据进行描述性和分析性分析。我们将那些具有显著 - 值(≤0.25)的因素纳入多变量逻辑回归模型。在最终的多变量模型中,我们将那些在95%置信区间内 < 0.05的因素视为护士自我报告所定义的用药错误的显著预测因素。
298名(98.3%)护士完成了调查问卷。其中,203名(68.1%)报告在过去12个月中发生过用药错误。诸如缺乏充分培训[AOR = 3.16;95% CI(1.67,6)]、没有用药指南[AOR = 2.07;95% CI(1.06,4.06)]、工作经验不足[AOR = 6.48;95% CI(1.32,31.78)]、用药过程中受到干扰[AOR = 2.42,95% CI(1.3,4.49)]以及夜班[AOR = 5,95% CI(1.82,13.78)]等因素是 - 值 < 0.05时用药错误的显著预测因素。
预防用药错误很复杂,但对于确保患者安全至关重要。根据我们的研究,提供关于安全用药的持续培训、为护士提供用药指南以供应用、为护士创造安全用药的有利环境以及留住经验更丰富的护士可能是提高用药质量和安全性的关键步骤。