Correlation among the Medication Error Risk of High-alert Medication, Attitudes to Single Checking Medication, and Medication Safety Activities of Nurses in the Intensive Care Unit

중환자실 간호사의 고위험약물에 대한 투약오류 위험과 약물단독확인 태도, 투약안전간호활동 간의 상관성

  • Received : 2015.02.03
  • Accepted : 2015.05.26
  • Published : 2015.06.30

Abstract

This study was conducted to examine the relationship among the error risk of high-alert medication, attitudes to single-person checking of medication, and medication safety activities. The participants were 60 nurses working in the intensive care unit. Data were analyzed using descriptive analysis, t-test, analysis of variance, and Pearson's correlation coefficient. The mean scores of the knowledge and certainty of high-alert medication were $0.71{\pm}0.11$ and $2.74{\pm}0.59$, respectively. The mean score of the error risk of high-alert medication was $1.63{\pm}0.24$ and that of attitudes to single checking medication was $3.32{\pm}0.49$. The error risk of high-alert medication had a positive correlation with nurses' attitudes to single checking medication (r = .258, p = .047), which is correlated with the scores for certainty of knowledge (r = .284, p = .028). Based on the results of this study, continuing education for high-alert medication and the development of an accurate protocol for single checking medication are needed to improve the stability of high-alert medication.

Keywords

References

  1. Baldwin, K., & Walsh, V. (2014). Independent double-checks for high-alert medications: essential practice. Nursing, 44 (4), 65-67. https://doi.org/10.1097/01.NURSE.0000444547.64972.dc
  2. Cho, H. W., & Yang, J. H. (2012). Relationship between perceived patient, safety culture and patient safety management activities among health personnel. Journal of Korean Academy of Fundamentals of Nursing, 19 (1), 35-45. https://doi.org/10.7739/jkafn.2012.19.1.035
  3. Cho, S. S., & Gang, M. H. (2013). Perception of patient safety culture and safety care activity of entry-level nurses. Korean Journal of Occupational Health Nursing, 22 (1), 24-34. https://doi.org/10.5807/kjohn.2013.22.1.24
  4. Cho, Y. J. (2012). A study on perception and performance for patient safety management in intensive care unit nurses. Unpublished master's thesis, Ajou University, Suwon.
  5. Cohen, H. (2007). Reduce the risks of high-alert drugs. Nursing, 37 (9), 49-55.
  6. Cullen, D. J., Sweitzer, B. J., Bates, D. W., Burdick, E., Edmondson, A., & Leape, L. L. (1997). Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. Critical Care Medicine, 25 (8), 1289-1297. https://doi.org/10.1097/00003246-199708000-00014
  7. Federico, F. (2007). Preventing harm from high-alert medications. Joint Commission Journal on Quality and Patient Safety, 33 (9), 537-542. https://doi.org/10.1016/S1553-7250(07)33057-2
  8. Franke, H. A., Woods, D. M., & Holl, J. L. (2009). High-alert medications in the pediatric intensive care unit. Pediatric Critical Care Medicine, 10 (1), 85-90. https://doi.org/10.1097/PCC.0b013e3181936ff8
  9. Gandhi, T. K., Seder, D. L., & Bates, D. W. (2000). Identifying drug safety issues: from research to practice. International Journal for Quality in Health Care, 12 (1), 69-76. https://doi.org/10.1093/intqhc/12.1.69
  10. Hsaio, G. Y., Chen, I. J., Yu, S., Wei, I. L., Fang, Y. Y., & Tang, F. I. (2010). Nurses' knowledge of high-alert medications instrument development and validation. Journal of Advanced Nursing, 66 (1), 177-190. https://doi.org/10.1111/j.1365-2648.2009.05164.x
  11. Institute for Safe Medicine Practices. (2014). ISMP list of high-alert medications in acute care settings. Retrieved July 31, 2014, from https://www.ismp.org/tools/highalertmedications.pdf
  12. Jarman, H., Jacobs, E., & Zielinski, V. (2002). Medication study supports registered nurses' competence for single checking. International Journal of Nursing Practice, 8 (6), 330-335. https://doi.org/10.1046/j.1440-172X.2002.00387.x
  13. Jeong, J., Seo, Y. J., & Nam, E. W. (2006). Factors affecting patient safety management activities at nursing divisions of two university hospitals. Korean Journal of Hospital Management, 11 (1), 91-109.
  14. Kane-Gill, S. L., Jacobi, J., & Rothschild, J. M. (2010). Adverse drug events in intensive care units: risk factors, impact, and the role of team care. Critical Care Medicine, 38 (6 Suppl), S83-S89. https://doi.org/10.1097/CCM.0b013e3181dd8364
  15. Kane-Gill, S. L., & Weber, R. J. (2006). Principles and practices of medication safety in the ICU. Critical Care Clinics, 22 (2), 273-290. https://doi.org/10.1016/j.ccc.2006.02.005
  16. Kang, J. H., Kang, H. Y., Kown, S. H., Kim, B. R., Kim, I. S., Park, M. H., et al. (2010). Patient safety and nursing . Seoul: Medical House.
  17. Korea Health Industry Development Institute (2010). 2010' Korea Institute for Healthcare Accreditation. Seoul: Ministry of Health and Welfare.
  18. Lee, J. H. (2012). Effectiveness of clinical decision support system for high-alert medications on prevention of medication errors. Unpublished doctoral dissertation, University of Ulsan, Ulsan.
  19. Lee, J. M., Hong, S. J., & Park, M. H. (2013). Perception of patient safety culture and safety care activity among ICU nurses. Korean Review of Crisis & Emergency Management, 9 (11), 273-290.
  20. Lu, M. C., Yu, S., Chen, I. J., Wang, K. W., Wu, H. F., & Tang, F. I. (2013). Nurses' knowledge of high-alert medications : a randomized controlled trial. Nurse Education Today, 33 (1), 24-30. https://doi.org/10.1016/j.nedt.2011.11.018
  21. Manias, E., Williams, A., Liew, D., Rixon, S., Braaf, S., & Finch, S. (2014). Effects of patient-, environment- and medicationrelated factors on high-alert medication incidents. International Journal for Quality in Health Care, 23 (3), 308-320.
  22. Ministry of Health and Welfare & Korea Institute for Healthcare Accreditation (2014). Korea Institute for Healthcare Accreditation. Healthcare accreditation for advanced general hospitals(Ver 2.0) . Seoul: Ministry of Health and Welfare.
  23. Nuckols, T. K., Paddock, S. M., Bower, A. G., Rothschild, J. M., Fairbanks, R. J., Carlson, B., et al. (2008). Costs of intravenous adverse drug events in academic and nonacademic intensive care units. Medical Care, 46 (1), 17-24. https://doi.org/10.1097/MLR.0b013e3181589bed
  24. O'Connell, B., Crawford, S., Tull, A., & Gaskin, C. J. (2007). Nurses' attitudes to single checking medications: before and after its use. International Journal of Nursing Practice, 13 (6), 377-382. https://doi.org/10.1111/j.1440-172X.2007.00653.x
  25. Oh, C. A., & Yoon, H. S. (2007). Perception and experience of medication errors in nurses with less than one year job experience. Journal of Korean Academy of Fundamentals of Nursing, 14 (1), 6-17.
  26. Park, J. H. (2014). Development and effectiveness of application based on smartphone for high alert medications nursing education. Unpublished master's thesis, Pusan National University, Busan.
  27. Simonsen, B. O., Johansson, I., Daehlin, G. K., Osvik, L. M., & Farup, P. G. (2011). Medication knowledge, certainty, and risk of errors in health care: a cross-sectional study. BioMed Central Health Services Research, 11 (1), 175.
  28. Valentin, A., Capuzzo, M., Guidet, B., Moreno, R. P., Dolanski, L., Bauer, P., et al. (2006). Patient safety in intensive care: results from the multinational sentinel events evaluation (SEE) study. Intensive Care Medicine, 32 (10), 1591-1598. https://doi.org/10.1007/s00134-006-0290-7
  29. van den Bemt, P. M., Fijn, R., van der Voort, P. H., Gossen, A. A., Egberts, T. C., & Brouwers, J. R. (2002). Frequency and determinants of drug administration errors in the intensive care unit. Critical Care Medicine, 30 (4), 846-850. https://doi.org/10.1097/00003246-200204000-00022
  30. Wilson, D. G., McArtney, R. G., Newcombe, R. G., McArtney, R. J., Gracie, J., & Kirk, C. R., et al. (1998). Medication errors in paediatric practice: insights from a continuous quality improvement approach. European Journal of Pediatrics, 157 (9), 769-774. https://doi.org/10.1007/s004310050932