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The effect of a clinical decision-making program for preventing high-alert medication errors among intensive care unit nurses in South Korea: a quasi-experimental study with a nonequivalent control group design

한국 중환자실 간호사 대상 고위험약물 투약오류 예방 임상의사결정 프로그램 효과: 비동등 대조군 전후설계 연구

  • Se Yeong Park (Department of Nursing Education Team, Wonju Severance Christian Hospital) ;
  • SoMi Park (Wonju College of Nursing, Yonsei University) ;
  • Ga Young Kim (Department of Nursing Education Team, Wonju Severance Christian Hospital) ;
  • Seung Ah Hong (Division of Nursing, Wonju Severance Christian Hospital) ;
  • Hyang Ok Choi (Department of Nursing Education Team, Wonju Severance Christian Hospital) ;
  • Sunyoung Moon (Department of Nursing Education Team, Wonju Severance Christian Hospital)
  • 박세영 (원주세브란스기독병원 간호교육팀) ;
  • 박소미 (연세대학교 원주간호대학) ;
  • 김가영 (원주세브란스기독병원 간호교육팀) ;
  • 홍승아 (원주세브란스기독병원 간호국) ;
  • 최향옥 (원주세브란스기독병원 간호교육팀) ;
  • 문선영 (원주세브란스기독병원 간호교육팀)
  • Received : 2025.05.15
  • Accepted : 2025.07.01
  • Published : 2025.08.31

Abstract

Purpose: This study aimed to evaluate the effectiveness of a simulation based clinical decision-making program for preventing high-alert medication errors among intensive care unit nurses. Methods: A nonequivalent control group pre/post-test design was employed. The study involved 40 nurses working in the intensive care unit of a tertiary general hospital. The results for an experimental group (n = 20) that participated in the simulation-based clinical decision-making program for preventing high-alert medication errors (duration 180 minutes) were compared with those of a control group (n = 20) that received lecture education (duration 90 minutes). The intervention was conducted and data were collected from June 24 to October 31, 2024. Registered with the Clinical Research Information Service (KCT0010214). Results: The experimental group exhibited improved clinical decision-making ability (χ2 = 10.57, p = .005), reduced risk of high-alert medication errors (χ2 = 6.17, p = .046), and fewer experiences of near-miss medication errors (χ2 = 7.05, p = .008) compared to the control group immediately and 3 months after the intervention. Conclusion: The findings suggest that the program can be effectively used to improve the clinical decision-making ability and to reduce the risk of high-alert medication errors among intensive care unit nurses, thereby contributing to ensuring medication safety in intensive care units by reducing the occurrence of medication errors.

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Acknowledgement

The authors would like to thank all the intensive care unit nurses who voluntarily participated in this study and all the experts who assisted with this investigation.