The Effect of Information Provision on Reduction of Errors in Intravenous Drug Preparation and Administration by Nurses in ICU and Surgical Wards
Malpractice in preparation and administration of intravenous (IV) medications has been reported frequently. Inadequate knowledge of nurses has been reported as a cause of such errors. We aimed to evaluate the role of nurses' education via installation of wall posters and giving informative pamphlets in reducing the errors in preparation and administration of intravenous drugs in 2 wards (ICU and surgery) of a teaching hospital in Tehran, Iran. A trained observer stationed in 2 wards in different work shifts. He recorded the nurses' practice regarding the preparation and administration of IV drugs and scored them before and after the education process. 400 observations were evaluated. Of them, 200 were related to before education and 200 were related to after education. On a 0-10 quality scale, mean ±SD scores of before and after education were determined. Mean ±SD scores of before and after education at the 2 wards were 4.51 (±1.24) and 6.15 (±1.23) respectively. There was a significant difference between the scores before and after intervention in ICU (P
Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, Shea BF, Hallisey R, et al. Incidence of adverse drug events and potential adversedrug events: Implications for prevention. JAMA 1995; 274(1):29-34.
Westbrook JI, Woods A. Development and testing of an observational method for detecting medication administration errors using information technology. Stud Health Technol Inform 2009;146:429-33.
Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P, Metnitz P; Research Group on Quality Improvement of the European Society of Intensive Care Medicine (ESICM); Sentinel Events Evaluation (SEE) Study Investigators. Errors in the administration of parenteral drugs in intensive care units: multinational prospective study. BMJ 2009;338:b814.
Calabrese AD, Erstad BL, Brandl K, Barletta JF, Kane SL, Sherman DS. Medication administration errors in adult patients in the ICU. Intensive Care Med 2001 Oct;27(10):1592-8.
Anselmi ML, Peduzzi M, Dos Santos CB. Errors in the administration of intravenous medication in Brazilian hospitals. J Clin Nurs. 2007 Oct;16(10):1839-47.
Fahimi F, Abbasi Nazari M, Abrishami R, Sistanizad M, Mazidi T, Faghihi T, Soltani R, Baniasadi S. Transcription errors observed in a teaching hospital. Arch Iran Med 2009;12(2):173–5.
Abbasinazari M, Salamzadeh J, Hajebi G, Gilbert B. The Role of Clinical Pharmacists in Educating Nurses to Reduce Drug-Food Interactions (Absorption Phase) inHospitalized Patients. IJPR 2011;10(1):173-8
Chua SS, Tea MH, Rahman MHA. An observational study of drug administration errors in a Malaysian hospital (study of drug administration errors). J Clin Pharm Ther 2009;34(2):215-23.
Beatrice B, Berenda R, Mark F. Drug information handbook for advanced practice nursing. Ohio: Lexi Comp Inc, 2009.
Gahart BL, Nazareno AR. Intravenous Medications; A Handbook for Nurses and Health Professionals.27th ed. Philadelphia: Mosby Inc, 2010.
Allen J, Loyd V, Popovich NG, Ansel HC. In: Ansels pharmaceutical dosage forms and drug delivery systems. 8th ed. Philadelphia: Lippinicott Williams and Wilkins.2005;443-4.
Dean B, Barber N. Validity and reliability of observational methods for studying medication administration errors. Am J health Syst Pharm 2001;58:54-9.
Taxis K, Barber N. Causes of intravenous medication errors: an ethnographic study. Quality and Safety in Health Care 2003;12: 343–8.
Tang FI, Sheu SJ, Yu S,Wei IL, Chen CH. Nurses relate the contributing factors involved in medication errors. J Clin Nurs 2007;16:447-57
Tarnow-Mordi WO, Hau C,Warden A, Shearer AJ. Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit. Lancet 2000;356:185-9.
Ndosi M & Newell R. Nurses' knowledge of pharmacology behind drugs they commonly administer. J Clinical Nursing 2009;18, 570–80.
Schneider PJ, Pedersen CA, Montanya KR, Curran CR, Harpe SE, Bohenek W, et al. Improving the safety of medication administration using an interactive CD-ROM program. Am J Health Syst Pharm 2006;63:59–64
Tromp M, Natsch S, Achterberg TV.The preparation and administration of intravenous drugs before and after protocol implementation. Pharm World Sci 2009; 31:413–20.
Folkard S,Tucker Ph. Shift work, safety and productivity. Occupational Medicine 2003;53:95-101.
Scott L, Rogers AE, Hwang W, Zhang Y. Effect of critical care nurses work hours on vigilance and patient’s safety. Am J Crit Care 2006;15: 30-7.
Marques TC, Reis AMM, Silva AEBDC, Gimenes FRE, Opitz SP, Teixeira TCA et al. Antimicrobial drug administration errors identified in Brazilian multi centric study. Brazilian J of Pharmaceutical Sci 2008;44:305-14.