الفهرس 
Medication ErrorsOnly 14 pages are availabe for public view
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Abstract
There are growing concerns about errors in clinical practice, particularly when they affect the quality of care or patient’s life. Medication errors may exist in every organization. Medication errors are common, occurring in nearly 20% of inpatient administered doses in US hospitals. Nearly half of all medication errors are preventable. Studies have shown that medication errors are one of the main causes for adverse events in hospitals. They cause disability, death in up to 6.5% of hospital admissions and waste of resources. Medication errors are multifactorial and multidisciplinary. They are mistakes that are made during the prescription, transcription, dispensing and administration phases of drug, preparation and distribution. Medication errors are common in hospital intensive care units (ICU) than general care units. Because errors are related to the intensity of care and the number of medications being used. The majority of errors were found to occur in ordering and administration phases of the medication use process.
Medication administration is a complex, time-consuming task occupying up to one-third of nurses’ time and with much potential for error. Since nurses actually administer the medication to the patient, they are assigned the responsibility for these errors. However, the actions of everyone involved in the system and the system design itself contribute to these errors.
Nursing is a very complex activity. As with any complex human activity; errors can arise in medication administration. A medication administration error can be broadly defined as the act of commission and omission that militates against the achievement of the therapeutic objective, or the benefit for the patient. Commission errors are usually defined according to established hospital protocol into: medication that was given in the wrong time, medication that was given to the wrong patient and medication administration of the wrong dose or wrong drug. Errors of omission include omission of a scheduled medication or discontinuation of medication without an authorized physician order. MAEs also include errors related to preparation, storage, and monitoring. Also, it is considered an error if the medication was given to patient with known allergy or if there is errors in transcription of the physicians’ order to the medication administration kardex.
The objectives of the present study were to determine rate, types and frequency of medication administration errors, identify points in the medication administration process where errors occur, main causes of medication administration errors in PICUs and identify potential nursing risk factors of errors in the process of medication administration. Furthermore, assess nurses’ perception of medication errors and determine the nurses’ required actions to reduce medication errors.
A. Material and Methods
• The study was conducted in the two Medical and Surgical intensive care units of El- Shatby Pediatric Hospital of Alexandria University.
• The population of the study consisted of drug doses, patients admitted to PICUs during the study period, Nursing personnel in Surgical and Medical PICUs throughout the study period (nursing officers in their training year are excluded), and patients medical records, unit and nursing records.
• A simple random sampling was used to select one nurse to be observed per shift. The selected nurse was observed for 7 weekdays on different work shifts.
• Sample size included 1) all nursing personnel in the Surgical and Medical Pediatric Intensive Care Units concerned with drug administration were included. Nursing officers in their post-graduation training year were excluded. Medication nurses amounted to 24 nurses out a total 33 nurses in the Surgical PICU and 23 out of a total 33 nurses in the Medical PICU; 2) All patients assigned to the observed nurse were observed whenever receiving medications; and 3) drug doses: assuming an average error rate of 30%, and α of 0.05 and absolute precision of 2%, a minimum sample size of 2016 doses (1134 doses in the Surgical PICU and 882 doses in the Medical PICU) was determined to be adequate to obtain a valid measure of an observation-based error rate for each of the two PICUs. The actual observed doses amounted to 1246 doses in the Surgical PICU and 952 doses in the Medical PICU